Professor Rodney Baber AM
Clinical Professor of Obstetrics and Gynaecology, Faculty of Medicine and Health, The University of Sydney
The principal indication for prescribing menopausal hormone therapy is to alleviate bothersome menopausal vasomotor symptoms (VMS).
MHT is a highly effective treatment for alleviation of VMS and has also been shown to protect against loss of post-menopausal bone density and fracture risk.
Estrogen only MHT, when prescribed within 10 years of the final menstrual period may also reduce the risk of coronary heart disease.
Side effects of MHT include unplanned vaginal bleeding and spotting, breast tenderness and bloating, all of which can be minimized by using lower doses of estrogen initially and by judicious choice of MHT regimens.
Other risks of MHT include an increased risk of thromboembolic events associated with oral estrogen therapy and risks of breast and endometrial cancer associated with long term use.
Protocols to minimize these risks including methods of delivery and choice of progestogens will be discussed.