Hormone postmenopausal women

Wenger NK. Hormonal and nonhormonal therapies for the postmenopausal woman what is the evidence for cardiopro-tection Am J Geriatr Cardiol 2000 9(4) 204-9. 

Should hormone-replacement therapy be prescribed for this postmenopausal woman ... 

Should we begin hormone-replacement therapy (intervention compared with no intervention) to prevent cardiovascular events (outcome) in this asymptomatic postmenopausal woman with a family history of coronary artery disease (patient) ... 

The initial visit of a perimenopausal or postmenopausal woman is the most appropriate time to obtain a complete medical history, perform a physical examination, and educate the patient. Medical history should include determination of a personal or family history of thrombotic problems. The physical examination should include a complete cardiovascular examination, clinical assessment of thyroid status, and breast and pelvic examinations. Papanicolaou cervical cytologic examination and screening mammography negative for malignancy are required before initiating hormone therapy. Thyroid function tests and lipoprotein lipid profile also should be performed at the discretion of the clinician. 

Which one of the following changes is most likely to be observed in a postmenopausal woman who is not taking hormone supplementation ... 

Many women seek medical treatment for the relief of menopausal symptoms, primarily hot flashes however, the role of hormone-replacement therapy (HRT) has changed dramatically over the years. HRT has long been prescribed for relief of menopausal symptoms and, until recent years, has been purported to protect women from CHD. The original reason behind recommending HRT in postmenopausal women revolved around a simple theory If the hormones lost during menopause were replaced through drug therapy, women would be protected from both menopausal symptoms and chronic diseases that often follow after a woman experiences menopause. Recent studies have disproved this theory. 

Evaluation of each individual woman is essential in determining the appropriateness of perimenopausal and postmenopausal hormone therapy, and collaboration between a woman and her primary care provider in the decision-making process is essential. The benefits and risks of hormone therapy should be reassessed annually. 

When a woman of reproductive age has a small uterus with indistinct zonal anatomy or undetectable ovaries, as seen in postmenopausal women, the possibility of a disorder related to insufficient hormone secretion should be considered [20]. 

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