Hormone replacement therapy women

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. 

Steiner MK, Clarkson PB, Lip GY. Myocardial infarction complicating hormone replacement therapy in a young woman with normal coronary arteries. Int J Clin Pract 2000 54(7) 475-7. 

A 71-year-old woman who had taken fluoxetine (dose unspecified) for a number of weeks noted unilateral galactorrhea and had a raised prolactin of 37 ng/ml (reference range 1.2-24 ng/ml) (419). She was also taking estrogen hormonal replacement therapy, benaza-pril, and occasional alprazolam. Withdrawal of the fluoxetine led to normalization of the prolactin concentration and resolution of the galactorrhea. 

A 50-year-old woman, who had taken one conjugated estrogen tablet daily for hormone replacement therapy and tricalcium phosphate twice daily for osteoporosis, took zolpidem 10 mg for insomnia and paracetamol 500 mg for a headache at bedtime (31). She began to have visual hallucinations within 20 minutes, lasting for about 30 minutes, and then her vision returned to normal. She only partially recalled the event. She had never taken zolpidem before and had not had any such disturbances in the past. 

Mrs Jean Akhurst is a 46-year-old woman who works in the local solicitors office. She has a history of hypertension, arthritis, mild heart failure and frequent urinary tract infections. She has a repeat prescription for hormone replacement therapy (HRT), her ACE inhibitor which she takes each morning, her anti-inflammatory which she takes three times a day and also a prescription for some antibiotics which she will need to take four times a day. The pharmacist decides to check that she knows what her tablets are for and when to take them. During this discussion it becomes apparent that she takes them when she remembers. 

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) ... 

Grady D. A 60-year-old woman trying to discontinue hormone replacement therapy. JAMA 2002 287 2130-2137. 

A 49-year-old woman receiving hormone replacement therapy was found to have a thyroid nodule. No lymphadenopathy was detectable and she appetued clinically to be euthyroid. A technetium scan revealed a cold nodule and an ultrasound scan indicated it was cystic. 

The nurse is discussing ways to prevent osteoporosis to a group of elderly women. A woman in the audience asks, Why aren t doctors prescribing hormone replacement therapy Which statement by the nurse would be most appropriate ... 

Hormone replacement therapy has a checkered history. At one time, the medical community was convinced that it reduced a woman s risk of heart disease after menopause, but the accumulated data don t bear this out. While there is evidence that the therapy increases bone strength and reduces the risk of osteoporosis, studies have also shown a link with breast cancer. These days, a significant number of women are looking instead to natural therapies, which they perceive to be safer. 

Fig. 3 Biochemical monitoring of a patient during treatment for thyroid disease. This 55-year-old woman was first diagnosed as hyperthyroid, and received radioiodine therapy. She became profoundly hypothyroid, and was treated with thyroxine. Her thyroid hormone results at first indicated good replacement, but recently they indicate that she Is under replaced. It is possible that she Is not taking her thyroxine tablets regularly.

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