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Diagnosis and Management of Menopause

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Dr Ganapathi Bantwal    20 November 2018

  1. Hormone therapy (HT) is the most effective treatment for vasomotor symptoms (VMS) and genitourinary syndrome of menopause (GSM).
  2. The concept of “lowest dose for the shortest period of time” may be inadequate or even harmful for some women.
  3. A more fitting concept is “appropriate dose, duration, regimen and route of administration.”
  4. Decision on duration requires individualization.
  5. Given the more favorable safety profile of estrogen alone, longer durations may be more appropriate.
  6. Risk stratification by age and time since menopause is recommended (<10 years from menopause or <60 years).
  7. Transdermal or lower doses of HT may decrease risk of VTE and stroke.
  8. Micronized progesterone is a safer alternative when use of progesterone is considered.

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