homonereplacementtherapy(hrt)：激素替代療法hrt-wenkub
2023-02-01 06:14:39 本頁(yè)面
【正文】 , progestogenic and androgenic properties. (estrogenic activity in bone, CNS vasomotor suppression of hot flushes and helpful in improving sexual function . STARTING HRT! “A full physical examination is mandatory” ? Full blood count ? Renal Profile Baseline ? Liver Function Test ? Lipid profile FOLLOW UP OF TAKING HRT! ? Review the woman 3 months after starting HRT and once each year thereafter. ? At 3months: – Enquire about bleeding patterns, check blood pressure, and body weight. – Assess the effectiveness of treatment and adjust to achieve symptom control. – Enquire about adverse effects and manage appropriately. FOLLOW UP OF TAKING HRT! ? Once each year: – Check blood pressure, effectiveness of treatment and adjust to achieve symptom control. – Enquire about adverse effects and manage appropriately. – Consider switching from cyclical HRT to continuous bined HRT, if appropriate. FOLLOW UP OF TAKING HRT! – Discuss the risks and benefits of HRT. – Perform a breast examination if indicated by personal or family history. – Encourage breast awareness and participation in the national breast screening programme as appropriate for their age. – Pelvic examination is required only if clinically indicated NON HRT Lifestyle modification Stop smoking Healthy diet Weight control Regular moderateintensity exercise Control blood pressure and cholesterol NON HRT ? For vasomotor symptoms – A trial (2 weeks) of paroxetine,fluoxetine citalopram or venlafaxine (SSRI) – A trial (2–4 weeks) of clonidine – A progestogen such as norethisterone or megestrol NON HRT ? For vaginal dryness Vaginal lubricant or moisturizer, such as Replens174。s periods. WHY? ? The menopause results from a fall in the level of the female hormone oestrogen in the blood. WHY? ? At a hormonal level as ovarian follicular activity begins to fail, oestrogen and progesterone levels fall and the reduced negative feedback to the pituitary causes a rise in luteinising hormone (LH) and follicle stimu
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