homonereplacementtherapy(hrt)：激素替代療法hrt-文庫吧資料
2025-01-23 06:14本頁面
【正文】 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 stimulating hormone (FSH). HOW? ? Oestrogen reduction eventually results in menstrual cycle disruption and other menopausal symptoms. HOW? ? Oestrogen reduction eventually results in menstrual cycle disruption and other menopausal symptoms. * FSH high (30 – 170 mU/ml) * LH high (20 – 80 mU/ml) * Estradiol low ( 110 pmol/L) Vasomotor Symptoms Sleep Disorders Menstrual Disorders
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