HORMONE REPLACEMENT THERAPY - MANAGEMENT OF COMMON PROBLEMS

Objective: To describe common pitfalls associated with hormone replace ment therapy (HRT) and recommendations to prevent or ameliorate them. Design: After pertinent articles and texts were reviewed, we outlined the available regimens of HRT, the commonly encountered side effects, and the management options. Results: HRT is frequently prescribed for elderly women, Vaginal bleeding, nausea, breast tenderness, migraine h eadaches, mood alterations, and abdominal bloating are common occurren ces with HRT. These problems often can be managed by changing the dose , using another preparation or regimen, or altering the route of admin istration. For example, transdermal administration of estradiol may be tolerated better than oral therapy in patients with nausea, Irregular bleeding warrants endometrial biopsy to rule out hyperplasia. Conclus ion: With simple measures, common side effects of HRT can easily be ma naged by primary-care physicians, Gynecologic referral is recommended when endometrial biopsy is necessary or when symptoms fail to respond to adjustments in hormone therapy.