Managing the climacteric

HRT taken for a sufficient duration may reduce the occurrence of osteoporos is and of cardiovascular disease by up to 50% and possibly also reduce inci dence and lessen severity of Alzheimer's disease. Nevertheless, it is often only prescribed when women request it to relieve climacteric symptoms. Fur thermore, many physicians prescribe it for only limited periods of time and few are willing to prescribe it to women in their sixties. As with any lon g-term prevention strategy, the uptake of HRT is much lower than the prescr iption rate, since the medication is often abandoned due to side effects or due to lack of motivation. But HRT is often abandoned also due to fear of cancer. While physicians may be aware of some beneficial effects of HRT, th ey often have no time to inform their patients of them. Alternatively, some of the beneficial effects such as cardioprotection or a reduced incidence of Alzheimer's may be less known. Likewise, HRT-related side effects or ris ks such as breast cancer or thromboembolic diseases should be discussed pri or to HRT prescription. Women need to be informed about these potential ris ks, and this should be done by their physician. Surveys have shown that man y women feel that they receive insufficient information from their physicia n. The quality of the relationship between physician and patient probably h as a large influence on HRT acceptance, but very few studies have been cond ucted to assess specifically factors influencing the prescription and the c ontinuation rate of HRT. Simple strategies may be among the most effective ones; these include listening to patients' fears, complaints and questions, and taking the time to answer them. The role of a practice nurse in such a setting may be also very important.