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When to stop prescribing HRT

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  • Most guidelines recommend that the use of HRT for around 5 years in women as they enter menopause (ie in their late 40’s/early 50’s) is likely to confer benefit and not harm
  • There are no reasons to place mandatory limitations on the duration of HRT, which should be decided with a well informed woman and her health professional, dependent on her specific goals and objective estimate of risks and benefits
  • Withdraw HRT slowly as this may reduce the chance of recurrent sypmtoms
  • It should be noted that 5% of women will have hot flushes for life

https://www.gwh.nhs.uk/media/163808/wiltshire_hrt_guidance_2014.pdf

 

Continuation or cessation of oestrogen only MHT

  • The dose and duration of oestrogen therapy should be consistent with treatment goals, such as symptom relief, and should be individualized (6).
  • Women who go through menopause before 45 years are advised to take oestrogen therapy until the average age of menopause, i.e. around 50 years. The discussion and decision to continue oestrogen therapy is then the same as it is for women are experiencing menopause at the usual age (See AMS Information Sheet Spontaneous Premature Ovarian Insufficiency).
  • Cessation of MHT is associated with increased cardiovascular and cerebrovascular events and increased risk of fracture (10) (11).

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