Menopause Hormone Therapy Programs

Risk Factors

Factors relevant to HRT suitability assessment include:

• Personal or family history of breast cancer
• History of blood clots (venous thromboembolism)
• Uncontrolled hypertension
• History of oestrogen-sensitive cancers
• Liver disease
• Route of administration influencing clotting risk (oral versus transdermal)

Who Is Suitable for HRT?

Most healthy women experiencing bothersome menopausal symptoms are suitable for HRT. Transdermal HRT is preferred for those with cardiovascular risk factors as it does not increase clotting risk. Women with a history of breast cancer require specialist assessment before starting HRT.

Diagnosis

Assessment for menopause hormone therapy includes:

• Detailed symptom assessment using validated tools
• Full medical and family history including breast and cardiovascular risk
• Blood tests including FSH, LH, and oestradiol if diagnosis is uncertain
• Bone density scan if osteoporosis risk is elevated
• Blood pressure and baseline health checks
• Breast and cervical screening status review

Treatment Options

HRT is the most effective treatment for menopausal symptoms. Treatment is individualised based on symptom profile, uterine status, and medical history. Route options include oral tablets, transdermal patches, gels, sprays, and implants. Non-hormonal options including SSRIs, clonidine, and cognitive behavioural therapy are available for those who cannot use HRT.

Personalised HRT Program

The personalised HRT program at Pristyn Care includes:

• Comprehensive consultation with a specialist menopause clinician
• Detailed symptom assessment and health risk evaluation
• Selection of the most suitable HRT type, dose, and route
• Transdermal oestrogen for lower thrombotic risk where appropriate
• Micronised progesterone preferred as the safest progestogen
• Testosterone therapy for low libido or persistent fatigue
• Vaginal oestrogen for genitourinary syndrome of menopause
• Review at 3 months then annually to adjust dose and monitor health

Our evidence-based approach provides the safest and most effective HRT regimen for each individual.

HRT Follow-Up Care

Ongoing care during HRT includes:

• Review at 3 months to assess symptom response and tolerability
• Annual review including blood pressure, breast awareness, and bone health
• Dose adjustment based on symptom control and side effects
• Mammography screening continued as per national guidelines
• Cervical screening maintained as per routine schedule
• Annual discussion of treatment duration based on individual benefit-risk assessment

Benefits and Risks of HRT

Key considerations in HRT use include:

• HRT is the most effective treatment for vasomotor symptoms with significant quality of life benefits
• Transdermal HRT does not increase venous thromboembolism risk
• Combined HRT carries a small increased breast cancer risk with use beyond 5 years
• Oestrogen-only HRT has a more favourable breast cancer risk profile
• HRT protects against osteoporosis and reduces fracture risk significantly
• Benefits generally outweigh risks for healthy women under 60 starting within 10 years of menopause