Hormone Replacement Therapy for the South African healthcare provider: Part I
Keywords:peri- and postmenopausal, quality of life, oestrogen, oestradiol, vasomotor symptoms, vulvovaginal atrophy, sexual dysfunction, depressive mood, cognition, dementia, osteoporosis, venous thromboembolism, transdermal hormone delivery
Menopausal symptoms are due to a lack of circulating oestrogen in women. Hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT) is very controversial, misunderstood and as a result often underutilised by clinicians. Hormonal therapy is instituted to improve quality of life in peri- and postmenopausal women by reducing hot flushes and improving sexual function. Oestrogen therapy does not improve muscle mass and muscle function. HRT is prescribed as a first-line treatment to prevent and treat osteoporosis. Oral oestrogens increase the risk for venous thromboembolism (VTE) but the risk with the use of transdermal oestradiol delivery systems is comparable to the risk in non-users. The lipid profile and carbohydrate metabolism in post-menopausal women is improved with oestrogen replacement therapy.