How can doctors encourage their patients to continue with our HRT?

Primarily by arriving at decisions in a partnership with our patients. Each patient must be involved in decisions about her treatment. Provision of information leaflets that answer key questions allow patients to be kept informed. Recommending the use of continuous combined preparations to avoid withdrawal bleeds after the menopause and regular review encourages women to enjoy the long-term benefits of HRT. Doctors should be willing to change preparations if problems arise.

In 1998, a fifty-seven year old health-visitor was referred to me as her withdrawal bleeds were heavy and she felt poorly for the last week of each course of her se quential HRT. Without HRT she felt “hot and bothered”. It became apparent that neither the patient nor the general practitioner were aware of continuous combined preparations. A continuous combined preparation was prescribed and she has become “a new woman”.?

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An article in the British Journal of Obstetrics and Gynaecology in 1997 found the information supplied with five HRT preparations was incorrect and misleading. The authors observed that ischaemic (coronary) heart disease, for example, was a contraindication to HRT according to the accompanying information, when the opposite was thought to be true (Q 27.3). Doctors should encourage the pharmaceutical industry to ensure that their data sheets are modified regularly so that the information they provide to patients is accurate.

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Women's Health