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 sequential 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.
Related Medical Abstracts - Click on the paper title:-
- Commencement and maintenance compliance of patients on hormone replacement therapy (HRT) following bilateral oophorectomy (2001)
- Estrogen replacement therapy in practice: Trends and issues (1995)
- A survey of views on hormone replacement therapy (1994)
- 25 mg oestradiol implants - The dosage of first choice for subcutaneous oestrogen replacement therapy? (1992)
- Enhancing patient compliance with hormone replacement therapy at menopause (1990)
Please click on the required question.
- 2 How can atrophic vaginitis - dry vagina at menopause - painful sex - be treated? - Topical Estrogen
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
