Choice of HRT
- 01 Dec 2023
- 1 Minute to read
- Print
- PDF
Choice of HRT
- Updated on 01 Dec 2023
- 1 Minute to read
- Print
- PDF
Article summary
Did you find this summary helpful?
Thank you for your feedback
- Both HRT containing estradiol and the combined hormonal contraceptive (CHC) pill containing ethinylestradiol (in eligible women), are suitable treatment options.
- Younger women may require higher oestrogen doses compared to older women for symptom relief.
- If using the CHC, it should be taken continuously with the pill free week omitted to avoid intervals of oestrogen deficiency.
- In younger women, the CHC pill might feel more aligned to their peers. However, HRT preparations containing body identical estradiol may be more beneficial in improving cardiovascular markers.
- NICE says to explain to people with POI that HRT may have a beneficial effect on BP when compared with a combined oral contraceptive. Both HRT and combined oral contraceptives offer bone protection.
- Zoely and Qlaira are CHC options that contain natural estradiol, rather than ethinylestradiol.
- Vaginal oestrogen should be considered for urogenital symptoms.
- Women with POI have a 2.8-fold increased risk of sexual dysfunction. Testosterone replacement can be considered in women for persistent symptoms of low sexual desire despite adequate oestrogen replacement.
References and Further Information:
- Menopause Practice Standards produced by the British Menopause Society (BMS), Royal College of Obstetricians and Gynaecologists (RCOG), Society for Endocrinology (SfE), Faculty of Sexual and Reproductive Health (FSRH), Faculty of Pharmaceutical Medicine (FPM) and Royal Pharmaceutical Society (RPS) 2022. Found on page 12.
- National Institute for Health and Care Excellence. Guideline. Menopause (update). Draft for consultation, Nov 2023.
- NICE CKS Guidance. Menopause. Management. Management of menopause, perimenopause or premature ovarian insufficiency. Last revised September 2022.
- Panay N, Anderson A, Nappi R et al. Premature ovarian insufficiency: an international society white paper. Climacteric 2020.
- Baber R, Panay N, Fenton A et al. 2016 IMS recommendations on women’s midlife health and menopause hormone therapy. Climacteric. 2016. Found on page 114.
- Premature ovarian insufficiency. Summary consensus statement. British Menopause Society. 2020.
Was this article helpful?