Other methods

STERILISATION

• It is safe to prescribe HRT in women who have undergone sterilisation.
• If a woman is nearing natural menopause, the benefits of sterilisation will be time-limited and non-surgical methods should be considered.
• Sterilisation does not alter or eliminate menstrual periods.

BARRIER METHODS

• Barrier methods include male condoms, female condoms, diaphragms and cervical caps. These methods are safe to use in combination with HRT.

• Condom integrity can be affected by some vaginal treatments, including:
  Imvaggis estriol pessaries.
  Intrarosa DHEA pessaries.
  Estriol 0.01% cream (Gynest).
  Oil based vaginal lubricants and moisturisers.

NATURAL FAMILY PLANNING

• HRT can be prescribed in women using natural family planning techniques.
• This is a method of fertility awareness associated with periodic abstinence.
• Women should be made aware that when approaching menopause, natural family planning becomes unreliable due to menstrual cycle irregularity and the increase in anovulatory cycles.

WITHDRAWAL

• It is safe to prescribe HRT in women using withdrawal techniques, although women should be advised that withdrawal is not considered reliable contraception.