Gynaecs believe in judicious use of HRT

I believe in judicious use of HRT. Regular protocol including screening tests like Blood Sugar, Lipid Profile, Bone Dexa Scan & Pap’s Smear & Mammography are a must for all women in perimenopausal age. I have had good results with the use of phytoestrogens and adjuvant drugs other than the conventional HRT.

Specific HRT for osteoporosis are freely available which should be given as & when reuired. With increasing life span, keeping quality of life in mind it is important to individualize the patients. History of breast cancer or any other predisposition of the patient should be looked into.

Dr Malvika Sabharwal,
Jeewan Mala Hospital, New Delhi

One of the early approaches to combat the menopausal symptoms was HRT. Today, it is well known that estrogen stimulates the growth of endometrium and may lead to endometrial cancer. Another reason why women fail to start or continue on HRT is the fear of cancer.

Another drawback is that estrogen-containing replacement therapy may lead to an increase in the risk for venous thromboembolism (VTE). Selective estrogen receptor modulators (SERMs), like ralaxifene, can be used to prevent postmenopausal osteoporosis without increasing the risk of breast or endometrial cancer, but they do not alleviate climacteric complaints and vaginal atrophy and may even induce vasomotor complaints. Ongoing research has revealed that eating more isoflavones (plant estrogens) can fight the single most critical consequence of menopause dropping estrogen levels, to which all other symptoms like mood swings, hot flushes, insomnia, depression and osteoporosis are linked.

Dr Parimala Devi, Bangalore