1. All postmenopausal women without contraindications should consider ERT. Contraindications include a family or individual history of breast cancer; estrogen dependent neoplasia; undiagnosed genital bleeding; and a history of or active thromboembolic disorder.
2. ERT should be initiated at the onset of menopause. Conjugated estrogens, at a dose of 0.625 mg per day, result in increases in bone density of 5%.
3. Bone density assessment at regular intervals (possibly every 3-5 years) provides density data to help determine if continuation of ERT may be further recommended. If ERT is discontinued and no other therapies are instituted, serial bone density measurements should be continued to monitor bone loss.
4. ERT doubles the risk of endometrial cancer in women with an intact uterus. This increased risk can be eliminated by the addition of medroxyprogesterone (Provera) either cyclically (12-14 days/month) at a dose of 5-10 mg or continuously at a dose of 2.5 mg daily.
5. Other adverse effects related to ERT are breast tenderness, weight gain, headaches, and libido changes. Some evidence suggests a small increase in breast cancer risk after 10-15 years of estrogen supplementation.
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Are Menopause Symptoms Playing Havoc With Your Health and Relationships? Are you tired of the mood swings, dryness, hair loss and wrinkles that come with the change of life? Do you want to do something about it but are wary of taking the estrogen or antidepressants usually prescribed for menopause symptoms?