• Estrogens: Estrogens are effective in prevention as well as treatment of osteoporosis.
  • Conjugated estrogens (0.625mg/day) orally is given in cycles for 25 days every month.
  • Estrogens, when used alone, increases the risk of cancer of uterus (endometrial carcinoma). Therefore, progestogens (medroxyprogesterone) can be given for last 10-14 days with estrogens. However, addition of progestogens causes cyclic uterine bleeding (like menstruation) and many older women do not like it.
  • In women after removal of uterus (hysterectomy), progestogens addition is not required.
  • Estrogen therapy may also improve menopausal symptoms such as hot flushes and vaginal dryness.
  • Estrogens can also be taken as a patch or gel.
  • Some of the contraindications of HRT are as follows:
  1. History of breast cancer
  2. History of thromboembolism
  3. Family history of cancer of uterus (endometrial carcinoma) and breast cancer are relative contraindications.
  • Precaution: Mammogram should be done before starting hormone therapy and yearly thereafter. Endometrial biopsy should be done yearly whenever estrogen alone is being used or whenever atypical uterine bleeding occurs (when uterus has not been removed)