AKT revision: menopause and HRT

1.In a non hysterectomised woman, for which one of the following perimenopausal conditions is systemic HRT likely to be recommended?

A. Poor concentration
B. Depression
C. Flushes
D. Incontinence
E. Vaginal dryness

Answer: C

Although many experts would recommend HRT for vaginal dryness this can generally be achieved with topical preparations.

2. Which one of the following lifestyle interventions is most likely to be of help in a patient of 50 with troublesome vasomotor symptoms?

A. Coffee
B. Occasional Exercise
C. Red wine in moderation
D. Weight loss

Answer: D


3.When counselling a 48 year old perimenopausal woman regarding the menopause which one of the following statements regarding combined HRT is correct?

A. Continuous combined preparations are the treatment of choice at this age
B. It is the treatment of choice for established osteoporosis
C. Her risk of arterial disease is unlikely to be significantly increased
D. Persistent bleeding problems are usual
E. Treatment usually continues for up to ten years

Answer: C

Studies suggest a minor increase heart disease risk in women 10 yrs post menopause, and no increased stroke risk detectable in the first year of HRT use. At this age therefore (assuming a duration of treatment of 1-2 years) problems are unlikely.
Generally speaking continuous combined preparations would be given to women who have finished menstruating. Whilst HRT is useful in preventing osteoporosis in those at high risk it has no place in managing the condition. Although bleeding problems can occur initially they should settle after three months. The duration of treatment is for the shortest time possible (as a rule of thumb around 1-2 years).