Practical HRT : Contents

Section I: Indications for symptomatic treatment

Diagram Indications for symptomatic treatment

Chapter 1: Hot flushes and night sweats

  • The basics
  • The theory
  • Clinical evaluation
  • Practical advice on treatment and management

Chapter 2: Urogenital atrophy

  • The basics
  • The theory
    • Epidemiology
    • Flush theories
  • Clinical evaluation
  • Practical advice on treatment and management

Chapter 3: Perimenopausal cycle disorders

  • The basics
  • The theory
    • Normal perimenopausal cycle variation
    • Organic causes for abnormal perimenopausal bleeding
    • Dysfunctional bleeding disorders
  • Clinical evaluation
  • Practical advice on treatment and management

Chapter 4: climacteric complaints and symptoms

  • The basics
  • The theory
    • Atypical complaints and lack of well-being
    • Depressive mood changes
    • Joint and muscle complaints
    • Epithelial atrophy
  • Clinical evaluation
  • Practical advice on treatment and management

Section II: Indications for preventive treatment

Chapter 5: Cardiovascular disease (CVD)

  • The basics
  • The theory
    • Menopause-induced changes in cardiovascular function and HRT
    • HRT and decreased CVD risk – the epidemiological evidence
  • Clinical evaluation
  • Practical advice on treatment and risk profiles

Chapter 6: Osteoporosis

  • The basics
  • The theory
    • Menopause-induced changes in bone mineral density
    • Effect of HRT on prevention of osteoporosis
    • Effect of HRT on established osteoporosis
    • Dosage
    • Biochemical markers
    • Alternatives
  • Clinical evaluation
  • Practical advice on treatment and management

Chapter 7: Central nervous system

  • The basics
  • The theory
    • Blood flow
    • Stroke
    • Cognitive functioning
    • Alzheimer’s disease
  • Clinical evaluation and practical advice

Section III: Contra-indications and risks of HRT

Chapter 8: Contra-indications

Contra-indications for oestrogens

Chapter 9: Conditions in which HRT is not contra-indicated

Chapter 10: HRT and cancer risk

Section IV: Guidelines for practical HRT

Chapter 11: Counselling

Chapter 12: Basics of practical HRT
The basic rules: background and exceptions

Chapter 13: Hormonal treatment options

Chapter 14: Route of administration

Chapter 15: HRT regimens

  • Recommended dosages
  • Unopposed oestrogen therapy (ERT)
  • Oestrogen combined with progestogen (cHRT)
  • Special considerations for non-standard HRT

Chapter 16: Duration of therapy

  • Hot flushes and night sweats
  • Atypical symptoms
  • Epithelial atrophy
  • Prevention of osteoporosis
  • Prevention of cardiovascular disease

Chapter 17: Special conditions

Chapter 18: Alternative treatment in the presence of contra-indications

Section V: Management of women on HRT

Chapter 19: The ABC of HRT

  • When starting all forms of HRT
  • Routine inspection
  • Initial visit
  • Follow-up visits

Chapter 20: Endometrial monitoring

  • The basics
  • The theory
    • Unscheduled vaginal bleeding
    • Monitoring procedures

Chapter 21: Vaginal bleeding episodes associated with combined HRT

  • The basics
  • The theory
    • Mechanism of endometrial bleeding
    • Clinical aspects of endometrial bleeding
    • Management of bleeding episodes

Chapter 22: Compliance

List of abbreviations
Acknowledgements

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