Section I: Indications for symptomatic treatment
Diagram Indications for symptomatic treatment
Chapter 1: Hot flushes and night sweats
- The basics
- The theory
- Epidemiology
- A flush hypothesis
- Clinical evaluation
- Practical advice on treatment and management
- 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
- 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
Contra-indications for oestrogens
- A history of breast cancer
- A history of endometrial cancer
- Severe liver dysfunction
- Porphyria
- Contra-indication for progestogens
- Meningioma
Chapter 9: Conditions in which HRT is not contra-indicated
Chapter 10: HRT and cancer risk
- The basics
- The theory
- Endometrial cancer
- Breast cancer
- Colorectal cancer
- Practical advice on treatment and management
Section IV: Guidelines for practical HRT
Chapter 12: Basics of practical HRT
The basic rules: background and exceptions
Chapter 13: Hormonal treatment options
Chapter 14: Route of administration
- 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
- Myoma uteri
- Endometriosis
- Mastopathy
- Migraine
- Venous thrombosis and embolism
- Familial hypertriglyceridaemia
- Gallstones
- Epilepsy
- Bronchial asthma
- Increased breast cancer risk
Chapter 18: Alternative treatment in the presence of contra-indications
- Contra-indication breast cancer
- Contra-indication endometrial cancer
- Contra-indications serious liver dysfunction and porphyria
- Contra-indication meningioma
Section V: Management of women on 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
List of abbreviations
Acknowledgements
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