Management of bleeding in women on HRT

2020 ◽  
Vol 31 (12) ◽  
pp. 495-499
Author(s):  
Debby Holloway
Keyword(s):  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Vaginal Bleeding ◽  
Combined Therapy ◽  
Hormone Replacement ◽  
Breakthrough Bleeding ◽  
Practice Nurses ◽  
Post Menopausal ◽  
The Individual

Bleeding while on hormone replacement therapy is common. Debby Holloway explains the causes of this, investigations needed, and how to tailor treatment to the individual if no pathology is found Bleeding while taking hormone replacement therapy (HRT) is a relatively common problem. The majority of women with post-menopausal bleeding – on and off HRT – will have either no cause or a benign cause, but about 10% of women will have endometrial cancer. Post-menopausal bleeding is defined as unscheduled vaginal bleeding that occurs a year after the last natural menstrual period or any breakthrough bleeding on cyclical HRT or breakthrough bleeding after 6 months on continuous combined therapy when there has been established amenorrhoea. Practice nurses must be aware of the problem of bleeding on HRT and each individual needs to be assessed for pathology. If no pathology is found, treatment should be tailored to the individual to overcome the bleeding issues.

The causes and management of endometrial breakthrough bleeding

2001 ◽  
Vol 9 (2) ◽  
pp. 153-171 ◽  
Author(s):  
M Hickey ◽  
IS Fraser
Keyword(s):  
Hormone Replacement Therapy ◽  
Menstrual Cycle ◽  
Replacement Therapy ◽  
Sex Steroids ◽  
Vaginal Bleeding ◽  
Hormone Replacement ◽  
Vascular Development ◽  
Sex Steroid ◽  
Breakthrough Bleeding ◽  
Normal Menstrual Cycle

The term breakthrough bleeding (BTB) is rather poorly defined, but essentially describes the symptom of vaginal bleeding occurring with scheduled periods of withdrawal bleeding, in the absence of pelvic pathology in women taking exogenous sex steroids, usually contraceptives or hormone-replacement therapy (HRT). It may also describe occasional bleeding in those who are predominantly experiencing amenorrhoea due to these preparations. Rather confusingly, the term is sometimes used to describe intermenstrual bleeding in women who are not taking sex steroids, when structural or other pathological causes are more likely. In the absence of such pathology intermenstrual bleeding in the normal menstrual cycle is relatively uncommon, suggesting that exogenous sex steroids can profoundly disrupt the tight regulation of endometrial vascular development, function and breakdown. Intermenstrual bleeding also occurs spontaneously in some women and it is possible that this phenomenon has similar mechanisms to that seen in sex-steroid-related breakthrough bleeding.

MENOPAUSAL HORMONOTHERAPY IN ONCOGYNECOLOGIC PATIENTS

2017 ◽  
Vol 63 (6) ◽  
pp. 843-854
Author(s):  
Olga Novikova ◽  
Yelena Ulrikh ◽  
V. Nosov ◽  
A. Charkhifalakyan
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Hormone Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Menopausal Hormone Therapy ◽  
Oncological Safety

There is presented the review of domestic and foreign references on the conserved oncological safety of the use of menopausal hormone therapy after treatment for endometrial cancer, cervical cancer, borderline and malignant ovarian tumors, various variants of sarcomas of the uterus, vulva and vaginal cancer. To the opinion of the authors the refusal to prescribe menopausal hormone therapy to patients with oncogynecologic diseases in the anamnesis is usually not justified, the category of patients, to whom hormone replacement therapy is contraindicated, is well described and mentioned in the text. In other cases sex hormones can be used to treat menopausal symptoms and improve the quality of life of patients.

The effects of conjugated equine estrogens plus cyclical dydrogesterone on serum lipoproteins and apoproteins in postmenopausal women

1988 ◽  
Vol 117 (3) ◽  
pp. 339-342 ◽  
Author(s):  
C. D. Fletcher ◽  
E. Farish ◽  
M. M. Dagen ◽  
F. Alazzawi ◽  
D. McQueen ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Hormone Replacement ◽  
Hdl Cholesterol ◽  
Serum Lipoproteins ◽  
Conjugated Equine Estrogens ◽  
The Individual ◽  
Equine Estrogens

Abstract. erum lipoprotein and apoprotein concentrations were monitored for 24 weeks in 26 postmenopausal women treated with conjugated equine estrogens (0.625 mg/day) with the addition of dydrogesterone (10 mg/day) for the last 12 days of each 28 day cycle. The women had had no previous hormone replacement therapy. The estrogen plus dydrogesterone regimen caused significant (P < 0.05) increases in triacylglycerol and HDL cholesterol concentrations. Both HDL2 and HDL3 cholesterol were increased. There were no other significant changes in lipoprotein concentrations. Both apoprotein AI and apoprotein All concentrations increased significantly (P < 0.05) over the study period. The ratios of apoprotein AI to apoprotein All, apoprotein AI to HDL cholesterol and apoprotein All to HDL cholesterol did not change. At the doses employed in this study, the use of dydrogesterone as a progestogen alters the effects of conjugated equine estrogens on lipoproteins and reinforces the view that the effects of a combined HRT regimen cannot be predicted from a consideration of the effects of the individual components.

Does hormone replacement therapy in post-menopausal women have any effect upon nasal physiology?

2008 ◽  
Vol 122 (7) ◽  
pp. 707-710 ◽  
Author(s):  
D C Wild ◽  
C M Philpott ◽  
C R Wolstenholme ◽  
G E Murty
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Oral Contraceptive Pill ◽  
Life Questionnaire ◽  
Female Hormone ◽  
Menopausal Women ◽  
Nasal Physiology ◽  
Post Menopausal ◽  
Age Range

AbstractBackground:Previous studies have suggested that the female menstrual cycle, pregnancy and the oral contraceptive pill have an effect upon nasal physiology.Objectives:This study aimed to assess the effects upon nasal physiology of female hormone replacement therapy in post-menopausal women. This has not been previously studied.Methods:Twenty post-menopausal women (age range 36 to 70 years; mean age 57.0 years) underwent measurements of the nasal airway, including anterior rhinoscopy, peak nasal inspiratory flow rate, acoustic rhinometry, anterior rhinomanometry, mucociliary clearance time and rhinitis quality of life questionnaire. Measurements of nasal patency were recorded prior to commencing hormone replacement therapy and at a time point 77–195 days (mean 101.9 days) following commencement.Results:There was no statistical difference found for any of the variables, using the paired t-test (p > 0.05 for all).Conclusions:Female hormone replacement therapy has no discernable effect upon nasal physiology and should not be considered a cause of rhinitic symptoms.

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