HORMONE COMBINATIONS AND SINGLE-DRUG FORMATS: OESTROGEN ALONE

With one exception, oestrogen on its own in any form is considered safe only if you no longer have a uterus. Since about 30 per cent of Australian women have had a hysterectomy by the age of sixty-five, the number of potential users of this relatively straightforward form of HRT is large. The exception is women with an intact uterus whose menopausal problems are confined to vaginal dryness, urinary frequency or recurring urinary tract infections. If this is your situation, you can use oestrogen alone in the form of vaginal creams, tablets or pessaries two or three times a week (but no more frequently) after using it for seven to ten days in a row initially if your doctor so advises. If vaginal or urinary symptoms are still quite troublesome, this form of therapy may be inadequate and you may be advised to consider a hormone format (for example oestrogen pills) that will have more widespread effects on the body.

It is very important, if you have an intact uterus and are using oestrogen creams, tablets or pessaries intermittently in your vagina without added progestogen for an extended time, to be assessed by a doctor at least every six to twelve months. Monitoring is necessary because endometrial hyperplasia (excessive thickening of the uterine lining) and subsequent endometrial cancer may occur after some years if the oestrogen dose is too high. Even a single spot of vaginal blood could indicate a problem and should immediately trigger a visit to your doctor.

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