reproductive change with menopause
smooth, shiny, pale, epithelial surface
inc. bacterial invasion b/c disappearance of lactobacilli
pruritis, burning, soreness, dyspareunia
urinary complaints: freq, urg, dysuria, urge incontinence
Tx: water-soluble lubricants, vaginal estrogen preparations preferred (vs systemic)
Significant ↓↓ of endometrial cancer with estrogen + progestogen vs. estrogen alone.
Estrogen plus progestins, the occurrence of hyperplasia was 6%
The combined, continuous administration of estrogen plus progestogen is the most common mode of administration today.
This regimen promotes endometrial atrophy
Results in amenorrhea in 70-90% if used for > 1 year.
Other SE's: fatigue, depression, breast tenderness, bloating, cramps, HA's, Inc risk of breast cancer!
Women who have been receiving long-term estrogen-progestin hormone replacement therapy, even in the absence of complications, should be encouraged to stop, especially if they do not have menopausal sx.