Hormone replacement therapy.

HRT is indicated for the treatment of moderate ▪ to severe vasomotor and urogenital symptoms associated with menopause. HRT is not recommended for primary prevention of ▪ disease because of increased risk of other adverse events. The use of HRT increases the risk of stroke, venous ▪ thromboembolism (VTE) and gall bladder disease and combined oestrogen progestogen therapy is also associated with an increased risk of breast cancer and dementia (women >65). Individual risk assessment is essential before starting ▪ HRT therapy. For women younger than 50, or those at low risk of cardiovascular disease, stroke, or breast cancer, the absolute risk from HRT is likely to be small. HRT should be prescribed at the lowest effective dose ▪ for the shortest duration possible. Other treatments should also be considered. Regular monitoring is necessary, along with attempted withdrawal after one to two years.