View HRT Guidance Flow Chart
| Angina/Ischaemic Heart Disease |
Currently no evidence that HRT is beneficial in females with established heart disease. Some risk factors may improve eg. lipid profile |
| Endometrial Hyperplasia |
May be corrected by appropriate choice of HRT. If previously treated by hysterectomy, HRT not contraindicated. Advise referral to specialist menopause clinic. |
| Gall Bladder Disease |
Deterioration has been reported with estrogen treatment, but to avoid first pass effect transdermal HRT. No contraindication after cholecystectomy. |
| Lactose Intolerance |
Advise transdermal route or implant. All oral preparations contain lactose. |
| Liver Disease |
Check LFT prior to and after 12 weeks’ treatment. Advise effect transdermal HRT. No. This includes chronic liver disease with mildly adnormal LFTs, previous jaundice, pruritus of pregnancy, Dubin-Johnson Syndrome, Rotox Syndrome. |
| Otosclerosis |
May deteriorate with estrogen, but little clinical evidence to support this. Advise referral to specialist menopause clinic. |
| Ovarian Cancer |
not always contraindicated, but usually managed in conjunction with gynae oncologist. Advise referral to specialist menopause clinic. |
| Porphyria |
May prescribe HRT. Advise referral to specialist menopause clinic. |
| Systemic Lupus Erythematosus |
Sometimes deteriorates on HRT. Studies show no clear trend. Use transdermal to minimise thrombotic risk. Advise referral to specialist menopause clinic. |
| Thrombo-Plebitis |
HRT not contraindicated with history of superficial thrombo-phlebitis. Defer HRT if disease still active. |
| Varicose Veins |
No contraindication if uncomplicated. |