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
||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.
||Advise transdermal route or implant. All oral preparations contain lactose.
||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.
||May deteriorate with estrogen, but little clinical evidence to support this. Advise referral to specialist menopause clinic.
||not always contraindicated, but usually managed in conjunction with gynae oncologist. Advise referral to specialist menopause clinic.
||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.
||HRT not contraindicated with history of superficial thrombo-phlebitis. Defer HRT if disease still active.
||No contraindication if uncomplicated.