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Perimenopausal and postmenopausal hormone replacement therapy. Part 2. Hormonal regimens and complementary and
1Columbia University School of Nursing, New York, NY 10032, USA.
As midwives increasingly provide care to women throughout the lifecycle, they need to become familiar with a variety of treatments for perimenopausal and postmenopausal problems and preventive measures for the potentially disabling conditions that can accompany aging. This article reviews various regimens of hormone replacement therapy. It discusses types of estrogen and progestin, appropriate dosages, routes of administration, and duration of therapy. It offers guidelines for initiation, contraindications, and required follow-up. It addresses the management of side effects and problems. The article briefly reviews a variety of complementary and alternative therapies including various self-help measures, such as nutrition and exercise, and selected herbal treatments. Part 1 of this article, which appeared in the January/February 1996 issue of JNM, reviewed the literature on recommended therapeutic and preventive indications for hormone replacement therapy, providing guidelines for the provision of informed consent.
As midwives increasingly provide care to women throughout the lifecycle, they need to become familiar with a variety of treatments for perimenopausal and postmenopausal problems and preventive measures for the potentially disabling conditions that can accompany aging. This article reviews various regimens of hormone replacement therapy. It discusses types of estrogen and progestin, appropriate dosages, routes of administration, and duration of therapy. It offers guidelines for initiation, contraindications, and required follow-up. It addresses the management of side effects and problems. The article briefly reviews a variety of complementary and alternative therapies including various self-help measures, such as nutrition and exercise, and selected herbal treatments. Part 1 of this article, which appeared in the January/February 1996 issue of JNM, reviewed the literature on recommended therapeutic and preventive indications for hormone replacement therapy, providing guidelines for the provision of informed consent.