Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about hormone replacement therapy.

And you can find written notes on this topic at zero definals.com slash HRT or in the gynecology section of the zero toinals, obstetrics and gynecology book.

So let's get straight into it.

Hormone replacement therapy is used in perimenopausal and postmenopausal women

to alleviate the symptoms associated with the menopause.

These symptoms are associated with a decline in the level of estrogen.

Exogenous estrogen, meaning estrogen from outside the body, is used to alleviate the symptoms of the

menopause. Progesterone needs to be given in addition to the estrogen to women that have a uterus.

The primary purpose of adding the progesterone is to prevent endometrial hyperplasia

or thickening of the endometrium and ultimately endometrial cancer secondary to the unopposed

estrogen.

Unopposed estrogen refers to using estrogen on its own without the protection of progesterone.

It's also worth bearing in mind that women have often tried non-hormonal methods of controlling their symptoms before they seek help from their GP.

HRT can be very effective relief from symptoms and in the majority of women, the benefits will

outweigh the risks. A quick Tom tip for you early on, hormone replacement therapy is a massive

topic. If you remember one thing about HART for your exams, remember the basics of choosing

the HART regime. Women with a uterus

require endometrial protection with progesterone, whereas women who don't have a uterus, for example,

who have had a hysterectomy, can have estrogen-only HRT. Women that still have periods should go on cyclical HRT with cyclical progesterone that allows them to have

regular breakthrough bleeding similar to a period. Postmenopausal women with a uterus and more than

12 months without periods should go on continuous combined HRT,

...