Abstract
SummaryA great change in the attitude of the medical profession and public towards the menopause has occurred in the past 5 years in the United Kingdom. The concept of normality of the menopause is being replaced by one of a chronic deficiency state lasting for up to 20 years. In some patients this may require therapy, and clinics have now been established for this purpose. Such therapy is not without problems and practitioners should be aware of the indications, contra-indications and side-effects, as well as the benefits of hormone replacement therapy.Contra-indications include a history of thromboembolic disease, liver dysfunction and oestrogen dependent tumours. Obesity, hypertension and oestrogen-activated gynaecological disease are relative contra-indications.The classical indications for therapy are vasomotor instability, such as hot flushes, night sweats and palpitations, and dyspareunia or loss of libido due to atrophic vaginitis. Insomnia, fatigue and loss of drive are often associated with vaso...
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