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The regular medical check-up and duration of hrt THE REGULAR MEDICAL CHECK-UP AND DURATION OF HRT
It usually takes six months for side effects associated with HRT to settle. A doctor will normally start with an 'off-the-shelf hormone format and then make adjustments to suit your particular responses. Two months after starting on HRT you should be reviewed by your doctor, with a follow-up three months later. Once-yearly checks are appropriate from then on, unless side effects or other concerns like irregular bleeding occur, in which case prompt investigation is in order. Also make sure you ask your doctor to check your breasts and to confirm that you are not overdue for a mammogram.
Once a format and dosage of hormones that suit your individual needs are found, it is usual to stay with this formula for as long as HRT is required.
Duration of HRT
The length of time for a woman to have HRT remains a matter of debate. Most doctors advise patients to continue the therapy until a break from their hormone format no longer results in troublesome symptoms. This generally occurs in one to three years, but sometimes five, ten or even fifteen years.
If HRT is given solely to reduce a perceived risk of osteoporosis or heart disease, current evidence suggests that the longer the use, the greater the benefit. It seems that at least five years of HRT are needed to obtain a statistically significant benefit for the bones or heart, and to get maximum benefit you need from fifteen years to lifetime therapy. Bone density measurements (see chapter 3) may give helpful information when the question arises of whether or not to continue with HRT. If the bone density is excellent and menopausal symptoms are no longer troubling, you may wish to stop HRT pending a review of your situation (including another bone density measurement) in two to three years time. If the bone density is of concern and there are no compelling reasons to discontinue HRT, staying on the therapy is the best course.
If the main consideration prompting HRT was abnormal blood fat levels, an improvement to normal in cholesterol and triglyceride levels does not provide a convincing reason for stopping it. Indeed, it may be an argument for persisting with the therapy as it is doing the job required.
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