title: Menopause: when hormone replacement therapy is not an option. Part I.
abstract: Although the perimenopausal period is often experienced as a positive life transition, it is frequently accompanied by a variety of distressing physical and emotional sequelae. Hormone replacement therapy (HRT) has been hailed as the first-line treatment for many of these symptoms. A significant number of women, however, are unable to take exogenous hormones because of absolute or relative contraindications to therapy. Other women are unwilling to use this treatment for a variety of reasons, including reluctance to use unnatural exogenous hormones and fear of unknown risks of HRT. This two-part review discusses the physiology of menopause and its related symptoms, as well as the risks and benefits of both oral and non-oral routes of hormone administration. Self-help measures and alternative therapeutic options are recommended for the treatment of menopausal symptoms, which include vasomotor instability, urogenital atrophy, psychologic disturbances, and risk of osteoporosis and cardiovascular disease.
authors.affiliation: Admission Evaluation Center, University of Pennsylvania Health System, Philadelphia, USA.
authors.forename: T N
authors.initials: TN
authors.lastname: Waldman
mesh_terms: D001294:Attitude to Health; D000075202:Contraindications; D016503:Drug Delivery Systems; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004967:Estrogens / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D016312:Treatment Refusal
chemical_list: D004967:Estrogens