What are the brand names as HRT in India?

What are the available options before us if we decide for & woman concerned agrees to accept for hormonal tr  for   certain specified period?? The followings are the drug options for women with intact uterus?  1) Cyclical basis, not continuous:-Conj. Oestrogen alone for 3 weeks—gap for 7 days --- cyclical.  2) Continuous combined :-Conj. Oestrogen & MPA (0.625 & MPA 2.5 mg as daily basis 3) Sequential but combined i.e.  same formulation for 3 weeks and 1 week off. 4) Same formulations:  Monday to Friday. 3) Low dose daily Oestrogen only i..e. Premarin 0.3mg. 4)  Continuous combined:  oestrogen and cyclical progesterone    5) Tibolone 6) Progesterone alone (Norethindrone alone Noreta HRT 1 mg- but but  but what about  ? br Ca if she don’t report for regular check up à say lost to follow up ??

The other options:-. What are hormonal options available as HRT for a woman who had hysterectomy & BSO?  1) Conj. Oestrogen alone FOR 3 WEEKS- cyclical      2) Continuous combined Conj. Oestrogen & MPA   3) Tibolone.

Q. 4:-Any scope of Inj. Androgens./   Tab form in menopause?? Ans: Not very much. ---> Only in selected cases where there is poor sex drive !! May be!! . Drug are 1) Restore Tab?  ESTRATESTtAB( E 2 & Methyl Testosterone  tab/ Mesterolone/ provironum )

Q. 5:-Is it true that Prog  Challenge test should be always employed before initiation of HRT. If she bleeds HRT should be avoided. What about Tibolone? Should we do such PCT ??

. Q 6:-. Is there any chance of systemic absorption if someone uses EVALON CREAM for years together?  Q. 7:  Someone is having bleeding after Tibolone Ry.--What should be done?  What are the possible causes in such situation? Hysteroscopy after USG. Or wait & watch.

Q. 8> Any member prescribes  micro gram  alpha Calcidol? Is there any clinical situation where one has to estimate ration of E2/E1 (menopause = 0.23)

Q, 9:--What about Transdermal oestrogen suppl in Indian context?   PATCH / CREAMS? Which one  members prefer in Indian context (Non oral HRT maintain E2/E1 ratio in a better way-acceptable to us- i.e. above 1.     Why it has not become that popular?  I believe in cases where high dose of oestrogens are not wanted the one can opt for skin patches/implants (slow release) e.g. CHD, HTN, DM,

Estraderm /oestrogel/Sandrine gel/ IMPLANTS?

VAGIFEN(sustained Release E2 Novo Nordsk co.)

Q, 8:- Is Indian Menopausal Society is propagating this message to gynaecologists?

It is often quoted that HRT should be usually administered for about 7 yrs  after attaining natural menopause unless there is some medical sytemic  compl./ local pathology .Is that true? Or some members like to stop oat 52 yrs of age? In cases of family H/O Br Ca-avoid oestrogens or Progesterone  as HRT? What about  following  agents ?  

ESPAUZ    (G. R). NORETA HRT 1mg Norethindrone, Styptin 5mg.  Premelle . Prempro, Progynova (E1?-oestrone? Oetradiol Valerate) , Evalon Cream