Thursday, 21 November 2019

What are the ongoing debates in hormonal, hormonal Therapy in health asymptomatic menopausal woman ??


Here we go: No alternative questions  U have to all answer all the Questions. Members expect that U should disseminate your expertise, knowledge, and above all wisdom  and members like to know  your practice pattern to all of us .Q.1 . Does all healthy (disease free) & symptomless women mandate HRT as soon as she achieves menopause?
Q..2 Timing of initiation of Nonhormonal HRT or hormonal HRT?? In such healthy women what will be ideal HRT (first choice) and what will be the time of initiation of HRT?  AT what time such healthy women (absence of DN, HTN, and hyperlipidaemia) --- such HRT should be stopped. What will be rough annual cost of such HRT in perfectly well woman excluding the cost of monitoring due to drug?
Q. 3:  What is your/Society’s view on routine calcium and Vit. D suppl. to all Indian women after attaining the age of 35 yrs. If you do approve such suppl at what age you propose to stop such nutritional suppl. Any monitoring during such Ry or side effects.
Q.4. Do you routinely prescribe/inject some oestrogen if you perform TAH and BSO before she leaves nursing home? On which postoperative day you would be happy to initiate HRT if you perform oophorectomy concurrently / do not sacrifice ovaries? What should be usual choice of HRT in medically fit women after TAH & BSO?
Q. 5 .   What HRT will be ideal for women suffering from some medical diseases like DM, HTN, IHD (CAD), Hyperlipidaemia, Chr. Joint disorders, Hyperuricaemia   etc. etc?
Q. 6 . what important prophylactic steps doctors/gynecologist usually misses or usually does not advice in premenopausal years to prevent bone loss/ breast cancer? What are the lapse on the part of doctors that cause much annoyance to people like you who are more concerned about pre/postmenopausal wellbeing of Indian women?  What will be your message to people like us?
Q. 7 . what are the different pharmaco-prophylaxis of osteopenia /osteoporosis in postmenopausal years excluding aerobic exercises. From our experience we have learnt that they seldom undergo exercises as prescribed. There is no point in denying this.
Q. 8. What are the usual prophylactic therapeutic measures to protect Breast malignancy? Is any drug available to prevent Breast malignancy? What will be HRT of choice in cases with family history of Breast Cancer/personal history of having fibroadenosis of breast? What type of HRT will be safe in a woman with mammographic evidence DENSE BREAST?
Q.9 . the investigative process of mammography is underutilized in India: what is your view on this personal feeling? To put in other way what are the usually globally accepted indications/ recommendation of mammography in otherwise asymptomatic women. Any difference of timing in women who are on HRT and who are not on HRT.
Quiz 10: What is the list of Pretests prior to initiation of HRT? Any difference with hormonal/ nonhormonal HRT in this regard?
Q. 8.  What is your opinion on routine evaluation of bone health by BMD?
/ T—Score?

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