MHT: Initiation, safety, endometriosis & practical prescribing — Your questions answered

2 minute read


Listen to this Q&A series with Associate Professor Gino Pecoraro OAM responding to questions collected from GPs at HealthEd's face-to-face seminars around Australia.


Prof Rod Baber AM answers questions submitted by GPs during our face-to-face seminars around Australia.

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In this episode:

The questions answered in this podcast are listed below.

  • Is there a specific age at which women should be advised to stop MHT?
  • Can we restart MHT in a woman now in her early 60s who stopped MHT 3–4 years ago and has recurrent vasomotor symptoms?
  • Can MHT be initiated more than 10 years after menopause?
  • For women who missed the MHT window and are now in their late 60s or 70s, what are the options?
  • How do we manage symptomatic women over 60 requesting MHT for symptoms other than vasomotor symptoms, such as fatigue, muscle aches, or concerns about dementia and cardiovascular protection?
  • Can oral progesterone alone be used in women who missed the MHT window?
  • Can vaginal progesterone be used in women intolerant of oral progesterone?
  • Should women always have a pelvic ultrasound before initiating MHT?
  • How should bleeding on MHT be investigated and managed?
  • Is a baseline mammogram required before commencing MHT?
  • If MHT was started during perimenopause, when should it be changed to continuous combined therapy?
  • What is the impact of MHT on weight gain?
  • Is MHT safe in women with BRCA mutations?
  • What is the evidence for MHT use after breast cancer?
  • Is MHT safe in ovarian cancer survivors?
  • If MHT may be cardioprotective, why is it not recommended for primary prevention of cardiovascular disease?
  • Can women with a history of thrombosis use MHT?
  • Can topical Estrogel be used in a patient with Factor V Leiden?
  • Why do some menopause clinics prescribe progesterone after hysterectomy in women with a history of endometriosis?
  • Is Mirena sufficient endometrial protection with higher doses of Estrogel?
  • Is Slinda adequate for endometrial protection during MHT?

Expert: Prof Rod Baber AM, Obstetrician and Gynaecologist

Host: Dr Terri Foran, GP & Sexual Health Physician

Total time: 33 mins

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