الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
The menopause is a physiologic event that brings clinicians and patients together, providing the opportunity to enroll patients in health maintenance. Contrary to popular opinion, the menopause is not a signal of impending decline, but a start of something positive. Postmenopausal hormone therapy is an option that should be considered by all women as a legitimate part of their preventive health program. Menopause and other estrogen deprivation syndromes are associated with short and long term sequelae. Short-term sequelae that accompany menopause include hot flushes, genitourinary atrophy manifested by incontinence and sexual dysfunction. The long-term sequelae include bone loss and increased incidence of fracture especially hip bone and neck of femur as well as the unfavorable alternation in lipoproteins with increased risk of cardiovascular disease. Postmenopausal hormone therapy is an option that should be offered to most women as they consider their paths for successful aging, but the attitude and beliefs of the clinician have a major influence on the decisions made by patients. A careful history can help to identify which patients are likely to benefit from hormone replacement therapy and those having contraindications to therapy such as patients with ischemic heart disease, breast cancer, endometrial carcinoma, active liver disease and cardiovascular accidents. The expanded number of new choices today, with development and evaluation, have complicated provider and patient choices, but greatly improved the potential for effective intervention. The decision whether to use HRT should be made by each woman having been given sufficient information by her health professional to make a fully informed choice. The HRT dosage, regimen and duration should be individualised, with annual evaluation of pros and cons. Arbitrary limits should not be placed on the duration of usage of HRT. If symptoms persist, the benefits of hormone therapy usually outweigh the risks. HRT prescribed before the age of 60 has a favourable benefit/risk profile. It is imperative that women with POI are encouraged to use HRT at least until the average age of the menopause. If HRT is to be used in women over 60 years of age, lower doses should be started, preferably with a transdermal route of administration. It is imperative that in our ageing population research ; development of increasingly sophisticated hormonal preparations should continue to maximize benefits and minimise side effects and risks. This will optimise quality of life and facilitate the primary prevention of long-term conditions which create a personal, social and economic burden. Each woman is unique, having her own risk profile and preferences. When HRT is desired by patients, individualization of therapy is the key to provide health benefits with minimal risks, thereby enhancing the quality of life. Finally, HRT for postmenopausal women is a gift from modern science, provided to be placed in its case, which fits.