Low dose

Foot Notes

1. Cauley JA, Robbins J, Chen Z et al. Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women’s Health Initiative randomised trial. J Am Med Assoc 2003; 290:1729-38.
2. Lindsay R et al The minimum effective dose of estrogen for prevention of postmenopausal bone loss. Obstet Gynecol. 1984 Jun;63(6):759-63.
3. Panay et al. Ultra-low-dose estradiol and norethisterone acetate: effective menopausal symptom relief Climacteric; 2007 Apr;10(2):120-31.

OK

The recommendation is that HRT be given at the lowest effective dose for the shortest length of time necessary to achieve the desired clinical effect forms part of medical guidance from the International Menopause Society (IMS), the North American Menopause Society (NAMS) and the British Menopause Society. All acknowledge the need for lower doses to be employed. When given at appropriate doses, there is broad medical agreement that:

• HRT is the best available treatment for relieving troublesome symptoms of the menopause such as hot flushes and night sweats.
• HRT reduces the risk of osteoporotic fractures¹ (breakage of bones that have thinned following the menopause).
• HRT can also effectively relieve vaginal symptoms of the menopause, such as vaginal dryness, soreness, and pain on intercourse. Urinary problems such as urinary frequency and urgency may also improve with HRT. For vaginal and urinary problems, HRT should preferably be given locally (i.e. vaginal tablets, creams or suppositories).

Trend to lower doses

There has been a steady decrease in HRT dose quantities since the 1950s. Moving from high dose to standard dose in the 1980s and to low dose in the 1990s, the trend towards lower dose HRT continues.

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