A medical examination is required before and periodically in the course of treatment. At regular intervals (at least once a year), the doctor will invite the patient to discuss the benefits and risks associated with hormone replacement therapy in order to evaluate whether the patient should continue or stop the treatment.
The doctor will carry out regular clinical examination of the breasts, especially in cases involving history of breast cancer in the family or if the patient has cysts or lumps in the breasts. The doctor could also decide to prescribe a mammography. Inform the doctor if the patient notices a modification in the breasts during treatment.
Women who use a hormone replacement therapy have an increased risk of developing a thrombo-embolic disease, a breast cancer or uterine cancer and perhaps a cardiovascular incident or a cerebral vascular problem.
With women who still have their uterus, a progestogen treatment will be added during at least 12 days in the cycle.
Inform the doctor of any disease occurring during treatment. In the following situations, treatment of the menopause is not contraindicated but requires special attention: hypertension, diabetes, endometriosis (an infection characterized by the presence of uterine mucous outside the uterus), uterine fibroma, hepatic or biliary problems, epilepsy, migraines or severe head-aches, renal or cardiac otospongiosis (an infection of the ear leading to a loss of hearing).
Contact the doctor immediately in the case of the appearance of one of the following: allergic reactions (breathing difficulties, thoracic oppression, generalized eruption such as urticaria, itching); jaundice (of the eyes and skin); significant increase in arterial tension; significant increase in blood pressure; unusual pain in the legs, weakness in the limbs; chest pains, irregular pulse, sudden breathlessness; loss of consciousness, confusion, unusually severe headaches, vertigo, visual problems, slowness or loss of speech; pregnancy; lumps in the breasts.
Inform the doctor if the patient has to remain in bed or if the patient has to undergo a surgical operation.
If the symptoms of oestrogen deficiency linked to the menopause persist in spite of the treatment, tell the doctor.
If abundant bleeding occurs, consult the doctor.