A nurse's guide to hormone replacement therapy

Menopausal experiences and hormone replacement therapy use among women with physical impairments

This study describes the menopausal experiences of women with physical disabilities and their knowledge and use of hormone replacement therapy (HRT). 166 women completed a mailed survey of demographic and disability characteristics, health history, menopausal information, and HRT knowledge. The typical respondent was a 52-year-old, Anglo, college-educated woman with a neuromuscular disorder. Half of the menopausal women were taking HRT, and 47% had a hysterectomy. HRT use was significantly associated with hysterectomy status, amount of HRT information received from providers, and regular gynecologic examinations. Effective interventions are needed to assist these women in making key health decisions during menopause.

Postmenopausal bleeding: a practical approach

PURPOSE

To provide nurse practitioners (NPs) with a practical approach for the management of postmenopausal bleeding in office settings.

DATA SOURCES

Selected scientific literature and the author's own experience.

CONCLUSIONS

Postmenopausal bleeding should be considered cancer until proven otherwise, despite the fact that abnormal pathology is found in only 15% of endometrial biopsies.

IMPLICATIONS FOR PRACTICE

Post menopausal bleeding can be safely evaluated and managed by NPs using aspiration endometrial biopsies and/or transvaginal ultrasound. Hospitalization for dilation and curettage under anaesthesia can often be avoided.

Is physical activity as effective in reducing risk of cardiovascular disease as estrogen replacement therapy in postmenopausal women?

Coronary heart disease (CHD) is known as a disease of postmenopausal women. While hormone replacement therapy is recommended increasingly to postmenopausal women for the prevention of CHD, the potential impact of non-pharmacologic interventions on cardiovascular disease reduction has been largely unexplored. The purpose of this article is to develop the understanding of the research literature on three risk factors by which estrogen and physical activity, a non-pharmacologic intervention, may confer cardiovascular protection in postmenopausal women. Three risk factors are lipoproteins, systolic pressure, and changes in the vascular endothelial functions. Effects of estrogen and physical activity on these biological factors are compared.

Menopause: life event or medical disease?

Women throughout the world experience menopause, but it is often difficult to determine what it means and how it is perceived by women. A dilemma exists as to whether menopause should be medicalized or treated as a normal life event. The effects of this decision on the woman and the role of the advanced practice nurse in assisting the woman through this time of change are presented.