Troubleshooting menopause hormone therapy.

BACKGROUND: Public interest in menopause hormone therapy (MHT) is currently high, and more women are presenting to general practitioners (GPs) interested in starting medication. MHT can be complex to prescribe, and regimens will commonly need adjusting. Although there are increasing resources available to GPs around MHT prescribing, there is less available guidance in managing difficulties when they arise. OBJECTIVE: The aim of this paper is to summarise the key components to follow-up consultations for women starting on MHT and to provide some practical guidance to troubleshooting problems. DISCUSSION: Given the wide range of MHT products available, finding the right option for each woman can be both a challenge and an opportunity. The variety of formulations and delivery methods allows greater ability for GPs to adjust regimens and individualise. Initial difficulties when starting MHT are common and for some women it might take a few months to stabilise therapy. Most women will be able to find a regimen that suits them if proper care is given to exploring the balance between symptom control, side effects and bleeding patterns.