You know, with hormone replacement therapy what I try to tell the patient and get across is that the best therapy is what's gonna alleviate your symptoms and the best test for whether the therapy, what dose of therapy you need, or what therapy you need is does this alleviate your symptoms? We try to use the lowest dose of therapy that's going to alleviate your symptoms.
What particular combination of hormone therapy that we use also is very patient dependent. Generally most patients will need an estrogen and progesterone. You can't give estrogen alone, because it can promote overgrowth of the lining of the uterus and potentially increase the risk of endometrial cancer. If someone's had a hysterectomy, though, they can just take estrogen alone. They do not need progesterone, and shouldn't take progesterone. Of the two hormones, estrogen and progesterone, progesterone probably creates more of a risk of breast cancer than estrogen actually.
The way that the estrogen is given or hormone therapy is given, whether it's given orally or given transdermally is also very patient dependent, too. Depending on what the patient's symptoms are.
