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Physical examination and a complete medical and family history should be taken prior to the initiation of any hormone replacement therapy (HRT) with special reference to blood pressure, palpation of the breasts and the abdomen, and a gynecological examination. Mammography is advisable.
Breast cancer is diagnosed slightly more often in women on hormone replacement therapy for >5 years than in women not treated with these preparations.
There is evidence that the observed higher incidence of breast cancer during hormone replacement therapy is not associated with increased mortality from breast cancer.
Patients who are or have previously been treated with unopposed estrogens should be examined with special care in order to investigate a possible hyperstimulation of the endometrium before commencing therapy.
As a general rule, HRT should not be prescribed for >1 year without a general physical examination, including a gynecological examination. A mammogram on regular intervals is generally advised (1-2 years).
Breakthrough bleedings or abnormal findings at the gynecological examination may be an indication for endometrial assessment.
Femoston 1/10 is not a contraceptive. Patients in the perimenopausal phase are advised to take nonhormonal contraceptive precautions.
Epidemiological studies suggest that hormone replacement therapy in general increases the risk of developing venous thromboembolism.
The risk can be temporarily increased by prolonged immobilization as well as major trauma or surgery. In such cases interruption of hormone replacement therapy in the month before surgery should be considered.
Patients with or developing epilepsy, migraine, cardiac failure, hypertension, porphyria, hemoglobinopathies or otosclerosis should be carefully observed during treatment.
Special care should be taken in patients with uterine leiomyomata and patients with (a history of) endometriosis as estrogens may influence these conditions.
Effects on the Ability to Drive or Operate Machinery: No effects known.
