Hormone replacement therapy by implant: the need to rethink

Summary

To determine the relationship between menopausal symptoms and hormone status, 38 patients attending for hormone re-implantation were assessed. The association between menopausal symptoms and hormone status was poor. Twenty-four per cent of these patients had plasma oestradiol in the supraphysiological range of more than 1200pmol/l. This supraphysiological state was associated with longer periods of hormone replacement therapy by implant and shorter intervals between implants. Patients, especially those returning at short intervals, should be properly counselled before re-implantation. These patients, together with those who have been on hormone replacement by implant for over four years, would benefit from assessment of hormone levels before further implants. Patients with high oestradiol levels should be offered alternative forms of treatment and drugs to alleviate their withdrawal symptoms.