<p>Hormone therapy should only be continued as long as the benefit in alleviation of severe symptoms outweighs the risk. A complete medical history should be taken and a physical examination should be conducted prior to the initiation or reinstitution of HRT, should be repeated periodically. The frequency and nature of these examinations should be based on established practice guidelines, 6 monthly reviews are generally considered appropriate, and be adapted to the individual woman, but should generally include pelvic organs, including routine cervical cytology, abdomen, breasts and blood pressure. The need for continued therapy should be reconsidered at each review. Unless otherwise prescribed by the doctor, 1 tablet Estradiol is taken daily and the tablets are to be swallowed whole with some liquid. Each pack covers 30 days and treatment is continuous, which means that the next pack follows immediately without a break. It does not matter at what time of the day the patient takes her tablet, but once she has selected a particular time, she should keep it to every day. If she forgets to take a tablet at the usual time, she may take it within the following 12 to 24 hours. If the treatment is discontinued for longer, irregular bleeding may occur. Treatment may be started at any time provided that pregnancy has been excluded. High-dosed and long-term use of unopposed oestrogens during the climacteric may increase the incidence of endometrial carcinoma. Endometrial hyperplasia should be avoided in unopposed oestrogen treatment. It is therefore mandatory to add a progestogen for the last 10-14 days of each month of therapy. As a general rule, Estradiol treatment should be discontinued every 6 months in order to verify the persistence of complaints requiring treatment. It is essential to adhere to the dosage scheme prescribed by the doctor and to keep the appointments made for gynaecological check-ups.</p>

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