Library
OB/GYN
·
easy
Menopause Treatment
Flowchart
Play
Hormones if no contraindication; intact uterus needs progestin.
Decision
Outcome
Decision
Vasomotor symptoms severity?
✓
Mild → behavioral modifications
✓
Moderate/severe → assess contraindications to estrogen
Outcome
Lifestyle: dress in layers, avoid triggers, vaginal moisturizers
Decision
Estrogen contraindications? (Breast ca, CHD, endometrial ca, liver disease, thromboembolism)
✓
Yes → non-hormonal therapy (SSRI, SNRI, gabapentin, clonidine)
✓
No → assess uterus
Outcome
Paroxetine (only FDA-approved non-hormonal), gabapentin, clonidine, oxybutynin
Decision
Intact uterus?
✓
Yes → estrogen + progestin
✓
No (s/p hysterectomy) → estrogen only
Outcome
Combined HRT — progestin protects endometrium
Use lowest effective dose for shortest duration that achieves symptom control.
Outcome
Estrogen alone — fine without uterus
Consider transdermal route to lower VTE risk.
Drag to pan · scroll to navigate