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One of these statements about menopausal symptoms is false – which is it?
- They are estimated to affect two-thirds of women
- They are distressing for only 5 per cent of women
- They include sleep disturbance and joint pains
- Regular exercise can reduce symptoms
Which one of these statements about treating menopause symptoms is false?
- Over-the-counter preparations have no role
- HRT can reduce the frequency of hot flushes by 77 per cent compared with placebo
- HRT can reduce symptom severity compared with placebo
- Low-dose HRT controls vasomotor symptoms
Regarding HRT, which one of these statements is false?
- Perimenopausal women should be offered sequential combined HRT using daily oestrogen and cyclical progestogen
- Postmenopausal women may be offered continuous combined HRT
- Women who have undergone hysterectomy are generally offered oestrogen-only HRT
- The dose should be titrated to the maximum tolerated
Which one of these statements about the benefits of HRT is false?
- HRT reduces the risk of fractures of both the spine and hip
- Treatment with HRT to reduce fracture risk in postmenopausal women with osteoporosis may need to be lifelong
- HRT may improve dentition
- There is sufficient evidence to support the use of HRT specifically to reduce the risk of colorectal cancer
Which of these statements about the duration of HRT is untrue?
- Most UK women use HRT for symptom relief for less than a year
- In women who continue to use HRT, usual practice is to try reducing then stopping HRT every 2-3 years
- For women with a premature menopause, HRT should be offered until the age of 52
- HRT should be continued for as long as the woman feels that the benefits outweigh the risks
Which of these statements is false?
- Nonhysterectomised women who have bleeding after 6 months' use of continuous combined HRT should be assessed
- Greasy skin is an oestrogenic effect
- Breast tenderness associated with HRT may respond to a reduction in the dose of oestrogen
- Adverse effects of HRT usually settle by the third month of treatment
One of these statements about the risks of HRT is false – which one?
- HRT at least doubles the risk of venous thromboembolism
- The period of greatest increased risk of venous thromboembolism is within the first year of HRT use
- Oestrogen combined with cyclical progestogen (sequential HRT) or long-cycle HRT eliminates the risk of endometrial cancer
- Long-term HRT use (>5 years) confers a small increased risk of breast cancer similar to that of a late natural menopause
Which one of these statements is false?
- HRT commenced within the first 10 years of the menopause is very unlikely to be harmful to the cardiovascular system
- For women with menopause aged >70, the benefits of HRT far outweigh the risks and HRT should be offered
- For women aged between 50 and 60 with menopausal symptoms, the benefits of HRT outweigh the risks
- For women aged 60-70, the benefits of HRT are balanced by the risks and treatment should be individualised
Which one of these statements about other treatments for menopause symptoms is false?
- An SSRI such as fluoxetine or paroxetine may reduce hot flushes
- Norethisterone is effective as monotherapy at a dose of 5-10mg/day
- HRT and clonidine are the only prescribed therapies that are currently licensed for the treatment of menopausal vasomotor symptoms
- The initial dose of gabapentin is 1600mg/day
Which one of these statements about genitourinary symptoms is not true?
- Over half of menopausal women experience them
- Topical oestrogen therapy is often required
- There is now good evidence that long-term use of topical oestrogen increases the risk of endometrial neoplasia
- Nonhormonal lubrication may improve dyspareunia

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