SlideShare uma empresa Scribd logo
1 de 87
MENOPAUSE:  HRT or NO HRT ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Egypt
Suez Canal University Hospital
Starts as a date and continues as a status! ,[object Object],[object Object]
This is the Change The change is not a disease
For a woman without a uterus? ,[object Object],[object Object]
Which is best name?
Do we deal with Menopause or Climacteric? ,[object Object],[object Object]
Starts by a date that never ends? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Menopause is OK but its sequalae are not OK Hot flashes Osteo, Urogenital CVD Mood Collagen
Physiology ,[object Object],[object Object],[object Object],[object Object]
 
Ovarian Process. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
1. Physiology of Menopause ,[object Object],[object Object],[object Object],[object Object],[object Object]
Physiology of Menopause ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2. Reproduction and Meno. ,[object Object],[object Object],[object Object],[object Object]
3. Hormonal Changes ,[object Object],[object Object],[object Object],[object Object],[object Object]
4. Effects of Declining Estrogen ,[object Object]
 
1. Brain and CNS   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Brain and CNS   ,[object Object],[object Object],[object Object]
2. Hot Flushes ,[object Object],[object Object],[object Object],[object Object]
Hot Flushes ,[object Object],[object Object]
3. Vision ,[object Object],[object Object]
4. Collagen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
5. Urogenital Atrophy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
6. Bone Loss ,[object Object],[object Object],[object Object],[object Object]
Bone Loss ,[object Object],[object Object]
Bone Loss ,[object Object],[object Object],[object Object]
7. CardioVascular ,[object Object],[object Object],[object Object],[object Object],[object Object]
CVD ,[object Object],[object Object],[object Object],[object Object]
CVD ,[object Object],[object Object],[object Object],[object Object]
7.Sexuality ,[object Object],[object Object],[object Object]
7.Sexuality ,[object Object],[object Object]
How They Perceive Menopause ,[object Object],[object Object],[object Object]
Women’s Perceptions of Menopause ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
If she does not have any of these, why not to leave her alone??
How to Manage? ,[object Object],[object Object],[object Object],[object Object]
Preventive measures for menopause ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
1. Diet & Excercise ,[object Object],[object Object]
Diet & Exercise ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2. Supplement ,[object Object],[object Object],[object Object],[object Object]
3. Therapeutic Options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
a.Estrogen for vasomotor ,[object Object],[object Object],[object Object],[object Object]
b.Bisphophonate for osteoporosis ,[object Object]
c. Other treatment for osteoporosis. ,[object Object],[object Object]
Other treatment for osteoporosis. ,[object Object],[object Object],[object Object],[object Object]
d. SERM ,[object Object]
SERMs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ideal SERM ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object]
Women perception of HRT ,[object Object],[object Object],[object Object]
Women perception of HRT ,[object Object],[object Object]
Benifits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vasomotor ,[object Object],[object Object],[object Object]
Osteo, Preven & TT ,[object Object],[object Object]
 
CHD ,[object Object]
Reversal of urogenital atrophy ,[object Object]
Improv. Mood and Cognitive functions ,[object Object],[object Object]
Improv. Mood and Cognitive functions ,[object Object],[object Object]
What about risks?
RISKS ,[object Object],[object Object],[object Object],[object Object]
Idiosyncratic Reactions ,[object Object],[object Object]
Idiosyncratic Reactions ,[object Object],[object Object]
Vag Bleeding ,[object Object],[object Object],[object Object]
Endometrial Dis. ,[object Object],[object Object],[object Object],[object Object],[object Object]
Breast Cancer ,[object Object],[object Object],[object Object],[object Object]
Breast Cancer ,[object Object],[object Object],[object Object]
Breast Cancer ,[object Object],[object Object],[object Object]
Tibolone; another progestogen ,[object Object],[object Object],[object Object]
Compliance ,[object Object]
HRT status in 2010 ,[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]
Conclusions ,[object Object]
[object Object]
[object Object]
[object Object]
[object Object]
[object Object],[object Object],[object Object]
[object Object]
Conclusions ,[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object],[object Object]
Thank you

Mais conteúdo relacionado

Mais procurados

Postmenopausal uterine bleeding
Postmenopausal uterine bleedingPostmenopausal uterine bleeding
Postmenopausal uterine bleedingAhmed Khattab
 
Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...
Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...
Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...Lifecare Centre
 
Approach to post menopausal bleeding
Approach to post menopausal bleeding Approach to post menopausal bleeding
Approach to post menopausal bleeding Niranjan Chavan
 
Female and male infertility Causes & Management by Asar Khan
Female and male  infertility Causes & Management by Asar KhanFemale and male  infertility Causes & Management by Asar Khan
Female and male infertility Causes & Management by Asar KhanAsar Khan
 
STRATEGIES TO PREVENT & CONTROL HPV INFECTION AND CERVICAL CANCER. Dr. Shar...
STRATEGIES TO  PREVENT & CONTROL  HPV INFECTION AND CERVICAL CANCER. Dr. Shar...STRATEGIES TO  PREVENT & CONTROL  HPV INFECTION AND CERVICAL CANCER. Dr. Shar...
STRATEGIES TO PREVENT & CONTROL HPV INFECTION AND CERVICAL CANCER. Dr. Shar...Lifecare Centre
 
Abnormal uterine bleeding prof jamiyah hassan
Abnormal uterine bleeding   prof jamiyah hassan Abnormal uterine bleeding   prof jamiyah hassan
Abnormal uterine bleeding prof jamiyah hassan Ikram Zilfikar
 
Abnormal Uterine Bleeding
Abnormal Uterine BleedingAbnormal Uterine Bleeding
Abnormal Uterine BleedingEddie Lim
 
NEW USES OF LASER IN GYNECOLOGY
NEW USES OF LASER  IN GYNECOLOGYNEW USES OF LASER  IN GYNECOLOGY
NEW USES OF LASER IN GYNECOLOGYAboubakr Elnashar
 
Panel Discussion on Post Menopausal Bleeding
Panel Discussion on Post Menopausal Bleeding Panel Discussion on Post Menopausal Bleeding
Panel Discussion on Post Menopausal Bleeding Lifecare Centre
 
Role of progesterone in pregnancy
Role of progesterone in pregnancyRole of progesterone in pregnancy
Role of progesterone in pregnancyDr Meenakshi Sharma
 
unexplained Recurrent miscarriages .. practical approach
unexplained Recurrent miscarriages .. practical approachunexplained Recurrent miscarriages .. practical approach
unexplained Recurrent miscarriages .. practical approachIftikharsadique
 
Prophylactic Salpingectomy
Prophylactic SalpingectomyProphylactic Salpingectomy
Prophylactic SalpingectomySujoy Dasgupta
 
Recurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Recurrent pregnancy loss Presentation by Dr.Laxmi ShrikhandeRecurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Recurrent pregnancy loss Presentation by Dr.Laxmi ShrikhandeDr.Laxmi Agrawal Shrikhande
 
Lasers in gynaecology
Lasers in gynaecologyLasers in gynaecology
Lasers in gynaecologySai Sashãnk
 

Mais procurados (20)

Menopause
Menopause Menopause
Menopause
 
Postmenopausal uterine bleeding
Postmenopausal uterine bleedingPostmenopausal uterine bleeding
Postmenopausal uterine bleeding
 
Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...
Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...
Genital tb in infertility & our experience dr. sharda jain, dr. jyoti agarwal...
 
Approach to post menopausal bleeding
Approach to post menopausal bleeding Approach to post menopausal bleeding
Approach to post menopausal bleeding
 
Female and male infertility Causes & Management by Asar Khan
Female and male  infertility Causes & Management by Asar KhanFemale and male  infertility Causes & Management by Asar Khan
Female and male infertility Causes & Management by Asar Khan
 
Management of menopause
Management of menopauseManagement of menopause
Management of menopause
 
STRATEGIES TO PREVENT & CONTROL HPV INFECTION AND CERVICAL CANCER. Dr. Shar...
STRATEGIES TO  PREVENT & CONTROL  HPV INFECTION AND CERVICAL CANCER. Dr. Shar...STRATEGIES TO  PREVENT & CONTROL  HPV INFECTION AND CERVICAL CANCER. Dr. Shar...
STRATEGIES TO PREVENT & CONTROL HPV INFECTION AND CERVICAL CANCER. Dr. Shar...
 
Menopause & HRT
Menopause & HRTMenopause & HRT
Menopause & HRT
 
Menopausal Hormone Replacement Therapy by Dr Shahjada Selim
Menopausal Hormone Replacement Therapy by Dr Shahjada SelimMenopausal Hormone Replacement Therapy by Dr Shahjada Selim
Menopausal Hormone Replacement Therapy by Dr Shahjada Selim
 
Abnormal uterine bleeding prof jamiyah hassan
Abnormal uterine bleeding   prof jamiyah hassan Abnormal uterine bleeding   prof jamiyah hassan
Abnormal uterine bleeding prof jamiyah hassan
 
Abnormal Uterine Bleeding
Abnormal Uterine BleedingAbnormal Uterine Bleeding
Abnormal Uterine Bleeding
 
NEW USES OF LASER IN GYNECOLOGY
NEW USES OF LASER  IN GYNECOLOGYNEW USES OF LASER  IN GYNECOLOGY
NEW USES OF LASER IN GYNECOLOGY
 
Panel Discussion on Post Menopausal Bleeding
Panel Discussion on Post Menopausal Bleeding Panel Discussion on Post Menopausal Bleeding
Panel Discussion on Post Menopausal Bleeding
 
Menopause
Menopause Menopause
Menopause
 
Role of progesterone in pregnancy
Role of progesterone in pregnancyRole of progesterone in pregnancy
Role of progesterone in pregnancy
 
unexplained Recurrent miscarriages .. practical approach
unexplained Recurrent miscarriages .. practical approachunexplained Recurrent miscarriages .. practical approach
unexplained Recurrent miscarriages .. practical approach
 
Prophylactic Salpingectomy
Prophylactic SalpingectomyProphylactic Salpingectomy
Prophylactic Salpingectomy
 
Recurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Recurrent pregnancy loss Presentation by Dr.Laxmi ShrikhandeRecurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
Recurrent pregnancy loss Presentation by Dr.Laxmi Shrikhande
 
Lasers in gynaecology
Lasers in gynaecologyLasers in gynaecology
Lasers in gynaecology
 
Menopause
MenopauseMenopause
Menopause
 

Destaque

Menopause and HRT by Dr. Taila Amber
Menopause and HRT by Dr. Taila AmberMenopause and HRT by Dr. Taila Amber
Menopause and HRT by Dr. Taila AmberTaila Amber
 
Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)Shahab Riaz
 
Menopause: Symptoms, Concerns, and Management Strategies
Menopause: Symptoms, Concerns, and Management StrategiesMenopause: Symptoms, Concerns, and Management Strategies
Menopause: Symptoms, Concerns, and Management StrategiesSummit Health
 
Menopause copy joannie
Menopause copy   joannieMenopause copy   joannie
Menopause copy joannieJou011
 
hormonal replacement therapy
hormonal replacement therapyhormonal replacement therapy
hormonal replacement therapyJv Tglee
 
HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY Karl Daniel, M.D.
 
State of the Word 2011
State of the Word 2011State of the Word 2011
State of the Word 2011photomatt
 
Hormone replacement therapy Hormone replacement therapy
Hormone replacement therapy 	 Hormone replacement therapyHormone replacement therapy 	 Hormone replacement therapy
Hormone replacement therapy Hormone replacement therapyMedicineAndHealth14
 
Menopause - The Journey
Menopause - The JourneyMenopause - The Journey
Menopause - The JourneyKathryn Colas
 
Menopause..The Big M With Ease!
Menopause..The Big M With Ease!Menopause..The Big M With Ease!
Menopause..The Big M With Ease!Lauren Dansereau
 
Bio Identical or Natural Hormone Replacement Therapy
Bio Identical or Natural Hormone Replacement TherapyBio Identical or Natural Hormone Replacement Therapy
Bio Identical or Natural Hormone Replacement Therapymiddela
 
Final Slideshow Version
Final Slideshow VersionFinal Slideshow Version
Final Slideshow Versionprch08
 
Disorders of the menstrual cycle 2
Disorders of the menstrual cycle  2Disorders of the menstrual cycle  2
Disorders of the menstrual cycle 2Magda Helmi
 

Destaque (20)

Menopause and HRT by Dr. Taila Amber
Menopause and HRT by Dr. Taila AmberMenopause and HRT by Dr. Taila Amber
Menopause and HRT by Dr. Taila Amber
 
Menopause overview
Menopause overviewMenopause overview
Menopause overview
 
Menopause ppt
Menopause pptMenopause ppt
Menopause ppt
 
Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)Menopause (Signs and Symptoms)
Menopause (Signs and Symptoms)
 
Menopause: Symptoms, Concerns, and Management Strategies
Menopause: Symptoms, Concerns, and Management StrategiesMenopause: Symptoms, Concerns, and Management Strategies
Menopause: Symptoms, Concerns, and Management Strategies
 
Menopause copy joannie
Menopause copy   joannieMenopause copy   joannie
Menopause copy joannie
 
Menopause
MenopauseMenopause
Menopause
 
hormonal replacement therapy
hormonal replacement therapyhormonal replacement therapy
hormonal replacement therapy
 
HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY
 
State of the Word 2011
State of the Word 2011State of the Word 2011
State of the Word 2011
 
Hormone replacement therapy Hormone replacement therapy
Hormone replacement therapy 	 Hormone replacement therapyHormone replacement therapy 	 Hormone replacement therapy
Hormone replacement therapy Hormone replacement therapy
 
Menopause - The Journey
Menopause - The JourneyMenopause - The Journey
Menopause - The Journey
 
Menopause
MenopauseMenopause
Menopause
 
Menopause..The Big M With Ease!
Menopause..The Big M With Ease!Menopause..The Big M With Ease!
Menopause..The Big M With Ease!
 
Bio Identical or Natural Hormone Replacement Therapy
Bio Identical or Natural Hormone Replacement TherapyBio Identical or Natural Hormone Replacement Therapy
Bio Identical or Natural Hormone Replacement Therapy
 
Hrt
HrtHrt
Hrt
 
Menopaus1
Menopaus1Menopaus1
Menopaus1
 
Final Slideshow Version
Final Slideshow VersionFinal Slideshow Version
Final Slideshow Version
 
Disorders of the menstrual cycle 2
Disorders of the menstrual cycle  2Disorders of the menstrual cycle  2
Disorders of the menstrual cycle 2
 
1.menopause dr rabi
1.menopause  dr rabi1.menopause  dr rabi
1.menopause dr rabi
 

Semelhante a Menopause: When to use HRT?

Menopause overview
Menopause overviewMenopause overview
Menopause overviewMini Sood
 
Aging one view dr shriniwas kashalikar
Aging one view dr shriniwas kashalikarAging one view dr shriniwas kashalikar
Aging one view dr shriniwas kashalikarshriniwas kashalikar
 
Presentation10a
Presentation10aPresentation10a
Presentation10alanrevoice
 
Probable Consequences of Menopause on body tissues and systems
Probable Consequences of Menopause on body tissues and systemsProbable Consequences of Menopause on body tissues and systems
Probable Consequences of Menopause on body tissues and systemsiosrjce
 
28.Peri Menopausa
28.Peri Menopausa28.Peri Menopausa
28.Peri MenopausaDeep Deep
 
ageing final.pptx
ageing final.pptxageing final.pptx
ageing final.pptxanintamelie
 
BIOLOGY OF AGEING complete.ppt
BIOLOGY OF AGEING complete.pptBIOLOGY OF AGEING complete.ppt
BIOLOGY OF AGEING complete.pptrenerine
 
molecular presentation 2.pptx
molecular presentation 2.pptxmolecular presentation 2.pptx
molecular presentation 2.pptxbirhankassa
 
Women's Disorders-Revised.ppt
Women's Disorders-Revised.pptWomen's Disorders-Revised.ppt
Women's Disorders-Revised.pptShama
 
menopause part 1.pptx
menopause part 1.pptxmenopause part 1.pptx
menopause part 1.pptxNisha822935
 
MENOPAUSE AND HRT finall From AIIMS .pptx
MENOPAUSE AND HRT finall From AIIMS .pptxMENOPAUSE AND HRT finall From AIIMS .pptx
MENOPAUSE AND HRT finall From AIIMS .pptxssuserac8367
 
26- Menopausal health.ppt
26- Menopausal health.ppt26- Menopausal health.ppt
26- Menopausal health.pptKareemSaeed17
 

Semelhante a Menopause: When to use HRT? (20)

Menopause overview
Menopause overviewMenopause overview
Menopause overview
 
Menopause
MenopauseMenopause
Menopause
 
Aging one view dr shriniwas kashalikar
Aging one view dr shriniwas kashalikarAging one view dr shriniwas kashalikar
Aging one view dr shriniwas kashalikar
 
Presentation10a
Presentation10aPresentation10a
Presentation10a
 
Probable Consequences of Menopause on body tissues and systems
Probable Consequences of Menopause on body tissues and systemsProbable Consequences of Menopause on body tissues and systems
Probable Consequences of Menopause on body tissues and systems
 
Menopause
MenopauseMenopause
Menopause
 
pragya.pptx
pragya.pptxpragya.pptx
pragya.pptx
 
28.Peri Menopausa
28.Peri Menopausa28.Peri Menopausa
28.Peri Menopausa
 
Repro Aging
Repro AgingRepro Aging
Repro Aging
 
Menopause by Dr syed m hussaini
Menopause by Dr syed m hussainiMenopause by Dr syed m hussaini
Menopause by Dr syed m hussaini
 
ageing final.pptx
ageing final.pptxageing final.pptx
ageing final.pptx
 
BIOLOGY OF AGEING complete.ppt
BIOLOGY OF AGEING complete.pptBIOLOGY OF AGEING complete.ppt
BIOLOGY OF AGEING complete.ppt
 
Menopause
MenopauseMenopause
Menopause
 
molecular presentation 2.pptx
molecular presentation 2.pptxmolecular presentation 2.pptx
molecular presentation 2.pptx
 
Menopause
MenopauseMenopause
Menopause
 
Women's Disorders-Revised.ppt
Women's Disorders-Revised.pptWomen's Disorders-Revised.ppt
Women's Disorders-Revised.ppt
 
menopause part 1.pptx
menopause part 1.pptxmenopause part 1.pptx
menopause part 1.pptx
 
menopause geet..pptx
menopause geet..pptxmenopause geet..pptx
menopause geet..pptx
 
MENOPAUSE AND HRT finall From AIIMS .pptx
MENOPAUSE AND HRT finall From AIIMS .pptxMENOPAUSE AND HRT finall From AIIMS .pptx
MENOPAUSE AND HRT finall From AIIMS .pptx
 
26- Menopausal health.ppt
26- Menopausal health.ppt26- Menopausal health.ppt
26- Menopausal health.ppt
 

Mais de Galal Lotfi

Placenta accreta
Placenta accretaPlacenta accreta
Placenta accretaGalal Lotfi
 
Broad ligament Fibroid, 8.5Kg
Broad ligament Fibroid, 8.5KgBroad ligament Fibroid, 8.5Kg
Broad ligament Fibroid, 8.5KgGalal Lotfi
 
Vaginal Hysterectomy: Revival
Vaginal Hysterectomy: RevivalVaginal Hysterectomy: Revival
Vaginal Hysterectomy: RevivalGalal Lotfi
 
Ovarian Tumors, Diagnosis Or Prognosis
Ovarian Tumors, Diagnosis Or PrognosisOvarian Tumors, Diagnosis Or Prognosis
Ovarian Tumors, Diagnosis Or PrognosisGalal Lotfi
 
Endometrial Ablation
Endometrial AblationEndometrial Ablation
Endometrial AblationGalal Lotfi
 
Vaginal Hysterectomy: Safe Technique
Vaginal Hysterectomy: Safe TechniqueVaginal Hysterectomy: Safe Technique
Vaginal Hysterectomy: Safe TechniqueGalal Lotfi
 

Mais de Galal Lotfi (7)

Placenta accreta
Placenta accretaPlacenta accreta
Placenta accreta
 
Broad ligament Fibroid, 8.5Kg
Broad ligament Fibroid, 8.5KgBroad ligament Fibroid, 8.5Kg
Broad ligament Fibroid, 8.5Kg
 
Myomas
MyomasMyomas
Myomas
 
Vaginal Hysterectomy: Revival
Vaginal Hysterectomy: RevivalVaginal Hysterectomy: Revival
Vaginal Hysterectomy: Revival
 
Ovarian Tumors, Diagnosis Or Prognosis
Ovarian Tumors, Diagnosis Or PrognosisOvarian Tumors, Diagnosis Or Prognosis
Ovarian Tumors, Diagnosis Or Prognosis
 
Endometrial Ablation
Endometrial AblationEndometrial Ablation
Endometrial Ablation
 
Vaginal Hysterectomy: Safe Technique
Vaginal Hysterectomy: Safe TechniqueVaginal Hysterectomy: Safe Technique
Vaginal Hysterectomy: Safe Technique
 

Último

Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...astropune
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...narwatsonia7
 
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...narwatsonia7
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...astropune
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...narwatsonia7
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...Arohi Goyal
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...perfect solution
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...vidya singh
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...tanya dube
 

Último (20)

Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Jabalpur Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
♛VVIP Hyderabad Call Girls Chintalkunta🖕7001035870🖕Riya Kappor Top Call Girl ...
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
 
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
Best Rate (Hyderabad) Call Girls Jahanuma ⟟ 8250192130 ⟟ High Class Call Girl...
 
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Dehradun Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 

Menopause: When to use HRT?

  • 1.
  • 4.
  • 5. This is the Change The change is not a disease
  • 6.
  • 8.
  • 9.
  • 10. Menopause is OK but its sequalae are not OK Hot flashes Osteo, Urogenital CVD Mood Collagen
  • 11.
  • 12.  
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.  
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.  
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38. If she does not have any of these, why not to leave her alone??
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.  
  • 60.
  • 61.
  • 62.
  • 63.
  • 65.
  • 66.
  • 67.
  • 68.
  • 69.
  • 70.
  • 71.
  • 72.
  • 73.
  • 74.
  • 75.
  • 76.
  • 77.
  • 78.
  • 79.
  • 80.
  • 81.
  • 82.
  • 83.
  • 84.
  • 85.
  • 86.