A. Continuous estrogens and progestogens (oral) hormone replacement therapy (HRT)
B. HRT not recommended
C. Levonorgestrel IUS (Mirena)
E. Estrogens plus progestogens plus testosterone (oral)
F. Testosterone only (oral) HRT
G. Estrogens only (oral) HRT
H. Estrogen transdermal patch and vaginal progesterone cream HRT
I. Estrogen transdermal patch only HRT
J. Estrogen cream or pessaries vaginally HRT
K. Estrogen cream for vaginal application and oral progestogens HRT
L. Sequential Estrogens and progestogens (oral) HRT
Choose the single most appropriate hormonal drug therapy from the list of options above. Each option may be used once, more than once, or not at all.
1. A 50-year-old woman presents with one episode of postmenopausal bleeding which lasted for 2 days but has now stopped. Clinical examination reveals atrophic vagina and cervix. A transvaginal scan shows an endometrial thickness of 3mm. She gives a history of breast cancer in her first cousin who is 69 years old.