For many years a popular form of postmenopausal replacement therapy has been an injection of Climacterone, a combination of estradiol and testosterone that is given every six weeks. This preparation not only treats estrogen-deficiency symptoms but also may improve libido as a result of the testosterone in the mixture. Occasionally, a small dose of testosterone is prescribed alone specifically to treat problems of decreased libido.
Treatment Routines The most common routine using both estrogen and progestin is to give estrogen alone for 14 to 15 days, then add progestin (such as Provera) for 7 to 14 days. Both hormones are stopped, and a period follows in one or two days. The cycle is repeated monthly.
Similarly, if continuous estrogen is given and progestin is added only for 12 to 14 days, a period is expected one or two days after the progestin is stopped. This routine is frequently used with transdermal preparations.
For women who do not wish to have a period but want and need HRT, a combined routine of estrogen and progestin is given continuously. After a short adjustment period (approximately six months) during which some vaginal bleeding may occur, most women enjoy all the benefits of HRT, including relief of hot flashes, insomnia and vaginal and urinary symptoms, while protecting themselves from osteoporosis and cardiovascular problems.
