'Ask an Expert: Q&A' is a place for health professionals to ask our team of experts about cases seen in work and/or clinical practice.
Questions can cover a wide range of women’s health topics and will be answered by an expert in the multidisciplinary Jean Hailes health professional team. Read more about this series or learn how to ask a question here.
Answering your question for this edition of 'Ask an Expert: Q&A' is Dr Elizabeth Farrell AM, Jean Hailes gynaecologist and Medical Director.
I am looking after a lady with some menopausal flushing and sweats in her mid-40s, she is taking POP [progesterone-only pill]. Can I use topical MHT alongside POP? Is this enough progesterone for endometrial protection?
From Jean Hailes gynaecologist and Medical Director Dr Elizabeth Farrell AM (pictured)
The issues your patient has is that she has flushing and sweating in the perimenopause but I assume is still menstruating as she is on the POP. The dose of POPs are usually very low and are not considered sufficient for standard doses of oestradiol e.g. oestradiol patch 50ug or oestradiol 2mg oral tablet. By topical MHT I assume you mean either transdermal patches or gels.
This woman obviously requires contraception so consider a Levonorgestrel IUD with the oestrogen. I would also exclude thyroid disease in this woman prior to commencing her on hormone therapy.
Vaginal or local/topical oestrogens for vaginal symptoms do not require progestogens.