ABSTRACT
Any woman at the climacteric (usually aged 40-60) should be considered for oestrogen replacement on request, as should oophorectomised woman at any age. The main indication is patient request.
Symptoms of climacteric include oestrogen deficiency (flushes, vaginal dryness, atrophy), amenorrhoea over six months duration, serum FSH greater than 20 (especially if the patient has had a hysterectomy without oophorectomy, as the time that oestrogen failure occurs is difficult to predict) and psychological symptoms (depression, lethargy, psychosexual).
