153 - References

References

Depression and anxiety disorders CHAPTER 3 If COCPs are ineffective, not tolerated, or contraindicated, a second-­line approach is to prescribe continuous percutaneous bioidentical estradiol (i.e. implants or transdermal preparations).9 In patients with a uterus, combination with a progestogen is required to reduce the risk of endometrial hyperplasia. Gonadotrophin-­releasing hormone agonists lead to (reversible) medical menopause. This can be used as a diagnostic test for PMDD and/or to determine the likely benefits of a hysterectomy and oophorectomy. Owing to the adverse effects typically associated with acute menopause, an ‘addback’ regime of estradiol alone or combined with a progestogen is required (i.e. dependent on whether the woman has a uterus). References

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