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I m aware other estrogen products such as premarin are now considered a higher risk.

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In women with no personal history of VTE but with a first degree relative with a history of thrombosis at young agescreening may be offered after careful counselling regarding its limitationsonly a proportion of thrombophilic defects are identified by screeningIf a thrombophilic defect is identified which segregates with thrombosis in family members or if the defect isseveree.gantithrombinprotein Sor protein C deficiencies or a combination of defectsHRT is contraindicated.

Use of estrogen-aloneor in combination with a progestinshould be with the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual womanPostmenopausal women should be re-evaluated periodically as clinically appropriate to determine if treatment is still necessary.

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