Table 2.

Practical guidance for treating gonadotropin deficiency in women

1. Women should receive oestrogen replacement with or without progesterone (depending on the need for endometrial protection) until at least the age of natural menopause.

2. Discuss how the risks and benefits of HRT differ between postmenopausal women and those with gonadotropin deficiency, particularly if women are reluctant to commence hormone replacement.

3. Highlight the beneficial effects of transdermal oestrogen relative to oral, particularly in those co-prescribed GH replacement.

4. Assess the adequacy of oestrogen replacement periodically by monitoring for symptoms of oestrogen deficiency and evidence of over replacement.

5. Undertake periodic assessments of cardiovascular risk factors. Clinicians should be cognisant of the harmful effects of treatment inertia and manage risk factors appropriately, taking into account women with hypopituitarism’s elevated risk of cardiovascular disease.