Q: I am a 43 years old woman who underwent hysterectomy 8 years back and since then I am on hormone replacement therapy (HRT). I am taking Premarin 0.625 mg, A to Z, Sandocal and Topocar 400 daily. My family doctor discourages me from taking HRT on a continuous basis. Should I continue taking these medicines?

A:You have not given any information as to the reasons for hysterectomy and also whether ovaries were removed or left behind. HRT is basically required for tackling unpleasant symptoms of hormonal deprivation such as hot flushes, psychological problems and even more important to prevent osteoporosis. If your BMD (bone mineral density) is fine and you do not have distressing "menopausal" symptoms, then I should think HRT is no longer required since after surgical removal of uterus, one year's therapy is generally acceptable though some experts are in favour of continued therapy till 50 years of age. There are conflicting views on the use of HRT due to its opposite effects: reduction of heart attacks on one hand but increased risk of breast cancer on the other, not to mention side effects such as weight gain. If at all HRT is required, then Premarin (conjugated estrogens) is a good choice. Sandocal (calcium and vitamin D) may be helpful. Nothing else is required such as A to Z that contains minute, sub-therapeutic (hence ineffective) amounts of a long list of vitamins and minerals. Topocar does not appear on the national and global databank of quality medicines.