Why provide HRT?
There are three chief indications for HRT following gonadectomy: (1) initiation of puberty; (2) control of symptoms that affect quality of life; (3) prevention of progressive osteoporosis. The initiation of puberty is a relatively easy justification for HRT. Because this use is uncontroversial, this letter will not discuss this indication. HRT is also indicated for patients who have had gonadectomy when they suffer from considerable symptoms attributable to hypogonadism. Hormone replacement is the simplest and surest method of controlling symptoms attributable to a lack of estrogen such as hot flashes, vaginal dryness, as well as changes in skin, mood and libido. Symptom control is, of course, important for a person’s quality of life. It is also important to creating and maintaining a useful and durable patient-physician relationship. HRT may be used to prevent progressive osteoporosis in patients who have had gonadectomies because of an anomaly in sex development. However, because alt
