Internal medicine

  Hormone Replacement Therapy in Postmenopausal Women: A Practical Guide to Initiation and Monitoring Dr Neeraj Manikath, claude. ai  Abstract Hormone replacement therapy (HRT) remains one of the most effective treatments for vasomotor symptoms and genitourinary syndrome of menopause, yet its prescription requires nuanced clinical judgment. This review provides a comprehensive, evidence-based approach to initiating and monitoring HRT in postmenopausal women, incorporating current FDA recommendations and contemporary clinical wisdom. We present practical algorithms, monitoring strategies, and clinical pearls derived from landmark trials and real-world experience to guide internists and gynecologists in optimizing therapeutic outcomes while minimizing risks. Introduction The landscape of HRT has evolved dramatically since the Women's Health Initiative (WHI) findings in 2002 fundamentally altered our approach to menopausal hormone therapy.¹ Today's evidence-based practice emphas...

  CLINICAL REVIEW A Stepwise Clinical Approach to the Management of Hypogonadotropic Hypogonadism in Girls: From Diagnosis to Fertility For Postgraduate Medical Students and Endocrinology Consultants Dr Neeraj Manikath , claude.ai ABSTRACT Hypogonadotropic hypogonadism (HH) in girls represents a complex endocrine disorder characterized by absent or incomplete pubertal development due to deficient gonadotropin-releasing hormone (GnRH) secretion or action. This comprehensive review provides a practical, stepwise clinical framework for diagnosis and management, with emphasis on bedside clinical pearls, therapeutic protocols, and long-term outcomes including fertility preservation. We present evidence-based treatment algorithms integrating hormonal replacement therapy, transition protocols, and fertility management strategies. Special attention is given to distinguishing constitutional delay from pathological HH, monitoring treatment response, optimizing bone health, and addres...