Hormone replacement therapy often requires long-term medication, so regular review follow-ups are essential because the doctor has to evaluate the pros and cons based on the results of the review, and only if the pros outweigh the cons can the medication be continued. Usually, follow-ups are held once at 1 month, 3 months and 6 months after the first dose, and then once a year thereafter. The review within 3 months is particularly important because the evaluation of the effect of the medication and discomfort occurs mainly within 3 months of starting hormone therapy, and the doctor will adjust the type and dosage of the medication according to the patient’s efficacy and adverse effects. What to do if you experience vaginal bleeding and breast tenderness within 3 months of starting hormone therapy The main adverse effects within 3 months of starting hormone therapy include vaginal bleeding, breast tenderness and some gastrointestinal symptoms. 1. Vaginal bleeding does not represent a lesion of the endometrium, but is just one of the common phenomena after hormone replacement therapy. Numerous studies have proven that standardized hormone replacement therapy does not increase the incidence of endometrial lesions. However, to be on the safe side, doctors may still recommend that patients undergo vaginal ultrasound and, if necessary, biopsy of the endometrium. 2. Breast swelling and pain are also relatively common, and the symptoms usually diminish gradually without stopping the medication. Of course, some breast examinations are needed to clarify the diagnosis. If it is just breast enlargement, no special attention is needed; if breast nodules are found, it is still recommended to go to breast surgery to further diagnose whether it is a malignant tumor, and then the doctor will judge whether to operate or to follow up regularly. If surgery is needed, hormone replacement therapy may have to be suspended. 3. It is also normal to have milder digestive symptoms, which will usually be relieved in a short period of time. However, if the GI symptoms persist, the doctor will change the medication according to the situation. Contents of follow-up examinations and items to be examined In addition to the above-mentioned mammogram and ultrasound examination, we know that the long-term hazards of menopause include osteoporosis, elevated blood lipids and cardiovascular diseases, so it is also necessary to check bone density, blood lipids, blood sugar, electrocardiogram and so on during the follow-up examinations, which we will not go into here. In short, the purpose of each review is to re-evaluate the risks and benefits and determine the medication plan for the next year. Specific examination items include: ① routine physical examination: height, weight, blood pressure, cardiopulmonary examination, breast examination, gynecological examination, etc.; ② updated medical records, including whether the patient’s symptoms are relieved, whether new uncomfortable symptoms appear, lifestyle exploration, etc.; ③ laboratory examination: liver and kidney function, thyroid function, blood routine, blood sugar, blood lipid, cervical cancer prevention examination; ④ imaging examination: pelvic ultrasound, breast ultrasound or mammography, bone density examination. Reminder: ①Multiple examinations may be required for follow-up examinations, so patients are advised to get a checklist from the doctor before the follow-up examinations, and then come to the clinic for follow-up examinations after all the examination results are available; ②Not only should you bring the results of the new examinations, but also all the results of the previous examinations.