This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
[{'content': 'Major source of estrogen in postmenopausal women is: \nSelect and explain. \nA. Peripheral conversion of androstenedione, B. Secretion from adrenals, C. Testosterone from the ovary, D. HRT', 'role': 'user'}, {'content': 'Answer: A \nExplanation: All postmenopausal and symptomatic per menopausal women who do not have contraindication particularly\xad\n\nThose with high risk factors osteoporosis.\nThose with premature menopause\nEvaluation before starting HRT:\nHistory-personal, medical, gynecological, family\nExamination -HT, wt., BMI, BP, breast, vaginal examination\nPap smear\nMammography\nLipid profile\nTransvaginal sonography-endometrial thickness\nWork up relevant to symptoms, e.g. urinary continence, carbohydrate intolerance, psychoemotional states.\n\nContraindications of HRT:\n\nPregnancy\nCA breast\nCA endometrium\nUndiagnosed abnormal vaginal bleeding\nActive liver disease\nPresent deep vein thrombosis, thromboembolic disorder\n\nInvestigation not routinely needed before starting HRT\n\nEndometrial sampling-Only done if history of abnormal vaginal bleeding, TVS shows endometrial thickness> 5 mm.\nSerum FSH-Only done if diagnosis of menopause is not clear, e.g. vasomotor symptoms in absence of amenorrhoea\nBone densitometry-Using DEXA (dual energy X-ray absorptiometry) oflumber vertebrae, hip bone for women with risk factors for osteoprosis, persistent backache, bone aches, history of recent fracture, for research purpose', 'role': 'assistant'}]