Hormone replacement therapy drugs, reviews. Menopause therapy: history and new generation drugs Consequences of using drugs

According to experts, new drugs generations of HRT are the optimal method of treating menopausal syndrome. The products contain a minimal amount of synthetic hormones, which makes the drugs practically harmless and suitable for long-term use. Let's consider reviews about.

Hormone replacement therapy

For many women, menostasis becomes a very difficult period in life. However, it is completely wrong to regard menopause as a disease, just as it is completely wrong to regard hormone therapy as a treatment for menopause. HRT for menopause with new generation drugs, according to doctors, is only to help the body move more smoothly into the stage of complete cessation of reproductive function, without the risk of developing dangerous pathologies caused by a sharp estrogen deficiency. Not everyone can take synthetic estrogens, and even in the absence of contraindications, gynecologists do not advise some women to resort to hormone therapy.

For example, a woman does not experience strong hot flashes, her hormonal levels are within acceptable limits, and the risks of developing osteoparosis are low - experts cannot advise such a woman to take HRT, since it is clear that her body copes with hormonal changes on its own and does not require treatment. It’s another matter when a patient comes to the doctor with complaints of a significant decrease in quality of life, frequent and intense hot flashes, nervous exhaustion and the inability to continue her usual lifestyle. Such a woman will be carefully examined, and if there are no contraindications, HRT may be recommended to her.

Absolute contraindications:

• Uterine bleeding;
• Suspicions of cancer;
• History of oncology;
• Hypertension;
• Atherosclerosis;
• Ischemia;
• Benign neoplasms;
• Diabetes;
• Liver pathologies;
• Kidney pathologies;
• Pregnancy and lactation.

Important! Treatment with HRT is possible only under the strict supervision of a specialist. Self-medication is strictly prohibited!

Early menopause is a pathology that is dangerous primarily due to the development of complications. Menostasis is considered early if reproductive function begins to fade before the age of 40. Such patients most often encounter severe symptoms of menopause, because, in fact, the body is not yet ready for hormonal changes, and a sharp deficiency of estrogen leads to early hypertension, heart disease, osteoporosis, benign neoplasms, Alzheimer's disease and other diseases.

In the absence of contraindications, women with early menopause should definitely take hormonal pills. It is HRT in this case that will allow you to delay menopause for several years and smooth out unpleasant manifestations, and will also prevent the occurrence of the above pathologies. The same can be said for patients with surgical menopause, they also need to take HRT to protect themselves from these diseases.

Important! Before prescribing HRT for early menopause, the cause of the deviation must be identified.

Non-hormonal drugs taken during menopause to relieve symptoms

Hormone-free treatments are alternative methods for relieving menopausal symptoms. Today, there are a lot of herbal medicines on sale that have an estrogen-like effect and, while not being synthetic analogues of sex substances, can also eliminate the unpleasant symptoms of menostasis. Phytohormones are quite effective with long-term use, but in order to feel the first positive changes in well-being, they need to be taken for at least 2-3 months.

Phytohormones are not drugs; they have virtually no contraindications and are easily tolerated by patients. Many ladies today choose herbal remedies for menopause, and experts agree with this choice, but only if the patient does not require serious hormonal treatment. The choice of treatment always remains with the patient, but experts insist that if you are prescribed certain pills, it is better to follow the doctor’s recommendations so as not to encounter unpleasant complications in the future.

Important! Not hormone therapy also requires the supervision and control of a doctor, because dietary supplements also have contraindications and side effects.

Many reviews can really be alarming. Ladies on social networks and forums share their sad stories when hormones, in their opinion, cause the development of cancer, fibroids, cysts and others dangerous diseases, but gynecologists insist that with an adequate approach, hormone replacement therapy cannot cause these diseases. Let's consider the most common myths about, which often become a reason for refusing to take funds from this group:

• HRT causes cancer. This is of course the scariest and most widespread myth. However, according to official statistics, the incidence of cancer due to hormone therapy is approximately 1 in 5,000 diseases. Moreover, more than half of the cases occur in women with a genetic predisposition to cancer, and another 30% are discovered when they take medications on their own without prior examination and observation.
• Hormone therapy causes obesity. This is a fundamentally incorrect statement; on the contrary, with the right medication and dosage, medications in this group prevent excess weight gain. You just need to know that fat reserves during menopause are just the body’s reaction to a lack of estrogen. The body, thus, tries to compensate for the deficiency of the sex hormone, because fat synthesizes one of the types of estrogens.
• Hormone therapy is forever. Completely false. Patients who claim that it is impossible to stop taking hormones should simply contact an experienced doctor. Both entry and exit from hormone replacement therapy should be smooth, by changing the dosage and schedule of taking the medication.

In addition to this, there are a lot of myths that are passed on from mouth to mouth and are filled with horrifying details, but experts advise paying attention to the advantages that treatment can give, namely:

• Absence of hot flashes and other manifestations of menostasis. Thanks to replacement therapy, the body does not face estrogen deficiency, which means that all organs and systems continue to function properly.
• Prevention of long-term complications of menostasis. Today, only hormone replacement treatment can guarantee the prevention of osteoparosis, hypertension, heart attack and stroke due to a lack of sex hormones.
• Great appearance. Patients taking replacement therapy do not experience rapid aging and look much younger than their peers who refuse treatment. It should be noted that youth is preserved not only on the face, but also in the internal organs, blood vessels, reproductive system, etc.
• Cheerfulness and stable mood. The absence of depression, irritability and apathy allows ladies to lead a normal lifestyle and continue to enjoy everyday little things. Such women are sociable and cheerful, they enjoy life and can afford to do what they love.
• Completeness of sexual life. One of the problems of menostasis is decreased libido and vaginal dryness, which often become a reason for a complete refusal of physical intimacy. Hormone replacement therapy eliminates these abnormalities and allows normal life. sex life, which undoubtedly has a positive effect on self-esteem, family relationships, health status, etc.

Important! Despite all positive sides replacement therapy, this treatment cannot be used as an anti-aging agent or used in advance, even before the onset of unpleasant symptoms.

List of new generation HRT drugs

Reviews about hormone replacement therapy drugs for menopause are quite varied, but patients and doctors highlight the most effective medications of the new generation, namely:

• Klimonorm. The product contains two synthetic analogues of the sex hormones estrogen and histagene, which helps to avoid hormonal imbalance, which in some cases becomes an impetus for the development of oncology.
• . This is a new generation two-phase combination drug that effectively relieves the main symptoms of menopause and is a prevention of long-term complications of menopause.
• . The tablets contain active substances estradiol and drospirenone. The drug is prescribed for both early and timely menostasis as a prevention of long-term complications, and a drug that significantly improves the well-being of a woman during menopause.
• Levial. Active ingredient: tibolone. This medication is gaining more and more popularity, because it rarely causes side effects and perfectly fights all manifestations of menopause. According to gynecologists, this is a drug of the 21st century.

Hormone replacement therapy - abbreviated HRT - is now actively used in many countries around the world. To prolong their youth and replenish sex hormones lost with age, millions of women abroad choose hormonal therapy for menopause. However, Russian women are still wary of this treatment. Let's try to figure out why this happens.

Should I take hormones during menopause?or 10 myths about HRT

After the age of 45, women’s ovarian function begins to gradually decline, which means the production of sex hormones decreases. Along with a decrease in estrogen and progesterone in the blood comes deterioration in physical and emotional state. Menopause is ahead. And almost every woman begins to worry about the question: what can she do take during menopause to avoid aging?

In these difficult times, the modern woman comes to the aid of. Because during menopause estrogen deficiency develops, it is these hormones that have become the basis for all medications drugs HRT. The first myth about HRT is associated with estrogens.

Myth No. 1. HRT is unnatural

There are hundreds of queries on the Internet on the topic:how to replenish estrogen for a woman after 45-50 years . No less popular are queries about whether they useherbal remedies for menopause. Unfortunately, few people know that:

• HRT drugs contain only natural estrogens.
• Today they are obtained by chemical synthesis.
• Synthesized natural estrogens are perceived by the body as their own due to complete chemical identity with the estrogens produced by the ovaries.

And what could be more natural for a woman than her own hormones, analogues of which are taken to treat menopause??

Some might argue that herbal remedies are more natural. They contain molecules that are similar in structure to estrogens, and they act on receptors in a similar way. However, their action is not always effective in removing early symptoms menopause (hot flashes, increased sweating, migraines, blood pressure surges, insomnia, etc.). They also do not protect against the consequences of menopause: obesity, cardiovascular diseases, osteoporosis, osteoarthritis, etc. In addition, their effect on the body (for example, on the liver and mammary glands) has not been well studied and medicine cannot vouch for their safety.

Myth No. 2. HRT is addictive

Hormone replacement therapy for menopause- just a replacement for the lost hormonal function of the ovaries. Drugs HRT is not a drug; it does not disrupt the natural processes in a woman’s body. Their task is to compensate for estrogen deficiency, restore the balance of hormones, and also improve overall well-being. You can stop taking the medications at any time. True, it is better to consult a gynecologist before this.

Among the misconceptions about HRT, there are truly crazy myths that we get used to from our youth.

Myth No. 3. HRT will make a mustache grow

The negative attitude towards hormonal drugs in Russia arose quite a long time ago and has already moved to the subconscious level. Modern medicine has come a long way, but many women still trust outdated information.

The synthesis and use of hormones in medical practice began in the 50s of the 20th century. A real revolution was made by glucocorticoids (adrenal hormones), which combined powerful anti-inflammatory and antiallergic effects. However, doctors soon noticed that they affected body weight and even contributed to the manifestation of masculine characteristics in women (the voice became rougher, excess hair growth began, etc.).

Much has changed since then. Preparations of other hormones have been synthesized ( thyroid gland, pituitary gland, female and male). And the type of hormones has changed. Modern medications contain hormones that are as “natural” as possible, and this makes it possible to significantly reduce their dose. Unfortunately, all the negative qualities of outdated high-dose drugs are attributed to new, modern ones. And this is completely unfair.

The most important thing is that HRT preparations contain exclusively female sex hormones, and they cannot cause “masculinity.”

I would like to draw your attention to one more point. A woman's body always produces male sex hormones. And that's okay. They are responsible for a woman’s vitality and mood, interest in the world and sex drive, as well as the beauty of her skin and hair.

When ovarian function declines, female sex hormones (estrogens and progesterone) stop being replenished, while male sex hormones (androgens) are still produced. In addition, they are also produced by the adrenal glands. That's why you shouldn't be surprised that older ladies sometimes need to pluck their mustache and chin hairs. And HRT drugs have absolutely nothing to do with it.

Myth No. 4. People get better from HRT

Another unreasonable fear is to gain weight while taking drugs hormone replacement therapy. But everything is quite the opposite. Prescription of HRT during menopause can have a positive effect on women's curves and shapes. HRT contains estrogens, which generally have no ability to influence changes in body weight. As for the gestagens (these are derivatives of the hormone progesterone) included innew generation of HRT drugs, then they help distribute adipose tissue “according to the female principle” and allow during menopause keep your figure feminine.

Don’t forget about the objective reasons for weight gain in women after 45. First: at this age, physical activity noticeably decreases. And second: the influence of hormonal changes. As we have already written, female sex hormones are produced not only in the ovaries, but also in adipose tissue. During menopause, the body tries to reduce the lack of female sex hormones by producing them in fatty tissues. Fat is deposited in the abdominal area, and the figure begins to resemble a man’s. As you can see, HRT drugs do not play any role in this matter.

Myth No. 5. HRT can cause cancer

The idea that taking hormones can cause cancer is an absolute misconception. There is official data on this topic. According to World Health Organization, thanks to the use hormonal contraceptives and their oncoprotective effect annually prevents about 30 thousand cases of cancer. Indeed, estrogen monotherapy increased the risk of endometrial cancer. But similar treatment remains far in the past. Partnew generation HRT drugs includes progestogens , which prevent the risk of developing endometrial cancer (body of the uterus).

As for breast cancer, there has been plenty of research on the effect of HRT on its occurrence. This issue has been seriously studied in many countries around the world. Especially in the USA, where HRT drugs began to be used back in the 50s of the 20th century. It has been proven that estrogens, the main component of HRT preparations, are not oncogenes (that is, they do not unblock the gene mechanisms of tumor growth in the cell).

Myth No. 6. HRT is bad for the liver and stomach

There is an opinion that a sensitive stomach or liver problems may be a contraindication for HRT. This is wrong. New generation HRT drugs do not irritate the mucous membranes gastrointestinal tract and do not have a toxic effect on the liver. It is necessary to limit the use of HRT drugs only in cases where there are pronounced liver dysfunctions. And after the onset of remission, it is possible to continue HRT. Also, taking HRT drugs is not contraindicated in women with chronic gastritis or with peptic ulcer stomach and duodenum. Even during seasonal exacerbations, you can take tablets as usual. Of course, simultaneously with therapy prescribed by a gastroenterologist and under the supervision of a gynecologist. For women who are especially concerned about their stomach and liver, special forms of HRT preparations are produced for local application. These may be skin gels, patches or nasal sprays.

Myth No. 7. If there are no symptoms, then HRT is not needed

Life after menopause not all women immediately aggravated by unpleasant symptoms and a sharp deterioration in well-being. In 10 - 20% of the fair sex vegetative system resistant to hormonal changes and therefore for some time they are spared from the most unpleasant manifestations during menopause. If there are no hot flashes, this does not mean at all that you do not need to see a doctor and let the course of menopause take its course.

The serious consequences of menopause develop slowly and sometimes completely unnoticed. And when after 2 years or even 5-7 years they begin to appear, it becomes much more difficult to correct them. Here are just a few of them: dry skin and brittle nails; hair loss and bleeding gums; decreased sexual desire and vaginal dryness; obesity and cardiovascular diseases; osteoporosis and osteoarthritis and even senile dementia.

Myth No. 8. HRT has many side effects

Only 10% of women feel certain discomfort when taking HRT drugs. Those who smoke and are overweight are most susceptible to unpleasant sensations. In such cases, swelling, migraines, swelling and tenderness of the breast are noted. Usually these are temporary problems that disappear after reducing the dosage or changing the dosage form of the drug.

It is important to remember that HRT cannot be carried out independently without medical supervision. Each specific case requires an individual approach and constant monitoring of results. Hormone replacement therapy has a specific list of indications and contraindications. Only a doctor, after conducting a number of studies, will be able tochoose the right treatment . When prescribing HRT, the doctor observes the optimal balance between the principles of “usefulness” and “safety” and calculates at what minimum doses of the drug the maximum result will be achieved with the least risk of side effects.

Myth No. 9. HRT is unnatural

Is it necessary to argue with nature and replenish sex hormones lost over time? Of course you need it! The heroine of the legendary film “Moscow Doesn’t Believe in Tears” claims that after forty, life is just beginning. And indeed it is. A modern woman at the age of 45+ can live a life no less interesting and eventful than in her youth.

Hollywood star Sharon Stone turned 58 years old in 2016 and she is sure that there is nothing unnatural in a woman’s desire to remain young and active as long as possible: “When you are 50, you feel that you have a chance to start life anew: a new career, a new love ... At this age we know so much about life! You may be tired of what you did for the first half of your life, but that doesn't mean you should sit back and play golf in your backyard. We are too young for this: 50 is the new 30, a new chapter."

Myth No. 10. HRT is an understudied treatment method

The experience of using HRT abroad is more than half a century, and all this time the technique has been subjected to serious control and detailed study. Gone are the days when endocrinologists used trial and error to find best practices, regimens and dosages of hormonal drugs for menopause. In Russia hormone replacement therapycame only 15-20 years ago. Our compatriots still perceive this treatment method as little studied, although this is far from the case. Today we have the opportunity to use proven and highly effective remedies with a minimum number of side effects.

HRT for menopause: pros and cons

For the first time, HRT drugs for women in menopause began to be used in the USA in the 40-50s of the 20th century. As treatment became more popular, it was found that the risk of disease increased during the treatment period uterus ( endometrial hyperplasia, cancer). After a thorough analysis of the situation, it turned out that the reason was the use of only one ovarian hormone - estrogen. Conclusions were drawn, and in the 70s biphasic drugs appeared. They combined estrogens and progesterone in one tablet, which inhibited the growth of the endometrium in the uterus.

As a result of further research, information was accumulated about positive changes in a woman’s body during hormone replacement therapy. To date known that its positive effect extends not only to menopausal symptoms.HRT during menopauseslows down atrophic changes in the body and becomes an excellent prophylactic agent in the fight against Alzheimer's disease. It is also important to note the beneficial effects of therapy on a woman’s cardiovascular system. While taking HRT drugs, doctors recorded improving lipid metabolism and reducing blood cholesterol levels. All these facts make it possible today to use HRT as a prevention of atherosclerosis and heart attack.

Information from the magazine was used [Climax is not scary / E. Nechaenko, - Magazine “New Pharmacy. Pharmacy assortment”, 2012. - No. 12]

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INTERACTIVE

It is extremely important for women to know everything about their health - especially for initial self-diagnosis. This rapid test will allow you to better listen to the state of your body and not miss important signals in order to understand whether you need to see a specialist and make an appointment.

After 45-50 years, the level of estrogen in a woman’s blood begins to gradually decrease. This can lead to symptoms such as night sweats, insomnia, and calcium leaching from bones.

Hormone replacement therapy aims to correct estrogen deficiency using medications containing synthetic (artificial) hormones and prevent these symptoms.

Why is hormone replacement therapy (HRT) needed during menopause?

Hormone replacement therapy can weaken or eliminate the symptoms of menopause, as well as reduce the risk of developing some consequences of menopause, such as osteoporosis, heart disease, atrophic vaginitis (depletion of the vaginal mucosa) and others.

Who needs hormone replacement therapy during menopause?

Despite the fact that hormone replacement therapy can ease the symptoms of menopause, taking hormones during menopause is not always really necessary and, most importantly, safe.

Hormone replacement therapy is prescribed:

To relieve severe hot flashes and night sweats, if these symptoms cause severe discomfort and interfere with daily life.

When symptoms such as: severe dryness and discomfort in the vagina appear.

Hormone replacement therapy is not prescribed if the only problem associated with menopause is depression. Although hormones can sometimes help combat depressed mood, depression is preferably treated with antidepressants.

Who should not take hormones during menopause?

• You have had breast cancer
• You had
• You have serious liver disease and liver failure
• Your blood triglyceride levels are elevated
• You have had deep vein thrombosis in your legs
• You
• You
• You

What tests need to be done before starting to take hormones?

In order to make sure that you need hormone replacement therapy and you have no contraindications for prescribing hormones, you need to undergo the following examinations and take the following tests:

• Height and weight measurement, definition.
• Blood pressure measurement.
• Examination by a mammologist and mammography (to exclude diseases of the mammary glands)
• Examination by a gynecologist
• General blood analysis
• General urine analysis
• Measuring triglycerides and cholesterol levels in the blood
• Measuring blood sugar levels
• (pap test)

In some cases, your doctor may order other tests or examinations, depending on your medical history.

What medications are prescribed for hormone replacement therapy?

Preparations containing estrogens are the most effective means in the treatment of symptoms of menopause (vaginal dryness, hot flashes, osteoporosis).

Hormones can be prescribed not only in the form of tablets, but also in the form of intramuscular injections, hormonal patches, subcutaneous implants, vaginal suppositories, etc. The choice of drug for hormone replacement therapy depends on how long ago your periods stopped, what symptoms bother you, and what diseases and surgeries you have had previously.

There are many different drugs prescribed for hormone replacement therapy. We will list just a few of them available in Russia:

• In the form of tablets (or dragees): Premarin, Hormoplex, Klimonorm, Klimen, Proginova, Cyclo-proginova, Femoston, Trisequence and others.
• In the form of intramuscular injections: Gynodian-Depot, which is administered every 4 weeks.
• In the form of hormonal patches: Estraderm, Klimara, Menorest
• In the form of skin gels: Estrogel, Divigel.
• In the form of an intrauterine device: .
• In the form of vaginal suppositories or vaginal cream: Ovestin.

Attention: the choice of drug is made only by the attending gynecologist. Self-prescribing any of these medications can be dangerous.

Can I get pregnant while taking hormones?

Hormone replacement therapy does not suppress ovulation, which means you still have a theoretical risk of becoming pregnant. Therefore, you need to use an additional 1 year after your last menstrual period if you are 50 years or more, or 2 years after your last menstrual period if you are under 50 years old.

How long can hormone replacement therapy last?

Most gynecologists are of the opinion that hormone replacement therapy is safe if it lasts no more than 4-5 years. However, there is evidence that treatment can be safe for 7-10 years in a row. Taking hormones for 10 years or more may increase the risk of ovarian cancer and other complications.

Unfortunately, after stopping taking hormones, some symptoms (vaginal dryness, urinary incontinence, etc.) may return.

What side effects can hormone replacement therapy cause?

Side effects may occur during hormone replacement therapy. Some of these effects are safe and go away after a few months, while others are a reason to stop hormonal treatment.

They often appear during hormonal treatment. Most often, this is only a slight spotting that goes away 3-4 months after the start of hormonal therapy. If the spotting lasts longer or appears later than 4 months after the start of hormonal therapy, then the woman needs a more thorough examination to make sure that it is not a polyp or endometrial cancer.

Swelling and increased sensitivity Breast problems are also a common side effect of hormonal treatment, but these symptoms go away after a few months.

Water retention in the body can lead to edema and weight gain.

What are the risks of hormone replacement therapy?

Hormone replacement therapy is undoubtedly effective method treatment, and nevertheless, against the background of long-term hormonal treatment, the following complications may develop:

Breast cancer. Whether hormone therapy causes breast cancer is still a matter of debate in the scientific world. Research conducted in this area provides conflicting results. However, most gynecologists are of the opinion that hormone replacement therapy slightly increases the risk of breast cancer, especially with a long duration of treatment in women over 50 years of age.

Studies have shown that using certain hormone replacement therapy drugs for 5 years or more may increase the risk of endometrial cancer. The main sign of endometrial cancer is spotting and irregular uterine bleeding, so when these symptoms appear in a menopausal woman, she needs an examination (endometrial biopsy).

The risk of blood clots may increase in women taking hormonal medications. That is why, if you have previously had thrombosis, hormone replacement therapy is not recommended.

Risk of stone formation in gallbladder(cholelithiasis) is slightly increased among postmenopausal women taking hormonal medications.

Ovarian cancer. Long-term hormonal treatment (10 years or more) increases the risk of ovarian cancer. Hormone replacement therapy lasting less than 10 years does not increase this risk.

How can you reduce the risk of these complications?

To minimize the risk of complications and side effects of hormonal therapy, first of all, it is necessary for your doctor to select the treatment that is right for you. In this case, the doctor must prescribe the most small dose medicine that gives the desired effect, and treatment should last exactly as long as necessary.

Since hormone replacement therapy can last for years, you need to visit your doctor regularly, even if nothing bothers you:

A month after the start of hormonal treatment you need to take biochemical analysis blood to determine the level of fats (lipids) in the blood, liver function indicators (ALT, AST, bilirubin), general urine analysis, measure blood pressure.

At each subsequent visit: general urine test, blood pressure measurement.

Every 2 years: biochemical blood test to determine the level of fats (lipids) in the blood, liver function indicators (ALT, AST, bilirubin), blood sugar levels, general urinalysis, mammography.

Menopause For many women it can be a serious challenge. The thing is that with the onset of menopause, the body experiences a gradual decline in reproductive function, as well as serious hormonal changes that affect different systems and organs. Hence the symptoms of menopause. In most cases, representatives of the fair sex can only normalize their condition special drugs as part of hormone replacement therapy. What kind of means are these? What are their indications for use and are there any contraindications? Which HRT drugs are most commonly prescribed?

Briefly about menopause

The menopause is a natural stage in the life of every woman, the next step, and not a disease, as many representatives of the fair sex believe, awaiting its onset with horror. On average, the onset of menopause occurs at 45-55 years of age, but there can be earlier or later menopause, which is influenced by certain factors.

All changes that occur in the body during this period are a consequence of a deficiency of female sex hormones due to the shutdown of ovarian function. This can happen with age or involuntarily if there has been surgery to remove the ovaries, chemotherapy or radiation therapy.

Lack of estrogen leads to symptoms that can appear in a woman even before her last period. Early symptoms of menopause include:

• frequent hot flashes;
• increased sweating;
• sudden changes in mood, irritability, anxiety;
• sleep disorders;
• fast fatiguability;
• changes in blood pressure;
• cardiopalmus;
• memory loss.

Many women do not feel such symptoms or they are mild, so they ignore them, which is fundamentally wrong. You should definitely consult a doctor to prevent more complex consequences of menopause, in particular:

• deterioration of the condition of the skin, hair, nails;
• unpleasant sensations in the vagina, which is expressed in dryness, itching, pain during sexual intercourse;
• problems with urination (frequent urge, involuntary urination, cystitis);
• diseases of the heart and blood vessels (heart attack, stroke, increased arterial decrease in libido;
• blood pressure, atherosclerosis);
• diseases of bones and joints.

What methods of solving the problem exist?

The following options will help you live through the menopause beautifully without being a hostage to its symptoms:

1. Modern cosmetology.
2. Healthy lifestyle. It is very important here to refuse bad habits, eat a balanced and healthy diet, and also be physically active, but do not overload the body.
3. Treatment non-hormonal drugs. Each drug, selected exclusively by a doctor, is aimed at overcoming a specific symptom. Such treatment is quite expensive and may not always give the expected effect.
4. Hormone replacement therapy (HRT). Timely treatment with hormonal drugs will help cope with many unpleasant manifestations of menopause.

HRT: what is it?

The method of treatment with drugs that contain predominantly female sex hormones is called hormone replacement therapy. Treatment is aimed at eliminating the lack of estrogen and progesterone, and this is caused by a decrease in the production of sex hormones by the endocrine glands.

Hormone replacement therapy for menopause can be of two types:

• Long lasting. Treatment of serious changes in the body, in particular the functioning of the heart, blood vessels, central nervous system, and endocrine glands. The course of treatment is 2-4 years, in some cases treatment can last 10 years.
• Short-term. Treatment of menopause symptoms. The course of treatment is 1-2 years.

Taking hormonal medications requires strict adherence to the doctor’s recommendations; only in this case can you count on successful treatment. New generation hormonal drugs can reduce pain and restore mucous membranes, reduce the frequency and intensity of hot flashes, and improve the condition of the skin, nails, and teeth.

Benefits of hormone replacement treatment

• New generation hormone replacement drugs may contain female sex hormones, as well as thyroid and pituitary hormones. They do not contain male hormones. The new generation of drugs have synthetic hormones that are as close in composition as natural hormones, which makes it possible to reduce the dosage and the manifestation of male characteristics in women, in particular hair growth and deepening of the voice.
• Do not contain narcotic substances, accordingly, the body does not get used to it. You can stop treatment at any time, but only after consulting your doctor.
• Hormone-containing drugs prescribed for menopause do not cause weight gain. The cause may be a decrease in physical activity.
• Hormone-containing preparations contain hormones synthesized in the laboratory, the composition of which is completely identical to the hormones produced by female body. This is what determines their widespread effect. If we compare these drugs with phytohormones, the latter are many times weaker and only temporarily alleviate the condition.
• Progesterone in modern hormonal drugs reduces the risk of the formation of estrogen-dependent tumors, and drugs selected individually are good prevention against cancer.
• It is convenient to use, because HRT for menopause, new generation drugs are available in various dosage forms. For gastrointestinal diseases, a type of hormonal medication such as a gel or patch can be used.

Indications and contraindications for hormone treatment

Hormone replacement therapy for menopause is a symptomatic and preventive method. Treatment with hormonal drugs is aimed at overcoming existing symptoms of menopause. If we talk about prevention, it is carried out to reduce the risk of complications of menopause that can arise due to hormonal changes at a late stage, in particular osteoporosis, arterial hypertension.

HRT is prescribed for menopause in the following cases:

• early menopause;
• pathologies of the heart and blood vessels;
• high risk of developing osteoporosis;
• high probability of developing diabetes mellitus.

There are contraindications to HRT in the presence of the following pathologies:

• liver diseases;
• thrombosis;
• estrogen dependent tumors;
• pathologies of the heart and blood vessels (complicated);
• diabetes(complicated);
• cancer of the genital organs, mammary glands, endometrium of internal organs;
• uterine bleeding of unknown nature;
• pregnancy (possible during early stages menopause).

Can there be side effects from the treatment?

HRT has a selective effect, and the drugs are prescribed in low dosages, so the risk of side effects is minimized. Adverse reactions organism may occur in rare cases, and their intensity is weakly expressed.

So, more often than other reactions, a woman may experience engorgement of the mammary glands. This phenomenon will go away on its own after a few months, when the body adapts to the introduction of female sex hormones.

It is extremely rare to have symptoms such as nausea and headache.

It is prohibited to discontinue medications on your own, as well as change the dosage. Only the doctor who prescribed it can correct HRT.

Do I need to prepare for hormone replacement therapy?

Taking hormonal medications on your own is highly not recommended. HRT can only be prescribed by a doctor, and the selection of drugs is made by the doctor individually and only after diagnosis.

The examination consists of laboratory and instrumental methods, which allows us to obtain the most complete picture of the condition of the female body.

Diagnostic measures before prescribing HRT:

• Ultrasound of the thyroid gland and abdominal cavity;
• examination and diagnosis of mammary glands;
• taking a smear from the cervix;
• blood test for hormones;
• blood pressure measurement.

Other diagnostic methods may be prescribed, as well as consultations with doctors if a woman has chronic diseases. In this case, it is necessary to minimize the impact of these diseases on the body, only then the doctor will be able to select hormonal drugs that will help reduce menopausal symptoms.

Mandatory observations with a doctor

When taking hormone-containing drugs, you must be observed by a gynecologist so that the doctor can monitor the progress of treatment and, if the need arises, adjust it to obtain a better effect.

The first time you need to visit a gynecologist is 3 months after the start of treatment. Follow-up visit after 6 months. Next, you need to visit the gynecologist regularly every six months.

Once a year you will also need to do a gynecological ultrasound, mammography, and a cytological analysis of a smear from the cervix.

Forms of HRT for menopause

The drugs included in HRT can be produced in the following dosage forms:

• For oral administration(dragées, tablets, pills);
• for topical use (gels, suppositories, creams, patches);
• transdermal form (injections, subcutaneous implants).

Each HRT product has both advantages and disadvantages, and can only be prescribed by a doctor in each case. special case individually.

The most convenient form of hormonal drugs are tablets; they are quickly absorbed and have a low cost, but they are contraindicated for problems with the gastrointestinal tract. In this case, local or transdermal forms of hormones are prescribed, which do not affect the gastrointestinal tract; they can be used with many drugs, because do not interact with them.

Popular hormone-containing drugs for menopause

Among the most effective hormone replacement therapy drugs for menopause, the following list can be distinguished:

• Femoston tablets;
• Cyclo-Proginova tablets;
• Ovestin tablets and suppositories;
• Estroferm tablets;
• Angelique tablets;
• Trisequence tablets;
• Klimara patch;
• Dermestril patch;
• Klimonorm dragee;
• Divigel gel.

These hormonal drugs are a new generation of drugs, because the hormones are in minimal doses. They have excellent healing properties and do not cause changes in the functions of internal organs.

When prescribing each drug, the doctor calculates the dosage, as well as the regimen, which must be followed.

Independently changing the dosage prescribed by the doctor can further affect the hormonal level, and increasing the dosage threatens oncology, especially in cases where there is a hereditary predisposition or benign tumors.

We can conclude that hormone replacement therapy can provide significant support to the female body during such a difficult menopausal period for her, especially with pronounced symptoms. Adequately selected medications can reduce the unpleasant symptoms of menopause, as well as minimize the likelihood of complications. Each medicine and its dosage should be prescribed only by a doctor based on the examination. Only in this case can you count on a positive effect of therapy.

For many ladies, the word “menopause” is associated with something scary and reminiscent of old age, although it is translated from Greek as “step”, but whether it will go down or up depends only on ourselves.

At the age of forty to fifty years, hormonal changes occur in the female body, which are caused by aging and “wear and tear” of the reproductive system. In particular, the production of estrogen decreases, the level of which in the blood decreases, and this is followed by the appearance of the most unpleasant symptoms:

• Tides;
• Night sweats;
• Insomnia;
• Leaching calcium from bone structures.

All this is just part of the clinical picture of menopause, from which a woman may suffer to a greater or lesser extent. The severity of symptoms is determined by individual characteristics and the general condition of the body.

Over many centuries of fruitful work by scientists, a huge number of remedies have been invented that should help with menopause. Traditional medicine also collected ancient knowledge passed down from generation to generation, which is said to reduce symptoms and improve well-being. But only specially developed drugs that can truly help, and not hide the symptoms, restore hormonal imbalance, and not aggravate the situation. Lately Highly qualified gynecologists strongly advise their patients.

New generation drugs

We are talking about hormone replacement therapy, which our ladies for some reason perceive with hostility. With its help, estrogen deficiency is restored, resulting in the prevention of dangerous symptoms. With the development of the process, the unpleasant symptoms first weaken and then disappear altogether.

The danger of menopause also lies in the consequences that follow it. Because of hormonal disorders Women are at risk of developing:

• Osteoporosis;
• Heart diseases;
• Atrophic vaginitis and other pathologies.

When the hormonal level returns to normal under the influence of HRT, the occurrence of abnormal processes becomes impossible, which gives the woman a chance to ensure a healthy old age without painful complications.

Although hormone replacement therapy has many benefits, it is not suitable for everyone. Just as they can bring relief, they can also cause harm, so prescribing them yourself is strictly prohibited. This should be done by a specialist, based on the results of your examination and other factors.

Typically, HRT is relevant for women who:

• Hot flashes and night sweats are very pronounced, especially if these symptoms cause terrible discomfort and interfere with leading a normal lifestyle;
• The following appear brightly pronounced signs: dryness of the vaginal mucosa, which causes unpleasant feeling and pain during intercourse, as well as urinary incontinence;
• There is an active leaching of calcium from the bones, fractures have occurred due to osteoporosis, or there is a high risk of developing these conditions.

Another symptom that accompanies menopausal women is depression. However, if there are no other complaints besides him, then HRT treatment- an extra measure. IN in this case Antidepressants are more effective.

Hormone replacement therapy is contraindicated in women who have had/have: breast cancer, endometrial cancer of the uterus, endometriosis or uterine fibroids, liver failure or other serious liver disease, vein thrombosis, or elevated triglycerides in the blood.

HRT - drugs containing estrogens, have long proven themselves to be the most effective remedy prescribed to patients diagnosed with menopause. But just so you know, these are not only pills, but also intramuscular injections, hormonal patches, vaginal suppositories, subcutaneous implants, spirals, gels and other forms of release. Such abundance is required in order to select the right treatment option for each woman, depending on:

• How long has it been since she stopped menstruating;
• What is the list of symptoms and their intensity in a particular case;
• What diseases does she have or have had?
• Have there been any surgical interventions?

Opinions for and against

Our women are wary of HRT, because as practice shows, only 0.2% of mature and elderly women in Russia resort to this type of treatment. Of these, only a fifth continue therapy for more than one year, although, as required by the instructions, the course duration should be about five years.

Their more modern peers living in Europe and America are much more positive about hormone replacement therapy, their number is about 25%. They note that their activity, vigor and cheerfulness remain, despite their age.

The effectiveness of HRT in relation to menopause and its symptoms is fully justified if treatment is started in a timely manner. Doctors say, and patients confirm, that a significant decrease in hot flashes is noticeable after the first week of continuous use of the drugs. There is no magic or anything inexplicable here. The bottom line is that estrogens that are part of hormone replacement therapy act on the cause that caused climacteric syndrome– to restore their deficiency in the blood. When the balance is balanced, clinical picture resolves itself.

• Our people are accustomed to treating all medications as something unnatural. HRT also falls under the same comb, although if you look at it, it cannot be more natural than estrogens. Let's say there are herbal preparations that are similar in structure to female estrogen, but they only imitate their presence. After all, there is protein plant origin, and there is an animal, but they are not interchangeable, but complementary for the human body. And so we learn that HRT contains real female estrogens.
• The second point, which also sounds ridiculous from women: “hormone replacement therapy is an unnatural intervention in the natural aging process.” They cite the example of their great-grandmothers, who could not imagine this and survived menopause through their own efforts. Of course, they didn’t need this, because they fulfilled their function inherent in nature: they gave birth to about ten children, did housework and housework, and ate natural products and lived in different ecological conditions. Moreover, such intimate topics were closed for discussion, and no one knows how they really felt.
• The absence of hot flashes allows women to think that they are completely healthy and can easily endure menopause. This is not true. It’s very good when there are hot flashes, they signal probable internal pathological processes. Even if the vegetative system turns out to be stable, nothing excludes the hidden development of diseases. The use of HRT is also relevant, because in addition to hot flashes, it can safely prevent all negative consequences.
• Some people are afraid that HRT will cause addiction, but such drugs do not contain any addictive drugs. Therefore, after completing a long-term course of treatment, you will not face anything other than improving your well-being.
• “HRT is hormones, which means I can gain weight or hair will appear on my face,” such jokes can sometimes be heard from uninformed women. Hormones are different from hormones! Estrogens are female sex hormones, they have been present inside you all your life, and have you noticed any of the above?! IN this moment, with the advent of menopause, there are fewer of them, and in order to normalize the situation, you can simply help your body without worrying about such dire consequences.
• HRT can cause cancer, this is another myth that scares patients away. Naturally, it will happen if you have not been examined by specialists, and have voluntarily started taking it with an existing neoplasm that is not manifesting itself in any way. Or, if you did not comply with the dosage and drank more than the prescribed amount. And also if, instead of a five-year course, you used the drugs for all 10 years. If HRT is prescribed correctly, when it is done by a specialist, based on the results of examinations and all tests, and with the conscientious implementation of all his recommendations, no terrible things will happen in your body.

The administration of the portal categorically does not recommend self-medication and advises consulting a doctor at the first symptoms of the disease. Our portal presents the best medical specialists with whom you can make an appointment online or by phone. You can choose the right doctor yourself or we will select one for you absolutely free. Also, only when you make an appointment through us, the price for a consultation will be lower than in the clinic itself. This is our little gift for our visitors. Be healthy!

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Estrogens during menopause: pros and cons

Menopause (menopause) is an inevitable stage in the life of every woman. Genetically determined decline in reproductive function occurs at the age of 45-55 years and is characterized by the cessation of ovulation, menstruation and the ability to bear children.

At the same time, the secretion of female sex hormones - estrogen and progesterone - gradually decreases. And at the same time, the female body becomes more and more vulnerable to the diseases of civilization: the development of atherosclerotic plaques in blood vessels accelerates, blood pressure rises, and metabolic processes, the heart and lungs, nervous and endocrine system, musculoskeletal system, skin and mucous membranes, immunity, the effectiveness of all decreases life processes.

If during childbearing age, thanks to estrogens, a woman was well protected from coronary heart disease and hypertension, osteoporosis and diabetes, various vegetative and vascular disorders, then with the onset of menopause, the female body has to fight all these ailments without its hormonal “helpers.”

And then there are these painful manifestations of menopausal syndrome: a sudden feeling of heat (“hot flashes”), increased sweating, palpitations and pressure changes, headaches and dizziness, irritability and decreased mood, problems with urination, dry skin and mucous membranes, pain in joints and excess weight... How to cope with these problems, maintain female attractiveness and slow down the aging of the body? To do this, first of all, you need an active lifestyle with regular moderate physical activity, proper nutrition, proper rest and protection from stress.

Plants will help reduce the unpleasant manifestations of menopausal syndrome. sedatives(valerian, motherwort, peony, St. John's wort, mint, chamomile, lemon balm, etc.), antispasmodics, beta blockers, vitamins, calcium supplements.

Hormone replacement therapy with estrogen during menopause: benefits

Hormone replacement therapy (HRT) using estrogens and gestagens is most effective during menopause. Combined hormonal drugs during menopause are recommended to be taken as prescribed by a doctor for a long period - from one to five to seven years.

Properly selected HRT with the use of estrogens can quickly improve the well-being of women aged 45-60 years, relieve them from the painful manifestations of menopausal syndrome, ensure the prevention of osteoporosis and slow down the aging process. Hormone replacement therapy has been successfully used in various countries around the world for 20 years and has proven its effectiveness during this period. Estrogens and gestagens can be used in the form of tablets, cream, patch, vaginal beads and intrauterine device.

Are estrogens safe during menopause? In what cases should you not use hormone replacement therapy? Here is the main list of contraindications for taking medications containing estrogens and gestagens during menopause:

Absolute contraindications to HRT

• Previous history of breast cancer or suspicion of having of this disease
• Previously suffered malignant tumors of the female genital organs (endometrial cancer, ovarian cancer)
• Uterine bleeding (the cause of which is not clear)
• Newly diagnosed endometrial hyperplasia, which has not yet been treated
• Ischemic disease heart (angina pectoris, previous myocardial infarction)
• Hypertonic disease II-III stages
• Presence of deep vein thrombosis of the lower extremities
• Acute hepatitis, liver cirrhosis

Relative contraindications to the administration of estrogens and gestagens during menopause

• Uterine fibroids
• Endometriosis
• Diseases of the liver and biliary tract (chronic hepatitis, cholecystitis, cholelithiasis)
• Diabetes mellitus with the presence of vascular complications
• Seizures
• Migraine
• Benign diseases of the mammary glands
• Age over 65 years at initial prescription of HRT

Research by scientists has shown that long-term (4-5 years or more) use of estrogen during menopause can increase the risk of developing malignant tumors breast and ovaries, as well as various thromboembolic complications. Therefore, hormone replacement therapy is prescribed by an obstetrician-gynecologist strictly according to indications: in the presence of severe manifestations of menopausal syndrome, a high risk of developing osteoporosis and cardiovascular diseases, genitourinary and sexual disorders, mental and neurotic disorders (including depression and memory impairment) .

If there are contraindications to taking estrogens and gestagens during menopause, you can use the previously listed sedative herbal remedies, as well as phytoestrogens and homeopathic drugs.

Phytoestrogens during menopause

• Regular consumption of foods containing phytoestrogens will help reduce the severity of menopausal syndrome:
• Isoflavonoids (source: soybeans and other leguminous plants, lentils, pomegranates, dates, cabbage, sunflower seeds)
• Lignans (found in bran and fiber obtained from the outer layer of wheat, rye, rice grains, as well as flax seeds, garlic and carrots, nuts, apples, cherries)
• Phytohormones contained in some plants (cohosh, mellbrosia, raponticine). The most famous is climadinone, a drug obtained from black cohosh.

As you can see, the choice of means to help get rid of unpleasant problems during menopause is quite wide. And choose best option In each specific case, your obstetrician-gynecologist will help you.

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Hormone replacement therapy for menopause: hidden effects and new opportunities – 45plus

Modern women are well informed about how effectively hormone replacement therapy drugs cope with the “classic” symptoms that appear during menopause: hot flashes, increased sweating, insomnia, irritability, etc. However, what remains behind the scenes is the successful “work” of HRT to protect the body from “non-classical” symptoms that arise due to hidden manifestations of deficiency of female sex hormones during menopause. Today we are talking about the additional beneficial properties of HRT.

Widely known in world medical practice positive results use of hormonal treatment for menopause. For several decades, doctors in Western Europe and the United States have been recommending hormone replacement medications for women over 45-50 years of age to maintain health and beauty. In our country, these methods of improving the quality of life during menopause became known in the nineties of the 20th century. But even today, many representatives of the fair half of Russia pass word of mouth “horror stories” about HRT, based on information from the 70s of the last century or data from long-outdated studies (we wrote about this in detail here).

But modern medicine has come a long way in recent years. The fact that progestogens protect the endometrium became known by the end of the eighties. Since then, doctors have abandoned estrogen monotherapy, which was previously used even with a preserved uterus. The negative experience of monotherapy, treatment with high doses of hormones, and the lack of an individual approach to each patient are left behind. But our compatriots (it’s funny to say!) are still “Google” on the Internet: “conspiracies for menopause and hot flashes.”

Very often, beautiful ladies of the age “45 plus” with complaints of various ailments find themselves at an appointment with a neurologist, ophthalmologist, rheumatologist, urologist, psychotherapist... But for some reason they go to the gynecologist last. And this is a big mistake

Today, science has unequivocally answered the question about the benefits of hormone replacement therapy (HRT) for traditional symptoms of menopause.1 And now another question is gaining relevance in professional medical communities: how the new generation of drugs affect the female body as a whole.

Classic and non-classical manifestations of menopause in women

Very often, beautiful ladies of the age “45 plus” with complaints of various kinds of ailments find themselves at an appointment with a neurologist, ophthalmologist, rheumatologist, urologist, psychotherapist... But for some reason they go to the gynecologist last. And this is a big mistake. There is a misconception that menopause symptoms cannot occur if menstruation continues. But for most women, the menopausal transition has already begun at this time, which means the body experiences a deficiency of female sex hormones. However, few people would suspect “dry eye syndrome” or periodontal disease as signs of menopause. So endless trips to doctors begin, the patient is prescribed a lot of medications for a variety of diseases, but no one deals with the real problem. And time is running out...

The “classic” symptoms of menopause have been well studied, and their treatment has been tested in practice. But aren’t there other, subtle signs of hormone deficiency that significantly reduce the quality of life? For example, vision deteriorates with age and dry eyes are a concern.

What are the first signs of menopause?

One of the postulates of endocrinology: sex hormones act on absolutely all organs and cells: reproductive and cardiovascular systems, bone and connective tissue, brain, lacrimal glands, hair, teeth, periodontium... Everything in our body has estrogen receptors. This is why the lack of these hormones during menopause in women has such a destructive effect on the entire body and for the same reason menopause has so many manifestations. The “classic” symptoms (hot flashes, unstable sleep and mood, osteoporosis and cardiovascular diseases) have been well studied, and their treatment has been tested in practice. But aren’t there other, subtle signs of hormone deficiency that significantly reduce the quality of life and bring a lot of worry? Here are just some “harbingers” of menopause:

• the appearance of pain in the joints, very similar to pain due to osteoarthritis;
• blurred vision and dry eye syndrome;
• decreased salivation (salivation) and unpleasant taste in the mouth;
• the occurrence or intensification of migraines;
• hyperpigmentation, dry skin and rapid formation of wrinkles;
• excess weight and accumulation of abdominal fat (around the waist);
• decreased libido.

Since 2014, the Women First program has been operating in Russia, which, under the auspices of the International Society for the Study of Menopause, conducts educational events around the world. As part of this project, international experts raise the most pressing topics and discussion of the additional beneficial effects of HRT has been on the agenda for several years now.

Interesting data on the beneficial properties of HRT were collected by a team of American scientists from Hopkins University. It turns out that natural and synthetic estrogens can protect the weaker sex from the flu

Domestic scientists also do not remain aloof from significant medical problems. For example, at one of the conferences within the framework of the Women First program, this topic was mentioned in the speech of the candidate medical sciences, Associate Professor of the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Advanced Training of Medical Workers, Federal State Budgetary Educational Institution of Higher Education Russian University Friendship of Peoples" by Irina Shestakova. She invited fellow gynecologists and endocrinologists to talk about the “hidden talents of an old friend” - hormone replacement therapy for menopause.2 The doctor spoke about a number of observational studies conducted in Russia and abroad, the results of which showed that HRT has “hidden talents” in the field of prevention and treatment wide range“non-classical” problems during menopause:

• effectively helps with joint pain (so-called “menopausal arthralgia”);
• reduces the risk of developing colorectal cancer;
• reduces the risk of degenerative diseases of the retina;
• protects connective tissue and has a protective effect against changes in intervertebral discs and bone matrix;
• helps reduce abdominal fat mass;3
• can stop the occurrence of regular headaches;
• maintains skin elasticity and helps solve the problem of hyperpigmentation;
• improves the outcomes of various treatment procedures in the field of periodontology (including dental implantation);
• has a positive effect on the condition of teeth, hair, nails, etc.

One of the postulates of endocrinology: sex hormones act on absolutely all organs and cells. All in female body has estrogen receptors. This is why the lack of these hormones has such a destructive effect on the entire body and for the same reason menopause has so many manifestations

It would not be amiss to remind you that modern drugs contain not only estrogens, but also progestogens, the main function of which is to protect the endometrium during menopause (progestogens block the proliferative effect of estrogens, that is, they prevent tissue proliferation and the occurrence of tumors, for example, endometrial hyperplasia).

Preparations with estrogens and “non-classical” symptoms during menopause

Interesting data on the beneficial properties of HRT were collected by a team of scientists from the School of Public Health at Johns Hopkins University (Baltimore, USA): natural and synthetic estrogens have a protective effect against influenza. Project leader Dr. Sabra Klein recalled that previous studies have already shown that estrogens demonstrate antiviral characteristics against HIV, Ebola virus and hepatitis. “Physicians have seen new clinical potential for therapeutic estrogens used to treat infertility and menopause. It turns out that they can protect the weaker sex from the flu,” the American journal AJP Lung Cellular and Molecular Physiology quotes the scientist.4

The North American Menopause Society has published research showing that estrogen therapy used to treat menopause symptoms significantly reduces the risk of developing periodontitis, as well as other dental and gum diseases.

Here's some good news from experts at the North American Menopause Society (NAMS): Estrogen therapy, used to treat menopausal symptoms, can significantly reduce a woman's risk of developing periodontitis. The society's executive director, Dr. Joanna Pinkerton, spoke about the results of joint scientific research between health institutions in Brazil and State University New York: “Estrogen, which has proven positive effects in preventing bone loss, may protect against dental and gum disease during menopause.”5

1 International Menopause Society (IMS) guidelines on the health of midlife women and the use of menopausal hormone therapy (MHT)

How not to go crazy after menopause?

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HRT (HRT) - hormone replacement therapy for menopause: new generation drugs

There comes a time in every woman’s life when the level of sex hormones begins to gradually fall. It is called menopause, and begins after 40-45, sometimes after 50 years, which has recently happened quite rarely. Female menopause has become younger, and in some cases (to be fair, it should be noted that this phenomenon is extremely rare and is rather considered a pathology) can occur after childbirth, and at any age.

The menopausal period is characterized by the following unpleasant symptoms:

• frequent and causeless mood swings, tearfulness, apathy, irritability and a tendency to depression;
• dizziness, sometimes reaching fainting states, headaches, migraines;
• hot flashes that occur at any time of the day, night sweats;
• sleep disturbance - insomnia is replaced by painful drowsiness;
• deterioration of general condition, increased fatigue, decreased concentration and memory acuity;
• changes in the mucous membranes of the genital organs, dryness of the vaginal mucosa, characterized by itching, burning and other unpleasant symptoms;
• rising blood pressure, sometimes developing into persistent hypertension;
• weight gain due to decreased appetite;
• painful sensations in lumbar region or in the suprapubic area after sex.

The female body reacts in this way to the lack of production of sex hormones. HRT - hormone replacement therapy is designed to help a woman survive menopause and maintain her quality of life.

When is hormonal therapy indicated and contraindicated?

Hormone replacement therapy for menopause (HRT) adheres to the following principles:

• the use of drugs that contain hormones similar to natural ones;
• Only low dosages of drugs with endogenous estradiol are used in women with early menopause;
• complex use of estrogens and progesterone, which makes it possible to avoid endometrial hyperplasia, excluding subsequent development malignant neoplasms;
• in case of artificial menopause (after removal of the uterus or appendages), only short courses estrogens to eliminate symptoms and prevent age-related pathologies of organs and body systems associated with hormonal dysfunction.

The benefits of hormonal therapy for women are obvious, despite the “horror stories” that talk about possible side effects from the use of artificial hormones. HRT for menopause with new generation drugs has its own clear indications:

• early menopause, when it is possible to partially restore the functions of one’s own production of sex hormones;
• at high risk of developing osteoporosis;
• a history of vascular and cardiac pathologies that are in a chronic condition;
• the risk of developing diseases of the cardiovascular system, especially in the presence of a hereditary factor.

Diagnostic methods

But replacement therapy can only be prescribed by highly qualified specialists after a series of examinations and laboratory tests. The required minimum diagnostic procedures include:

• general medical checkup with an assessment of the general condition of the body, the functioning of organs and systems, the presence of chronic pathologies;
• visual inspection And laboratory test cervical smear;
• examination of the mammary glands: visual, palpation, mammography, ultrasound;
• blood pressure control;
• Ultrasound of the pelvic and abdominal organs, thyroid gland;
• blood test for hormones to establish hormonal status and determine the prothrombin index (propensity to form blood clots).

For women over 40 years of age, hormone replacement therapy is indicated in the absence of chronic pathologies and ineffective treatment with phytoestrogens.

What are the possible contraindications and side effects?

Contraindications for replacement therapy are also very clear:

• renal and liver failure, pathologies of these organs in the acute or chronic phase, including oncology;
• increased susceptibility to thrombus formation, history of thrombosis or thromboembolism;
• oncological diseases mammary glands or other reproductive organs;
• uterine bleeding of various origins;
• hormone-dependent tumors various localizations;
• insulin-dependent diabetes mellitus;
• complex cardiac and vascular pathologies.

Despite the fact that hormonal drugs for menopause belonging to the new generation are safe, they still have side effects:

• engorgement of the mammary glands, pain on palpation. Although minimal, there is still a risk of developing breast cancer;
• pain in the epigastric region and stomach, nausea, increased appetite;
• swelling of the face and limbs due to fluid retention. For the same reason, body weight increases;
• You may experience either vaginal dryness or the production of too much vaginal mucus. Irregular or period-like bleeding may also occur, especially in women during menopause (when they no longer have periods);
• the general condition worsens, increased weakness, fatigue, headaches of a migraine nature appear;
• cramps and spasms in the legs, especially at night;
• appears acne various localization, seborrhea;
• the development of thrombosis and thromboembolism is possible.

All these manifestations may indicate that replacement therapy should be stopped. If necessary (the course of menopause is complex, the symptoms are pronounced and significantly affect the quality of life), after additional research, the specialist may try to prescribe another drug.

HRT is not a panacea and is not suitable for everyone. But a medicine containing hormones may be the only solution for pathological course menopause.

Forms and types of hormone replacement drugs

HRT drugs can be divided into several types:

• natural - homeopathic, organic. They are produced from plants that contain estrogens - plant hormone-like substances, similar in structure and functions to human hormones;
• synthetic - made from artificial, chemical components that are combined into entire complexes.

To carry out replacement therapy, drugs of different pharmacological forms are used, which differ in the nature of entry into the body and the time of exposure:

• oral – when the drug enters the body through the gastrointestinal tract. These are tablets, capsules, dragees, tinctures, extracts and some other forms;
• transdermal - the product is injected subcutaneously or intramuscularly. The latest and most innovative approach is the use of subdermal implants, which are installed for a year or several years. If desired, they can be easily removed. Such means are protection against unwanted pregnancy with early menopause during premenopause (when the functions of the gonads have not yet died out, only the harbingers of future changes in the body begin);
• local - drugs are available in the form of suppositories, creams and gels, which are used for external application to the vaginal mucosa, skin in the chest and abdomen.

HRT drugs, like everyone else medicines, each have their own spectrum of action, have advantages and disadvantages, which will be taken into account by an experienced specialist in each specific case.

For example, oral medications can irritate the stomach lining and have negative effects on the liver. Therefore, treatment with implants or local medications is recommended for patients with such problems. They do not affect the gastrointestinal tract and do not react with other medications.

Some drugs

Modern HRT has many different drugs in its arsenal. Some of them are suitable for women over 45, some are recommended for women over 50 years old. For some, replacement therapy is the last chance for a quality life, since menopause causes a lot of problems.

Some of the most popular HRT drugs, which have been collected positive reviews women:

• Klimonorm is an oral drug containing estradiol (a type of estrogen - the female sex hormone). Indicated for artificial menopause - after removal of the uterus or appendages, as well as to eliminate the unpleasant symptoms of early menopause. Caution – does not protect against pregnancy. Can be used for a long time.

• Trisequence is available in the form of tablets that contain estrogen and progesterone. Prescribed for early menopause to eliminate painful symptoms. If side effects occur, which are extremely rare, you must stop taking the drug and be sure to inform your doctor.

• Kliogest is a drug that helps eliminate hot flashes. Has a preventive effect on the development of osteoporosis and arterial hypertension. Indicated for use over a long period of time in the absence of side effects.

• Estrofem. This drug is of plant origin. Relieves menopausal symptoms and is prescribed as a preventive measure for cardiovascular pathologies. Contraindicated for ulcers and kidney pathologies.

• Proginova is a drug that completely compensates for the lack of female sex hormones during early menopause or after removal of the appendages. If side effects occur, you should stop taking the drug and replace it with a more suitable one.

• Livial is prescribed for the prevention of osteoporosis and the development of arterial hypertension. Completely relieves or significantly reduces the unpleasant symptoms of menopausal syndrome.

• Ovestin is a one-component medicine produced in the form of tablets and suppositories. However, suppositories are still more in demand. Used to treat atrophy of the mucous membrane of the vagina and cervix.

• Klimadinon is available in the form of tablets and drops. Contains black cohosh extract, a phytoestrogen that eliminates the symptoms of menopause, improves well-being and activates the body's defenses.

Sometimes hormone therapy is the only solution for a woman whose menopause has a complex course, with many unpleasant symptoms that significantly reduce the quality of life.

All these and many other drugs are new generation drugs that can gently and without any side effects influence the level of female hormones, which naturally stop being produced. However, the risk of adverse consequences, although minimal, still exists.

Therefore, before prescribing hormonal drugs, a specialist evaluates all possible risks, weighs the pros and cons, and compares the percentage of adverse effects. If the risk of developing these is high, then they resort to the use of natural preparations containing plant components similar to human sex hormones.

HRT uses a lot of drugs containing phytoestrogens. These drugs also effectively help fight the symptoms of menopause, with virtually no negative effects, which makes their use safer than synthetic hormones. However, they also have their own application characteristics, side effects and contraindications.

Knowing what hormonal therapy for menopause is, all its pros and cons, every woman can make a choice. But it is under no circumstances recommended to prescribe medications on your own. Let the specialist evaluate the pros and cons and make an appointment. Paying attention to your health not only prolongs life, but also makes it much happier and of better quality.



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2018 Blog about women's health.