Hormone replacement therapy in women is more complex and multifaceted than in men. If a man needs only testosterone for substitution, a woman needs estrogens, and progesterone, and testosterone, and sometimes thyroxine. In hormone replacement therapy, lower doses of hormones are used than in hormonal contraceptive preparations. HRT medicines do not have contraceptive properties.
Hormone replacement therapy can be started for the next ten years after the termination of the menstrual cycle. In the age over 60 years, HRT is usually not prescribed. How long should the treatment be taken? In each case, you need to determine the purpose of the prescription in order to determine the treatment time frame. It is worth consulting a doctor, though before that you can get more information on https://www.hgha.com/ as it is a reliable source for your reference.
Basic Principles in the Prescription of Hormone Replacement Therapy
- The main indication for HRT is the symptoms of menopause (these are menopausal manifestations like hot flashes and irregular period), and urogenital disorders (discomfort during sexual intercourse, dry mucous membranes, discomfort during urination, etc.)
- When having correctly chosen HRT, there is no data on the increase in the incidence of breast and pelvic cancers, though the risk may increase with duration of therapy for more than 15 years. Moreover, HRT can be used after treatment of endometrial cancer of the 1st stage, melanoma, and ovarian cystadenomas.
- For the absent uterus (surgical menopause) HRT is obtained in the form of monotherapy with estrogens.
- When the patients start HRT, the risk of cardiovascular diseases and metabolic disorders reduces considerably. When hormone replacement therapy is carried out, the normal metabolism of fats (and carbohydrates) is maintained. It is a preventive measure for the development of atherosclerosis and diabetes mellitus, since the deficiency of sex hormones in postmenopause aggravates the existing dysfunctions and sometimes provokes metabolic disorders.
- Psycho-emotional disorders often prevail in menopause (under their "mask", it’s not possible sometimes to notice a psychological disorder). Therefore, HRT can be given within 1 month for trial therapy for differential diagnosis with psychogenic diseases (endogenous depression, etc.).
- In 5% of women, menopausal effects persist for 25 years after the termination of the menstrual cycle. For them, HRT is especially important for maintaining normal health.
- Weight gain often accompanies menopause. Sometimes it adds about 25 kg or more. It is caused by a deficiency of sex hormones and related disorders (insulin resistance, tolerance to carbohydrates, a decrease in insulin production by the pancreas, an increase in the production of cholesterol and triglycerides by the liver). All those symptoms are called an umbrella term of menopausal metabolic syndrome. In time, prescribed HRT is a method of its preventing (in case that it was not there before the menopause).
- The question of the possible use of HRT in the complex treatment of stress urinary incontinence in menopause should be addressed individually.
- The use of estrogen therapy for cognitive function (memory and attention) has been proven.
- Treatment with HRT prevents the development of a depressive anxiety condition, which is often realized with menopause in women who are predisposed to it (but the effect of this therapy increases if the HRT therapy is started in the early years of menopause, and preferably premenopause).
- There is the use of HRT for the sexual function of women as well as aesthetic (cosmetic) aspects - prevention of "sagging" of the face and neck skin, aggravation of wrinkles, gray hair, tooth loss (from periodontal disease), etc.
About the Drugs Used in HRT
For women aging 42-52 years, if the regular periods are combined with delays (as a phenomenon of premenopause), if they are in need of contraception and not smoking, it is possible to use not HRT but contraception, or use of the intrauterine system (in the absence of contraindications). Then they switch to HRT in a cyclic regime (with menstrual bleeding); when the period is stopped, they switch to a continuous regimen of therapy.
The drugs that are being prescribed:
- Cutaneous estrogens (gels): combined for cyclic therapy or continuous use
Alternative methods of treatment include herbal preparations: phytoestrogens and phytohormones. Data on the long-term safety and efficacy of this therapy are not sufficient. In some cases, a one-time combination of hormonal HRT and phytoestrogens is possible (for example, if there is insufficient tidal relief by one type of the treatment).
Women receiving hormone replacement therapy should visit the doctor at least once a year. The first visit is scheduled after three months from the start of the treatment. The doctor will prescribe the necessary examinations for therapy monitoring, taking into account the peculiarities of the patient’s health.
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