Hormone therapy after 50: for and against - БАДы для здоровья и спорта | Качественные добавки

Hormone therapy after 50: for and against

Section 1: Introduction to hormonal therapy (GT) and period of perimenopause and menopause

Hormonal therapy (GT), also known as hormone replacement therapy (ZGT), is a treatment method aimed at facilitating symptoms associated with the deficiency of estrogen and/or progesterone, which occurs during perimenopause and menopause. This period in a woman’s life is characterized by a gradual cessation of ovarian functioning, which leads to a decrease in the production of sex hormones.

Perimenopausa is a transition period that can begin a few years before the last menstruation. At this time, the menstrual cycles become irregular, and the first symptoms of hormonal imbalance appear. The menopause is defined as the cessation of menstruation for 12 months in a row. After menopause, a postmenopause occurs, a period characterized by a stably low level of sex hormones.

A decrease in estrogen and progesterone levels during perimenopause and menopause can cause a wide range of symptoms that significantly affect the quality of life of a woman. The most common symptoms include:

Vasomotor symptoms: Tucks of heat, night sweating.
Urogenital symptoms: Dry vagina, discomfort during intercourse, frequent urge to urination, urinary tract infections.
Psychological symptoms: Mood swings, irritability, anxiety, depression, a decrease in concentration of attention, memory deterioration.
Symptoms from the side-muscular system: Joint pain, muscle weakness, decrease in bone density (osteoporosis).
Symptoms from the cardiovascular system: Changing the level of cholesterol, increasing the risk of cardiovascular diseases.
Other symptoms: Insomnia, headaches, weight gain, dry skin and hair.

Hormonal therapy is designed to replenish the deficiency of sex hormones and thereby facilitate or eliminate these symptoms. However, the decision on the beginning of the GT should be made individually, after a thorough assessment of risks and advantages, taking into account the general state of health of a woman, her personal and family history of the disease.

Section 2: Types of hormonal therapy

There are various types of hormonal therapy that differ in composition, dosage and method of use. The choice of a specific type of GT depends on the individual needs and health status of a woman.

Estrogen therapy: This type of GT involves the use of estrogen. It is usually prescribed for women who have undergone a hysterectomy (uterine removal). The use of estrogen without progesterone in women with intact uterus can increase the risk of endometrial cancer.
- Estrogens obtained from urine of pregnant mares (conjugated equal estrogens – KE): Premarin is an example.
- Synthetic conjugated estrogens: Cenesto, enjoops.
- Estradiol (bioidendic estrogen): Estrace, Climara, Vivelle-dot.
Combined estrogeno-projestone therapy: This type of GT involves the use of both estrogen and progesterone. It is prescribed for women with an intact uterus to protect the endometrium from hyperplasia and cancer caused by estrogen.
- Cyclic (consistent) therapy: Estrogen is accepted continuously, and progesterone is added within a certain number of days of each month. This leads to menstrual -like bleeding.
- Continuous combined therapy: Estrogen and progesterone are accepted daily without a break. This can lead to irregular bleeding in the first few months, but over time usually leads to the cessation of menstruation.
Tuplian: Synthetic steroid, which has estrogenic, progesterone and androgenic properties. Used to relieve symptoms of menopause and prevent osteoporosis.
Local estrogen therapy: Estrogen in the form of a cream, vaginal tablets or rings, is introduced directly into the vagina. It is used to treat urogenital symptoms such as dry vaginal and discomfort during intercourse.
- Vaginal estrogen cream: Premarin, Estrace.
- Vaginal estrogen tablets: Vagifem.
- Vaginal estrogen ring: Estring.
Selective estrogen receptor modulators (SMER): Medicines that have an estrogen-like effect on some tissues and an anti-estrogenic effect on others. Raloxifen is used for the prevention and treatment of osteoporosis.

Section 3: Advantages of hormonal therapy

Hormonal therapy can offer significant advantages for women experiencing moderate and severe symptoms of menopause.

Relief of vasomotor symptoms: GT is the most effective remedy for facilitating the heat of the heat and night sweating. Estrogen stabilizes the thermoregulation center in the brain, reducing the frequency and intensity of these symptoms.
Relief of urogenital symptoms: Estrogen helps restore the thickness and elasticity of the vaginal mucosa, reducing dryness, itching and discomfort during intercourse. It can also reduce the frequency of urinary tract infections.
Improving bone density and prevention of osteoporosis: Estrogen plays an important role in maintaining bone density. GT can slow down or stop the loss of bone tissue, reducing the risk of fractures, especially the vertebrae and hip neck.
Improving mood and cognitive functions: Some studies show that GT can improve mood, reduce anxiety and depression, as well as improve concentration and memory. However, the influence of GT on cognitive functions remains the subject of further research.
Reducing the risk of developing type 2 diabetes: Some studies show that GT can reduce the risk of type 2 diabetes. Estrogen can improve insulin sensitivity and contribute to the regulation of blood glucose levels.
A possible reduction in the risk of developing colorectal cancer: Some studies show that GT can reduce the risk of colorectal cancer. However, additional studies are needed to confirm this effect.
Improving the quality of sleep: Relief of vasomotor symptoms and mood improvement can help improve sleep quality.
Improving the condition of the skin and hair: Estrogen helps to moisturize the skin and maintain its elasticity. GT can help reduce dry skin and hair, as well as improve their appearance.

Section 4: Hormonal therapy risks

Hormonal therapy, like any other medical intervention, is associated with certain risks. It is important to understand these risks and take them into account when making a decision on the beginning of the GT.

Breast cancer: One of the most serious risks associated with GT is an increase in the risk of developing breast cancer, especially with prolonged use of combined estrogen-prohestronic therapy. The risk increases with the duration of the use of GT. However, the risk of breast cancer when using only estrogen (in women after hysterectomy) may be lower or even absent.
Endometry cancer: The use of estrogen in women with intact uterus significantly increases the risk of endometrial cancer. Combined estrogen-projestone therapy reduces this risk, since progesterone protects the endometrium from hyperplasia.
Thromboembolic complications (TEO): GT can increase the risk of developing deep vein thrombosis (TGV) and pulmonary artery thromboembolism (fella). The risk is higher when using estrogen oral forms than when using transdermal shapes (plasters, gels).
Stroke: GT can slightly increase the risk of stroke, especially in women over 60 or with risk factors for cardiovascular diseases.
Cardiovascular diseases: The results of studies on the influence of GT on the risk of cardiovascular diseases are contradictory. Some studies have shown that GT can increase the risk of coronary heart disease, especially in women starting GT at a late age (after 60 years) or many years after the occurrence of menopause. Other studies did not reveal a significant increase in risk or even showed some risk reduction at the beginning of GT at an early age (within 10 years after the occurrence of menopause).
Gall bladder diseases: GT can increase the risk of gallbladder diseases, such as gallstone disease.
Migraine: GT can aggravate migraines for some women.
Increasing the risk of dementia development: Some studies have shown that GT can increase the risk of dementia, especially in women starting GT at a late age. However, additional studies are needed to confirm this effect.
Other side effects: GT can cause other side effects, such as bloating, soreness of the mammary glands, headaches, mood swings, nausea and vaginal bleeding.

Section 5: Factors affecting the risks and advantages of GT

The risks and advantages of GT depend on many factors, including:

The age of the start of GT: The risks associated with the GT can be higher in women starting GT at a late age (after 60 years) or many years after the occurrence of menopause.
Type GT: Risks may vary depending on the type of GT (estrogenotherapy, combined estrogeno-progezherone therapy, thibolon, local estrogen therapy).
Dosage GT: Risks can be higher when using higher doses of hormones.
Method of application of GT: The risks of thromboembolic complications can be lower when using transdermal forms of estrogen (plasters, gels) than when using oral shapes.
Duration of GT: The risks of some diseases, such as breast cancer, can increase with the duration of GT.
Health status of women: GT risks can be higher in women with certain diseases, such as cardiovascular diseases, thromboembolic diseases, breast cancer or anamnesis endometrial cancer.
Family history of the disease: GT risks can be higher in women with the family history of breast cancer, endometrial cancer or thromboembolic diseases.
Life: Smoking, obesity and insufficient physical activity can increase the risks associated with GT.

Section 6: Alternatives of hormonal therapy

For women who do not want or cannot use GT, there are alternative methods for treating symptoms of menopause.

Life change change:
- Healthy nutrition: The use of a large amount of fruits, vegetables, whole grain products and lean proteins. Limiting the consumption of processed products, sugar and saturated fats.
- Regular physical exercises: Exercises help improve mood, strengthen the bones and reduce the risk of cardiovascular diseases.
- Maintaining a healthy weight: Excess weight can aggravate the symptoms of menopause.
- Refusal of smoking: Smoking exacerbates the symptoms of menopause and increases the risk of many diseases.
- Restriction of alcohol and caffeine consumption: Alcohol and caffeine can enhance the rush of heat.
- Stress management: Stress can aggravate the symptoms of menopause. Regular yoga, meditation or other relaxation techniques can help reduce stress.
Phytoestrogens: Plant compounds that have a weak estrogenic effect. Contained in soy products, red clover and other plants. The effectiveness of phytoestrogens in relief symptoms of menopause remains the subject of discussions.
Plant drugs: Some plant preparations, such as cystic clopone (Cimicifuga racemosa), are traditionally used to relieve symptoms of menopause. However, scientific data on the effectiveness and safety of these drugs are limited.
Selective inhibitors of the reverse capture of serotonin (SIOOS) and selective inhibitors of the reverse capture of serotonin and norepinephrine (SIOSSN): Antidepressants who can help alleviate the ebbs of heat and improve mood. Paroxils (Paxil) and Venlafaxin (Effexor) are examples of Sioles and SioZSN, approved for the treatment of vasomotor symptoms of menopause.
Gabapine: The anticonvulsant drug that can help alleviate the ebbs of the heat.
Clonidine: A drug that is usually used to treat high blood pressure, but can also help alleviate the ebbs of heat.
Lubyricans and moisturizing tools for the vagina: Used to relieve dry vagina and discomfort during intercourse.
Bio -accessible identical hormones (BIG): Hormones that are identical to what are produced by the body. The use of BIG remains controversial because they are not adjusted as strictly as traditional hormonal drugs, and their long -term safety and effectiveness are not established. It is important to discuss the use of BIG with a doctor.

Section 7: How to make a decision on hormonal therapy

The decision on the onset of hormonal therapy should be made individually, after a thorough assessment of risks and advantages, taking into account the general state of health of a woman, her personal and family medical history.

Discuss your symptoms with a doctor: Tell the doctor in detail about your symptoms, their intensity and influence on your life.
Give information about your medical history: Tell the doctor about all your diseases, transactions, drugs taken and allergies.
Give information about your family history of the disease: Tell the doctor about cases of breast cancer, endometrial cancer, thromboembolic diseases and cardiovascular diseases in your family.
Pass the necessary examinations: The doctor can prescribe to you mammography, an ultrasound examination of the pelvic organs, a blood test for hormones and other examinations to assess your health state.
Discuss with the doctor the risks and advantages of GT: Learn about all possible risks and advantages of GT, given your individual situation.
Consider alternative treatment options: Discuss with the doctor alternative methods for treating symptoms of menopause, if you do not want or cannot use GT.
Make a reasonable solution: After a thorough consideration of all factors, make a decision on whether hormone therapy is suitable for you.
Visit the doctor regularly: If you started GT, regularly visit a doctor to control the effectiveness of treatment and identify possible side effects.

Section 8: Modern recommendations and research in the field of GT

Modern recommendations in the field of hormonal therapy emphasize an individual approach to every woman. The decision on the beginning of GT should be based on a thorough assessment of risks and advantages, taking into account the age of the woman, her state of health and the severity of symptoms.

The minimum effective dose: It is recommended to use the minimum effective dose of hormones to alleviate the symptoms of menopause.
The shortest possible duration: It is recommended to use GT for the shortest time necessary to relieve symptoms.
Transdermal forms of estrogen: Transdermal forms of estrogen (plasters, gels) can be preferable to oral forms, especially for women with an increased risk of thromboembolic complications.
The beginning of GT at an early age: Some studies show that the beginning of GT at an early age (within 10 years after the onset of menopause) may be associated with a lower risk of cardiovascular disease.
Individual approach: The need for an individual approach to each woman is emphasized when deciding on the GT.

Modern studies in the field of GT continue to study the effect of hormones on the health of a woman during menopause.

Studies of the influence of GT on cognitive functions: Studies are conducted to assess the influence of GT on cognitive functions and the risk of dementia.
Studies of the influence of GT on the cardiovascular system: Studies continue to clarify the influence of GT on the risk of cardiovascular diseases.
Development of new GT methods: New GT methods are developed, such as selective estrogen receptor modulators (SMER) and tissue estrogen complexes (TSECs), which can have a more selective effect on various body tissues.

Section 9: Questions that should be asked a doctor about hormonal therapy

To get complete information and make a reasonable decision on hormonal therapy, ask the doctor the following questions:

What are my treatment options for symptoms of menopause?
What is hormonal therapy and how does it work?
What types of hormonal therapy are available?
What type of hormonal therapy do you recommend to me and why?
What are the risks and advantages of hormonal therapy for me?
How long will I need to take hormone therapy?
What side effects can occur when taking hormonal therapy?
How often will I need to visit a doctor while taking hormonal therapy?
What to do if I have side effects?
Are there alternatives to hormonal therapy?
How will hormone therapy affect the risk of breast cancer, endometrial cancer, cardiovascular diseases and other diseases?
How will hormone therapy affect my sexual function?
How will hormone therapy affect my mood and cognitive functions?
What tests will I need to pass before hormonal therapy?
What will happen if I stop taking hormonal therapy?
Can I try hormonal therapy for a short time and stop it if it does not suit me?
What changes in lifestyle can I make to alleviate the symptoms of menopause?
Are there any websites or other resources that I can study in order to learn more about hormonal therapy?
What is the difference between bioidient and traditional hormones?
How do I know that hormonal therapy works?
What dose of hormones do I need?
How often will I need to take hormones?
When should I start taking hormone therapy?

Section 10: Long -term observation and termination of GT

If you decide to start hormonal therapy, it is important to regularly visit a doctor to control the effectiveness of treatment and identify possible side effects.

Regular examinations: Pass regular examinations at the doctor to control your health status and discuss any changes in the symptoms or side effects.
Self -examination of the mammary glands: Regularly conduct a self -examination of the mammary glands to identify possible changes.
Mammography: Pass regular mammography in accordance with the recommendations of your doctor.
Ultrasound examination of the pelvic organs: Pass the ultrasound examination of the pelvic organs in accordance with the recommendations of your doctor.
Bone density assessment: Complete bone density assessment to monitor the risk of osteoporosis.

The decision to terminate hormonal therapy should be made individually, after consulting a doctor.

A gradual dose reduction: It is recommended to gradually reduce the dose of hormones before the complete cessation of the GT. This can help reduce the likelihood of symptoms of cancellation.
Alternative treatment methods: Discuss with the doctor alternative methods for treating symptoms of menopause if you plan to stop the GT.
Individual approach: The need for an individual approach to each woman is emphasized when deciding on the termination of the GT.

The termination of GT can cause the return of symptoms of menopause. In this case, it is important to consult a doctor to discuss possible treatment options.

Section 11: Hormonal therapy and quality of life

Hormonal therapy can have a significant impact on the quality of life of a woman during menopause. The relief of vasomotor and urogenital symptoms, improving mood and cognitive functions, reducing the risk of osteoporosis – all this can help improve the physical and emotional well -being of a woman.

Improvement: Relief of night sweating and improving mood can help improve sleep quality.
Increase in energy: Improving sleep and a decrease in fatigue can lead to increased energy and activity.
Improving sexual function: The relief of the dryness of the vagina and discomfort during intercourse can improve sexual function and satisfaction.
Improving mood: Reducing anxiety and depression can improve mood and general emotional state.
Improving cognitive functions: Improving the concentration of attention and memory can improve cognitive functions and the ability to learn.
Improving self -esteem: Improving physical and emotional well -being can lead to an increase in self -esteem and self -confidence.

However, it is important to remember that GT is not a panacea and is not suitable for all women. The decision on the beginning of the GT should be made individually, after a thorough assessment of risks and advantages.

Section 12: Future directions in hormonal therapy studies

Studies in the field of hormonal therapy are ongoing, and in the future we can expect new methods and approaches to the treatment of symptoms of menopause.

Development of new types of hormones: New types of hormones are developed that can have a more selective effect on various body tissues, reducing the risk of side effects.
Individualized hormone therapy: In the future, we can expect the development of methods of individualized hormonal therapy, which will take into account the genetic characteristics of each woman.
Studies of the influence of GT on the brain: Studies of the effect of GT on the brain and the risk of developing neurodegenerative diseases continue.
Studying the role of microbioma in menopause: The role of microbioma in menopause and its effect on the effectiveness of hormonal therapy are studied.
Development of new non -drug methods of treatment: New non-drug methods for treating symptoms of menopause are developed, such as cognitive-behavioral therapy and acupuncture.

Future studies in the field of hormonal therapy are aimed at increasing the safety and effectiveness of the treatment of symptoms of menopause, as well as to improve the quality of life of women during this period.

Section 13: Legal and ethical aspects of hormonal therapy

Hormonal therapy is also associated with certain legal and ethical aspects.

Informed consent: Before the start of the GT, a woman should receive complete information about the risks and advantages of treatment and give informed consent to the procedure.
Confidentiality: The doctor is obliged to comply with the confidentiality of information about the patient’s health status.
Accessibility: GT should be available to all women in need of the treatment of symptoms of menopause.
Justice: The decision on the appointment of GT should be made on the basis of medical indications, and not on the basis of age, race, ethnicity or socio-economic status of the patient.
Transparency: Information about GT should be transparent and understandable to patients.
Responsibility: The doctor is responsible for the correct purpose and monitoring of the GT.

Compliance with legal and ethical norms in the field of hormonal therapy is necessary to ensure the safety and well -being of patients.

Section 14: Hormonal therapy and public health

Hormonal therapy is important for public health. Relief of symptoms of menopause can improve the quality of life of millions of women around the world, which leads to increased labor productivity, reducing health costs and improving the general well -being of society.

Prevention of osteoporosis: GT can help prevent osteoporosis and reduce the risk of fractures, which leads to a decrease in the costs of treatment and rehabilitation.
Reducing the risk of cardiovascular diseases: Some studies show that GT can reduce the risk of cardiovascular diseases, which leads to a decrease in mortality and disability.
Improving mental health: GT can help improve the mental health of women during menopause, which leads to a decrease in the incidence of depression and anxious disorders.
Improving labor productivity: Relief of symptoms of menopause can increase women’s productivity and promote economic development.

However, it is important to remember that GT is not a universal solution for all women. The decision on the beginning of the GT should be made individually, after a thorough assessment of risks and advantages.

Section 15: Final remarks about GT

Hormonal therapy is an effective method of treating symptoms of menopause, but it is not devoid of risks. The decision on the beginning of the GT should be made individually, after a thorough assessment of risks and advantages, taking into account the general state of health of a woman, her personal and family history of the disease. It is important to discuss all the issues related to the GT, with the doctor and make a reasonable decision, which corresponds to your individual needs and preferences. Regular visiting a doctor and compliance with all the recommendations of a specialist will help ensure the safety and effectiveness of treatment. The use of GT should be part of an integrated approach to maintaining the health and quality of life of a woman during menopause, including healthy food, regular physical exercises and stress management.

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