Breathe
By Julie Salomon
The symptoms of menopause can be very distressing and significantly affect the personal and social lives of all of us. It is becoming increasingly evident that failure to treat symptoms at an early age can lead to an altered quality of life, reduced work productivity and possibly a general decline in health. These symptoms come from the cessation of hormone production by the ovaries, mainly estrogen, progesterone and testosterone.
Hormone therapy (HT) is an approved treatment and several studies have shown that it increases life expectancy and improves quality of life, and it has been studied that the risk of mortality from various causes is reduced by 20% to 50% compared to those who do not receive it.
The type of therapy, which you should choose, should be personal and individualized, we must always consider safety, benefit over risks and the most important thing is to know that regardless of hormone replacement we must include healthy habits that include a diet rich in protein, physical exercise to increase muscle mass, emotional support and above all a purpose in life.
Let's put it this way, HT is the first treatment that favorably modifies the physiological process of aging by preventing many diseases, including osteoporosis and cardiovascular disease (the main cause of death).
HT prescribing practices have evolved favorably in recent decades and today we know that the earlier you start the better. Guidelines have been published that support initiation of HT for symptomatic women who are within 10 years of menopause and under 60 years of age without contraindications, such as breast cancer or existing cardiovascular disease or history of thrombosis.
There are basically 2 basic types of HT: Estrogen therapy alone and estrogen-progesterone therapy.
And they can be administered basically by two main routes: systemic, which are all the products that circulate in the blood, or local.
Estrogens are well absorbed through the gastrointestinal tract, skin and mucous membranes, so formulations are available as oral preparations, transdermal patches, sprays, gels, topical emulsion preparations, vaginal preparations, and in combination with progesterone.
Estrogens alone are generally given to women who do not have a uterus, i.e., who have had a surgical hysterectomy.
The benefits of HT are multiple: in vasomotor symptoms (hot flashes) have an effectiveness of 70-90%. In osteoporosis all hormonal treatments recover the density of bone mass. They decrease the cardiovascular risk of coronary heart disease, there is an improvement in symptoms of depression and cognitive decline, we also know that giving HT reduces the risk of diabetes mellitus 2, as it lowers blood sugar levels and improves insulin sensitivity. The use of low-dose estrogen vaginal therapy is FDA approved to treat moderate to severe vaginal dryness and dyspareunia (pain with intercourse) .
In general, the recommendation is to use an individualized approach, starting at an early age for maximum benefit with periodic reassessment including the appropriate type, dose, formulation and route of administration to meet treatment goals for as long as necessary. There are alternatives for those women who are not candidates for HT and multidisciplinary treatments should always be included in this transition.
The opinions expressed are the responsibility of the authors and are absolutely independent of the position and editorial line of the company. Opinion 51.
Comments ()