Hormone replacement therapy: advantages of the method and contraindications

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

Menopause is a special period of the physiological state of women, characterized by a decrease in the functionality of the reproductive system. With a healthy lifestyle and the absence of depressing factors, a woman enters premenopause at an average age of 45-50 years. As a rule, without hormone replacement therapy in the body, a complex restructuring begins, the usual rhythm of menstruation, their duration and menstrual blood volume are disrupted.

Ultimately, all this gradually leads to menopause - a complete stop of menstruation. The woman loses the ability to ovulate and reproduce.

Signs of menopause

Many women go through this psychologically difficult period calmly, not noticing the disturbances in their well-being and changes in their state of health. But a decrease in the functionality of the ovaries after 50 years can provoke suppression of the endocrine, cardiovascular and nervous systems.

A decrease in the level of sex hormones (estrogen, progesterone, androgen) leads to the development of very unpleasant climacteric symptoms:

1. Distortion of menstrual cycles. They can shrink, lengthen, disappear for several months. Opening of uterine bleeding is possible.

2. Hot flashes are a typical sign of entering premenopause. The onset of a hot flush is usually triggered by stress, fright, eating a spicy or highly salty dish, cramped clothing, and high ambient temperatures. Attacks are accompanied by a sharp increase in pulse rate, redness of the skin surface from the face to the chest, a feeling of heat, and end with cold sweat and chills. During these 3-5 minutes, the woman is tormented by unpleasant sensations - discomfort, anxiety, excitement. According to the frequency of hot flashes, the doctor draws conclusions about the severity of the climacteric syndrome:

   • up to 15 times a day - mild;
   • 15-30 - medium degree;
   • 30-50 - severe.
3. A decrease in estrogen production affects the emotional state of a woman and causes the following disorders: frequent mood swings, irritability, depression, nervous breakdowns, fatigue.
4. About half of women over 45 complain of insomnia. Insufficient melanin in the body can affect sleep. Rest becomes restless and restless.
5. An uncontrolled increase in body volume in women during menopause is a consequence of a decrease in the production of estrogen, which plays an important role in the metabolic fat balance.
6. The structure of the skin, hair, nails after 40 also changes due to the loss of collagen. There is dryness on the skin, wrinkles, cracks, the growth of nails and hair slows down.

Almost all of the above symptoms will help eliminate hormone replacement therapy for menopause. But before using it, it is imperative to make sure that the diagnosis is accurate.

Diagnosis of menopause

The manifestations of menopause are varied, some of them may indicate other health problems that are not associated with oppression of the reproductive system, for example, abnormalities in the thyroid gland.

Therefore, for the reliability of diagnosing menopause in a woman of 45-50 years old, a comprehensive instrumental and laboratory examination of the body is required:

• ultrasound examination of the thyroid gland and thoracic region;
• complete examination of the breast, which includes ultrasound, mammography and external examination;
• electrocardiogram of the heart;
• laboratory analysis of a smear for cytology;
• detailed blood test;
• regular monitoring of blood pressure.

The most accurate way to diagnose menopause is considered to be a blood test for follicle-stimulating hormones, since during menopause its content in the blood increases dramatically several times.

If during the medical examination concomitant diseases were identified, then hormone replacement therapy is postponed until they are eliminated. After all chronic ailments have been cured, the gynecologist chooses drugs for hormone replacement therapy against the depressing effects of menopause.

Hormone replacement therapy: indications and contraindications

Taking hormone replacement drugs can be symptomatic or prophylactic, that is, to deal with the already existing symptoms of menopause or with the alleged pathologies of the last stage of menopause (osteoporosis, arterial hypertension, etc.).

Indications for use:

• early menopause (up to 40 years) as a result of autoimmune disorders, chemotherapy, smoking, stress, surgery;
• tendency to osteoporosis;
• increased risk of cardiac and vascular pathologies (hyperlipidemia, diabetes, hereditary predisposition);
• already existing disorders of the cardiovascular system;
• diseases of the genitourinary organs;
• climacteric symptoms that disrupt normal life (frequent hot flashes, mood swings, insomnia).

Timely started hormone replacement therapy, carefully selected by the gynecologist, taking into account the physiological state of the body, has a positive effect on health - it corrects almost all possible and existing manifestations of menopause. But in the opposite case, if the drugs are taken without the appointment of a qualified doctor, extremely unpleasant consequences are possible - aggravation of climacteric symptoms and contributing to chronic diseases.

Contraindications to the use of hormone replacement therapy:

• high blood clotting;
• neoplasms in the mammary glands, ovaries, uterus;
• cirrhosis of the liver;
• diabetes;
• bleeding of the uterus.

How to avoid complications

To reduce the risk of developing pathologies in the process of hormone replacement therapy, a woman needs to be constantly monitored by a doctor for several years and follow his advice, even if outwardly there are no problems and the patient is not worried about anything. Every month you need to donate blood for biochemical analysis, general urine analysis, and measure blood pressure.

If any deviations from the norm are detected, the hormonal drugs are stopped, the doctor conducts a full examination of the woman's body and prescribes other drugs.

The choice of the type and form of taking hormonal drugs

Depending on the components, hormone replacement drugs are:

• homeopathic (contain phytohormones produced from medicinal plants);
• synthetic (made from various chemical components in scientific laboratories).

The dosage form of hormonal agents depends on the method of ingestion of the active components:

• Dragee, pill, tablet, capsule, syrup are introduced into the body in the most natural way for it - through the mouth (Femoston, Divina, Klimonorm, Estroferm, Trissekvens, Angelik, Cyclo-proginova). It is simple and convenient to take them, however, the active substances from them are absorbed for a long time and not in full. Some of them are destroyed even before they enter the bloodstream under the action of stomach enzymes, intestinal juices and liver enzymes.
• Intramuscular and intravenous injections allow useful substances from hormonal preparations to completely enter the bloodstream almost instantly. However, it is problematic to give injections to yourself, you will need the help of medical personnel, and this procedure is extremely unpleasant (Genodian-depot).
• Gels, creams, suppositories, patches are applied topically and enter the bloodstream and internal organs in minimal quantities, but they successfully fight against many climacteric skin diseases (Ovestin, Estroleg, Klimara, Divigel).

Hormone therapy after removal of the uterus and ovaries

Removal of the uterus and ovaries is a complex gynecological operation that requires a long rehabilitation period. For several months the woman is under close medical supervision. If the doctor believes that the body has fully recovered, the question of prescribing hormone replacement therapy is decided, which will maintain the level of estrogen in the norm.

After the removal of the uterus and ovaries, menopause sets in, the woman loses her fertility and observes unpleasant menopausal symptoms (hot flashes, headaches, mood swings, decreased libido).

Prevention of early menopause

The topic of prevention of early onset of menopause deserves special attention of those who wish to avoid various pathologies during menopause. Many of its signs are similar to those of other serious illnesses.

Therefore, a woman after 30 years should carefully monitor her health and be regularly examined, even if outwardly she seems absolutely healthy. Almost all diseases are easily treated and do not leave behind negative consequences if detected at the initial stage.

Preventive measures that have a very positive effect on women's health:

• active lifestyle;
• proper nutrition;
• full sleep;
• personal hygiene.

If you begin to notice signs of approaching menopause, no matter how old you are, do not be discouraged and panic. With timely access to a competent doctor, most unpleasant symptoms can be avoided.

Many modern drugs are able to maintain the natural hormonal balance and the excellent well-being of women in menopause.