All February we talked about menopause: how to reduce the risk
Unfortunately, 10 years after menopause, treatment with MHT drugs is much less effective. This is due to a decrease in the sensitivity of estrogen receptors and the presence of baggage of metabolic disorders that have already formed over the years of the absence of hormonal influence. Treatment of menopausal syndrome involves replenishing the deficiency
estrogen preparations containing natural estradiol. This is a therapy with proven effectiveness, which cannot be said about the use of phytoestrogens – preparations containing plant components that have an estrogen-like effect (more about this
Another means is symptomatic treatment (replenishment of vitamin and microelement deficiencies, taking drugs to improve sleep and normalize the activity of the central nervous system) and the use of non-drug methods (diet, physical activity, breathing practices for stress tolerance).
Indications for the appointment of MHT:
- vasomotor symptoms (hot flashes) with mood changes, sleep disturbance;
- symptoms of urogenital atrophy, sexual dysfunction;
- prevention (note: prevention, not necessarily the disease must already be present) and treatment of osteoporosis;
- poor quality of life associated with menopause, including arthralgia, muscle pain, memory loss;
- premature and early menopause;
- surgical menopause (removal of the uterus without appendages, with appendages or removal of the ovaries).
Contraindications to MHT:
- bleeding from the genital tract of unknown origin;
- breast and endometrial cancer (absolute contraindication even in case of stable remission);
- acute hepatitis;
- acute deep vein thrombosis;
- acute thromboembolism;
- allergy to MHT ingredients;
- cutaneous porphyria;
- thrombophlebitis;
- meningioma.
Relative contraindications to MHT are:
- uterine fibroids, endometriosis;
- migraine;
- venous thrombosis and embolism (in history);
- familial hypertriceridemia (abnormally elevated levels of lipids and lipoproteins in human blood);
- cholelithiasis;
- epilepsy;
- ovarian cancer (history).
Please note that varicose veins and cervical cancer are neither absolute nor relative contraindications for MHT (cervical cancer has a viral nature of the disease, it is not an estrogen-dependent disease). Meanwhile, very often women are convinced of the opposite.
To date, Russia has almost the entire arsenal of modern highly effective drugs for MHT. Speaking of such drugs, I do not mean combined oral contraceptives, which include synthetic substitutes for steroid hormones, but analogues of natural sex hormones produced by the human body.