Hormonophobia is firmly rooted in the minds of our women. “On forums, ladies scare each other with horror stories about hormone replacement therapy (HRT), from which they get fat, get covered with hair, and even get cancer.” Is this really so, let's try to figure it out together!

Menopause– this is one of the physiological processes that affect the female body as a whole.

I. Depending on the age at which the last menstruation ceased, menopause is divided into:

• Premature menopause- cessation of menstruation at 37-39 years.
• Early menopause- cessation of menstruation at 40-44 years.
• Late menopause- cessation of menstruation after 55 years.

II. The following phases are distinguished in menopause:

Perimenopause– this is the period from the beginning of the decline in ovarian function until the onset of menopause.
A clinical reflection of the altered ovarian function in premenopause is menstrual cycles, which can have the following character: regular cycles, alternating regular cycles with delays, delays in menstruation from a week to several months, alternation of delayed menstruation with uterine bleeding.
The duration of premenopause varies from 2 years to 10 years.

Menopause This is the last independent menstruation in a woman’s life. The age of menopause is determined retrospectively - after 12 months of absence of menstruation.

Postmenopause lasts from menopause to almost complete cessation of ovarian function. This phase of menopause precedes the onset of old age. There are early (3–5 years) and late postmenopause.
Menopause characterized by a complete disruption of the secretion of sex hormones - estrogens, progesterone and androgens. It is well known that estrogen deficiency leads to the appearance of psychovegetative symptoms (hot flashes, poor health), urogenital atrophy, the formation of osteoporosis, the development of obesity and metabolic syndrome (increases the risk of diabetes), lipid metabolism disorders (increases the risk of atherosclerosis).

*You can learn more about all the processes occurring during menopause from our article “MANOPAUSE”.

HRT- it's not just life expectancy. Sex hormones ensure that a woman maintains her health and, to a certain extent, prolongs her youth. Why are we and our patients in no hurry to take HRT? According to Professor V.P. Smetnik, in Moscow only 33% of gynecologists take HRT themselves, in St. Petersburg - 17%, while, for example, in Sweden this figure is 87% . If we - doctors - are in no hurry to help ourselves, is it any wonder that only 0,6% Russian women take HRT.

Why is there such a big gap between foreign and domestic data regarding HRT? Unfortunately, Russian “bast shoe” medicine continues to base its prescriptions on personal experience, prejudices, speculation, a single authoritative (authoritarian) opinion of luminaries, or simply works the old fashioned way. World medicine bases its recommendations on the basis of evidence-based medicine - the results of clinical trials, on scientifically proven facts.

So, what does evidence-based medicine tell us regarding HRT:

* the use of low-dose HRT (1 mg/day estradiol) has the same effect on the lipid profile of the blood as statins (drugs for lowering cholesterol);

* early initiation of HRT (perimenopause) can reduce overall mortality by 30% due to a reduced risk of cardiovascular disease;

* assessment of the effect of HRT on carbohydrate metabolism showed that HRT either does not affect or has a positive effect on indicators such as glycated hemoglobin, fasting glycemia levels, and insulin concentration. A study involving 14 thousand women with diabetes demonstrated that women taking HRT had significantly lower levels of glycated hemoglobin compared to those who did not receive estrogen therapy;

Very often, patients ask about the effect of HRT on the risk of breast cancer:

— HERS and WHI studies, which are considered the “gold standard,” showed that the combined use of conjugated ethinyl estradiol and medroxyprogesterone acetate (this component is contained in the drugs Divina, Divisek, Indivina) led to a slight increase in the risk of developing aggressive breast cancer;

- in the WHI study, there was an increase in the incidence of aggressive breast cancer with the use of estrogens and progestins, while the incidence rate decreased in the group receiving estrogens only;

- the E3N study showed a reduction in the risk of breast cancer with the use of a combination of 17-b-estradiol and dydrogesterone (Femoston). There is no clear explanation for this fact; it is possible that this positive effect may be mediated through a decrease in the severity of obesity, a known risk factor for breast cancer;

— identified cases breast cancer especially the first three years of HRT indicate quicker about the manifestation of a tumor process that already existed before the start of HRT;

- position of the international society on menopause (2007): women taking HRT should be warned that risk of developing breast cancer does not increase within 7 years of taking HRT.

So, the use of hormone replacement therapy provides a real opportunity to correct the manifestations of an estrogen deficiency state and, therefore, to treat and prevent early and late complications of menopausal syndrome in women of the older age group. HRT started before age 60 reduces overall mortality by 30-35% and prevents many diseases, including cardiovascular disease, osteoporosis and Alzheimer's disease.

Like any other treatment, HRT has its contraindications and side effects.

Contraindications for hormone replacement therapy are:

• pregnancy;
• acute hepatitis;
• acute deep vein thrombosis;
• acute thromboembolic disease;
• untreated tumors of the genital organs, mammary glands;
• meningioma.

Contraindications to the use of certain sex hormones:

For estrogens:

• breast cancer;
• endometrial cancer;
• severe liver dysfunction;
• porphyria;
• estrogen-dependent tumors.

For progestogens:

• meningioma.

Examination of the patient before HRT

Required:

• Ultrasound of the pelvic organs (uterus and ovaries);
• Oncocytology smear from the cervix;
• Examination by a mammologist (mammography or ultrasound of the mammary glands);
• Blood hormones: TSH, FSH, estradiol, prolactin, blood sugar;
• Blood clotting - coagulogram;
• blood biochemistry: ASAT, ALAT, total bilirubin, blood sugar.

Additional:

• lipid profile;
• densitometry
• genetic predisposition to arterial and venous thrombosis when using HRT.

Drugs for hormone replacement therapy:

1. “Pure” natural estrogens - estrogen, divigel in the form of a gel, climara patch, progynova, estrofem.
2. Combination of estrogens with gestagens: a modern combination of natural hormones “estrogel-utrozhestan”, two-phase combined (Climen, Klimonorm, Divina, Cycloproginova, Femoston 2/10, Divitren - estradiol valerate for 70 days, then medroxyprogesterone acetate for 14 days).
3. Monophasic combination drugs: Cliogest, Femoston 1/5, Gynodian-depot.
4. Tissue-selective regulator of estrogen activity: Livial.

How to understand this endless ocean of HRT drugs, which drug to choose? Answers to the following questions can help with this:

What components are included in HRT?

HRT preparations usually include 2 components: estrogen and progestin (gestagen). Estrogen eliminates the main manifestations of estrogen deficiency: hot flashes, urogenital disorders, osteoporosis, atherosclerosis, etc. Progestins are necessary to protect the uterus from the protective (stimulating) effect of estrogens (hyperplastic processes of the endometrium, etc.). In the absence of a uterus, estrogen alone can be used as HRT, without a progestin.

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Which drug should I choose?

The main principle of HRT is the selection of the safest drugs that can be used in women with various extrogenital pathologies in order to prevent osteoporosis and atherosclerosis. The evolution of HRT drugs went mainly in two directions:

I. Improvement of the progestogen (gestagen) component, which has no influence on the woman’s weight, her coagulation system, but at the same time protected the uterus from the influence of the estrogen component. Today, the closest to natural progesterone (UTROGESTAN) are dydrogesterone, drospirinone, dienogest.

II. Reducing the dose of the estrogen component. The basic principle is “as much as necessary, as little as possible.” A lot is necessary to improve general well-being, prevent osteoporosis, atherosclerosis, and prevent urogenital disorders. A little - perhaps to reduce or neutralize side effects on the uterus. In our country, natural estrogen (ESTROGEL, DIVIGEL), estradiol valerate and 17 β-estradiol are used.

Therefore, when choosing an HRT drug, your gynecologist should be guided by the properties of the progestin component, which provides reliable protection of the endometrium and does not affect carbohydrate and fat metabolism, which do not provoke the development of breast cancer. The drugs of the third generation of gestagens that are closest to natural progesterones are dydrogesterone, drospirenone, dienogest.

Comparative table of the effect of progestins on lipid, carbohydrate metabolism and blood coagulation system

*Note: HDL – high density lipoprotein; LDL – low density lipoproteins; TG - triglycerides 0 - no effect ↓ - slight decrease ↓↓ - strong decrease - slight increase - strong increase - very strong increase

Thus, only 3 gestagens: natural progesterone and dydrogesterone, drospirenone do not worsen cholesterol metabolism and do not aggravate the development of atherosclerosis, and do not affect sugar metabolism, do not have a thrombotic effect, and are the safest with regard to the development of breast cancer. Therefore, you and your gynecologist should choose a drug for HRT that contains one of these substances (utrogestan, dydrogesterone or drospirenone) as a second component.

The following drugs meet these requirements: estrogel (divigel) + utrozhestan; femoston; angelique.

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What is the best way to use drugs?

Oral administration is the use of tablet forms of drugs, therefore these drugs will definitely affect the liver.

In patients with liver pathology, transdermal administration of estrogens (estrogel or divigel gel cutaneously) in combination with intravaginal use of utrozhestan (or MIRENA spiral) is preferable.

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Which treatment regimens to choose?

If there is a uterus in perimenopause Prescribe combination therapy with cyclic drugs - estrogen + gestagen, simulating the normal menstrual cycle. Preferable drugs with a low estrogen content up to 1 mg (estrogel or Divigel or Klimara + utrozhestan or duphaston or MIRENA; Femoston 1\10 and 2\10, etc.).

IN postmenopausal in the presence of a uterus, continuous therapy with estrogen + gestagen is indicated, which does not produce menstrual bleeding, preferable to low doses of estrogens (estrogel or Divigel or Klimara + utrozhestan or duphaston or MIRENA; femoston 1\5, Angelique).

At surgical menopause- if the uterus is removed (without the cervix), one component of HRT is enough - estrogen (since endometrial protection is no longer needed), drugs can be used for this purpose - estrogel, divigel, climara, progynova, estrofem.

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How long to take HRT?

The duration of HRT today is not limited. To relieve the symptoms of menopause, as a rule, 3-5 years are enough.

Every year, the gynecologist, together with the patient, evaluates the benefits and risks and individually decides on the duration of HRT.

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How often do you visit a gynecologist and get examined when using HRT?

During the period of HRT, a woman should visit a gynecologist at least once a year to perform colposcopy, ultrasound of the pelvic organs, ultrasound of the mammary glands or mammography and study of biochemical blood parameters (blood sugar, ALT, AST, coagulogram)!

The patient discusses all questions regarding HRT with her gynecologist. If the gynecologist refuses to prescribe HRT to the patient and does not explain the reason for this, consult another specialist and resolve all your questions

Hormone replacement therapy - abbreviated HRT - is now actively used in many countries around the world. To prolong their youth and replenish sex hormones lost with age, millions of women abroad choose hormonal therapy for menopause. However, Russian women are still wary of this treatment. Let's try to figure out why this happens.

Should I take hormones during menopause?or 10 myths about HRT

After the age of 45, women’s ovarian function begins to gradually decline, which means the production of sex hormones decreases. Along with a decrease in estrogen and progesterone in the blood comes a deterioration in physical and emotional condition. Menopause is ahead. And almost every woman begins to worry about the question: what can she do take during menopause to avoid aging?

In these difficult times, the modern woman comes to the aid of. Because during menopause estrogen deficiency develops, it is these hormones that have become the basis for all medications drugs HRT. The first myth about HRT is associated with estrogens.

Myth No. 1. HRT is unnatural

There are hundreds of queries on the Internet on the topic:how to replenish estrogen for a woman after 45-50 years . No less popular are queries about whether they useherbal remedies for menopause. Unfortunately, few people know that:

• HRT preparations contain only natural estrogens.
• Today they are obtained by chemical synthesis.
• Synthesized natural estrogens are perceived by the body as their own due to complete chemical identity with the estrogens produced by the ovaries.

And what could be more natural for a woman than her own hormones, analogues of which are taken to treat menopause??

Some might argue that herbal remedies are more natural. They contain molecules that are similar in structure to estrogens, and they act on receptors in a similar way. However, their action is not always effective in relieving the early symptoms of menopause (hot flashes, increased sweating, migraines, blood pressure surges, insomnia, etc.). They also do not protect against the consequences of menopause: obesity, cardiovascular diseases, osteoporosis, osteoarthritis, etc. In addition, their effect on the body (for example, on the liver and mammary glands) has not been well studied and medicine cannot vouch for their safety.

Myth No. 2. HRT is addictive

Hormone replacement therapy for menopause- just a replacement for the lost hormonal function of the ovaries. Drugs HRT is not a drug; it does not disrupt the natural processes in a woman’s body. Their task is to compensate for estrogen deficiency, restore the balance of hormones, and also improve overall well-being. You can stop taking the medications at any time. True, it is better to consult a gynecologist before this.

Among the misconceptions about HRT, there are truly crazy myths that we get used to from our youth.

Myth No. 3. HRT will make a mustache grow

The negative attitude towards hormonal drugs in Russia arose quite a long time ago and has already moved to the subconscious level. Modern medicine has come a long way, but many women still trust outdated information.

The synthesis and use of hormones in medical practice began in the 50s of the 20th century. A real revolution was made by glucocorticoids (adrenal hormones), which combined powerful anti-inflammatory and antiallergic effects. However, doctors soon noticed that they affected body weight and even contributed to the manifestation of masculine characteristics in women (the voice became rougher, excess hair growth began, etc.).

Much has changed since then. Preparations of other hormones (thyroid, pituitary, female and male) were synthesized. And the type of hormones has changed. Modern medications contain hormones that are as “natural” as possible, and this makes it possible to significantly reduce their dose. Unfortunately, all the negative qualities of outdated high-dose drugs are attributed to new, modern ones. And this is completely unfair.

The most important thing is that HRT preparations contain exclusively female sex hormones, and they cannot cause “masculinity.”

I would like to draw your attention to one more point. A woman's body always produces male sex hormones. And that's okay. They are responsible for a woman’s vitality and mood, interest in the world and sex drive, as well as the beauty of her skin and hair.

When ovarian function declines, female sex hormones (estrogens and progesterone) stop being replenished, while male sex hormones (androgens) are still produced. In addition, they are also produced by the adrenal glands. That's why you shouldn't be surprised that older ladies sometimes need to pluck their mustache and chin hairs. And HRT drugs have absolutely nothing to do with it.

Myth No. 4. People get better from HRT

Another unreasonable fear is to gain weight while taking drugs hormone replacement therapy. But everything is quite the opposite. Prescription of HRT during menopause can have a positive effect on women's curves and shapes. HRT contains estrogens, which generally have no ability to influence changes in body weight. As for the gestagens (these are derivatives of the hormone progesterone) included innew generation of HRT drugs, then they help distribute adipose tissue “according to the female principle” and allow during menopause keep your figure feminine.

Don’t forget about the objective reasons for weight gain in women after 45. First: at this age, physical activity noticeably decreases. And second: the influence of hormonal changes. As we have already written, female sex hormones are produced not only in the ovaries, but also in adipose tissue. During menopause, the body tries to reduce the lack of female sex hormones by producing them in fatty tissues. Fat is deposited in the abdominal area, and the figure begins to resemble a man’s. As you can see, HRT drugs do not play any role in this matter.

Myth No. 5. HRT can cause cancer

The idea that taking hormones can cause cancer is an absolute misconception. There is official data on this topic. According to The World Health Organization, thanks to the use of hormonal contraceptives and their oncoprotective effect, annually manages to prevent about 30 thousand cases of cancer. Indeed, estrogen monotherapy increased the risk of endometrial cancer. But such treatment is far in the past. Includednew generation HRT drugs includes progestogens , which prevent the risk of developing endometrial cancer (body of the uterus).

As for breast cancer, there has been plenty of research on the effect of HRT on its occurrence. This issue has been seriously studied in many countries around the world. Especially in the USA, where HRT drugs began to be used back in the 50s of the 20th century. It has been proven that estrogens, the main component of HRT preparations, are not oncogenes (that is, they do not unblock the gene mechanisms of tumor growth in the cell).

Myth No. 6. HRT is bad for the liver and stomach

There is an opinion that a sensitive stomach or liver problems may be a contraindication for HRT. This is wrong. New generation HRT drugs do not irritate the gastrointestinal mucosa and do not have a toxic effect on the liver. It is necessary to limit the use of HRT drugs only in cases where there are pronounced liver dysfunctions. And after the onset of remission, it is possible to continue HRT. Also, taking HRT drugs is not contraindicated for women with chronic gastritis or peptic ulcers of the stomach and duodenum. Even during seasonal exacerbations, you can take tablets as usual. Of course, simultaneously with therapy prescribed by a gastroenterologist and under the supervision of a gynecologist. For women who are especially concerned about their stomach and liver, special forms of HRT preparations are produced for topical use. These may be skin gels, patches or nasal sprays.

Myth No. 7. If there are no symptoms, then HRT is not needed

Life after menopause not all women immediately aggravated by unpleasant symptoms and a sharp deterioration in well-being. In 10 - 20% of the fair sex, the autonomic system is resistant to hormonal changes and therefore for some time they are spared from the most unpleasant manifestations during menopause. If there are no hot flashes, this does not mean at all that you do not need to see a doctor and let the course of menopause take its course.

The serious consequences of menopause develop slowly and sometimes completely unnoticed. And when after 2 years or even 5-7 years they begin to appear, it becomes much more difficult to correct them. Here are just a few of them: dry skin and brittle nails; hair loss and bleeding gums; decreased sexual desire and vaginal dryness; obesity and cardiovascular diseases; osteoporosis and osteoarthritis and even senile dementia.

Myth No. 8. HRT has many side effects

Only 10% of women feel certain discomfort when taking HRT drugs. Those who smoke and are overweight are most susceptible to unpleasant sensations. In such cases, swelling, migraines, swelling and tenderness of the breast are noted. Usually these are temporary problems that disappear after reducing the dosage or changing the dosage form of the drug.

It is important to remember that HRT cannot be carried out independently without medical supervision. Each specific case requires an individual approach and constant monitoring of results. Hormone replacement therapy has a specific list of indications and contraindications. Only a doctor, after conducting a number of studies, will be able tochoose the right treatment . When prescribing HRT, the doctor observes the optimal balance between the principles of “usefulness” and “safety” and calculates at what minimum doses of the drug the maximum result will be achieved with the least risk of side effects.

Myth No. 9. HRT is unnatural

Is it necessary to argue with nature and replenish sex hormones lost over time? Of course you need it! The heroine of the legendary film “Moscow Doesn’t Believe in Tears” claims that after forty, life is just beginning. And this is indeed true. A modern woman at the age of 45+ can live a life no less interesting and eventful than in her youth.

Hollywood star Sharon Stone turned 58 years old in 2016 and she is sure that there is nothing unnatural in a woman’s desire to remain young and active for as long as possible: “When you are 50, you feel that you have a chance to start life anew: a new career, a new love ... At this age we know so much about life! You may be tired of what you did for the first half of your life, but that doesn't mean you should sit back and play golf in your backyard. We are too young for this: 50 is the new 30, a new chapter."

Myth No. 10. HRT is an understudied treatment method

The experience of using HRT abroad is more than half a century, and all this time the technique has been subjected to serious control and detailed study. Gone are the days when endocrinologists, through trial and error, searched for optimal methods, regimens and dosages of hormonal drugs for menopause. To Russia hormone replacement therapycame only 15-20 years ago. Our compatriots still perceive this treatment method as little studied, although this is far from the case. Today we have the opportunity to use proven and highly effective remedies with a minimum number of side effects.

HRT for menopause: pros and cons

For the first time, HRT drugs for women in menopause began to be used in the USA in the 40-50s of the 20th century. As treatment became more popular, it was found that the risk of disease increased during the treatment period uterus ( endometrial hyperplasia, cancer). After a thorough analysis of the situation, it turned out that the reason was the use of only one ovarian hormone - estrogen. Conclusions were drawn, and in the 70s biphasic drugs appeared. They combined estrogens and progesterone in one tablet, which inhibited the growth of the endometrium in the uterus.

As a result of further research, information was accumulated about positive changes in a woman’s body during hormone replacement therapy. To date known that its positive effect extends not only to menopausal symptoms.HRT during menopauseslows down atrophic changes in the body and becomes an excellent prophylactic agent in the fight against Alzheimer's disease. It is also important to note the beneficial effects of therapy on a woman’s cardiovascular system. While taking HRT drugs, doctors recorded improving lipid metabolism and reducing blood cholesterol levels. All these facts make it possible today to use HRT as a prevention of atherosclerosis and heart attack.

Information from the magazine was used [Climax is not scary / E. Nechaenko, - Magazine “New Pharmacy. Pharmacy assortment”, 2012. - No. 12]

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INTERACTIVE

It is extremely important for women to know everything about their health - especially for initial self-diagnosis. This rapid test will allow you to better listen to the state of your body and not miss important signals in order to understand whether you need to see a specialist and make an appointment.

Fatigue, aging skin, insomnia - this is not the whole bouquet of what a woman can feel during menopause.

“You have to endure this, it happens to everyone, you don’t die from it,” our mothers and grandmothers and, unfortunately, many gynecologists assure.

“If I hadn’t started taking hormones on time, I would have lost my youth,” Madonna boldly states in one interview.

Why are our compatriots so afraid of hormone replacement therapy (HRT) during menopause, and abroad women during menopause are required to seek help from doctors so that they can prescribe them a hormonal drug that will help them survive the menopause?

We’ll talk about this on the women’s website “Beautiful and Successful”.

How does menopause occur?

After 40 years, the female body rises to a new level. The new “stage” has a completely medical name - menopause (by the way, “menopause” is literally translated as “step”). This period is directly related to the process of production of sex hormones, or more precisely, with a decrease in the production of these hormones - estrogen and progesterone. Due to their lack, significant changes begin to occur in the female body.

The restructuring of the body for menopause begins at 40-45 years old and ends at 51-53 years old - the time of the last menstruation.

After this age, hormonal changes continue to occur in a woman’s body, and she constantly feels all the delights of menopause. Is it worth enduring the ebbs and flows, depression and headaches all these years if hormonal therapy can help? What should women do with?

Why does menopause have so many symptoms?

The functioning of the mammary glands, genital organs, brain, cardiovascular system, the condition of the skin and hair, the functioning of the liver, large intestine and genitourinary system depend on estrogen, the female sex hormone. The lack of this hormone, which occurs during menopause, immediately affects all systems in the body.

There are more than 30 symptoms that a woman faces due to menopause after 40 years.

The most common mistake of modern women is that they are accustomed to letting everything take its course, especially if the symptoms are not pronounced. Like, this will pass. But at this time, a woman just needs to undergo the first diagnosis in order to start helping her body in a timely manner.

Why are women afraid of HRT?

In our country there is a “widespread hormone phobia”. Doctors often prescribe hormones for early menopause or after surgery, but, having no experience in using these drugs during menopause, they refuse to use them. Many of our compatriots are afraid of hormones, believing that they:

1. Total chemistry;
2. Contrary to feminine nature and cause cancer;
3. They make you fat and masculine;
4. Affects the liver and stomach;
5. Cause addiction;

So it turns out that there is a mutual responsibility: doctors don’t prescribe – women endure. But why be afraid of what has been practiced abroad for several decades?

How does HRT work?

The work of the female body can be conditionally divided into 2 periods: the first, when it has enough hormones, and the second, when hormones stop being produced and there is a deficiency. The second period is called menopause (menopause).

Hormone production stops when the ovaries stop producing eggs, or after the female organs are surgically removed. Lack of hormones manifests itself in different ways:

• Hot flashes in women during menopause indicate that she lacks estrogen.
• Weakness and malaise in women during menopause occur due to a lack of another hormone - progesterone.

The principle of action of HRT drugs during menopause is quite simple - the body is given a certain dose of hormones so that this deficiency is not felt. That is, the body receives what nature took from it. New generation drugs cope well with this. Only the drug must be prescribed in a timely manner after mandatory diagnosis.

When should you start taking hormones?

It is better to prescribe hormonal therapy as soon as a lack of estrogen begins, so you need to go for diagnosis at 40–45 years old - at the beginning of the premenopausal period.

It is also mandatory to prescribe HRT for early menopause - the drugs are selected strictly by the doctor after a preliminary examination, and for artificial menopause.

If 5 years have passed since menopause, then it is already too late to prescribe hormones - it is almost impossible to stop the aging process of the female body and help it.

Is it possible to do without hormonal drugs?

Let us remember that the main goal of hormonal therapy is to alleviate a woman’s condition during menopause. Therefore, you can not take hormones, but start fighting each symptom of menopause separately: take medications for headaches, antidepressants, medications to improve the functioning of the gastrointestinal tract, antipyretics for hot flashes, for osteoporosis, medications for blood pressure, etc. Note that such therapy also effective, but in comparison with hormonal it is:

• expensive
• troublesome
• not always effective
• psychologically difficult (“do I really need so much medication at this age to feel good?”)

Why take each drug separately if HRT has a complex effect on the cause and does not remove individual symptoms?

Prescribing new generation HRT drugs during menopause will help prevent many problems associated with a woman’s health: reduce the risk of diabetes and Alzheimer’s disease, obesity and skin aging.

Of course, you can go through menopause without HRT. There are alternative options for how to do without hormones during this period.

• First, you need to seriously think about a healthy lifestyle: stop smoking, eat a balanced diet, monitor your sleep and wakefulness, and limit exposure to the sun.
• Secondly, you need to constantly use the services of modern cosmetology, including expensive skin tightening operations and rejuvenation sessions.
• Well, and, of course, we must not forget about homeopathic medicines and dietary supplements, which are so widely popular in the modern world.

New generation HRT drugs

HRT drugs for menopause have always caused controversy for and against. Let's dispel several myths about the unnaturalness and danger of HRT for women's health.

• HRT drugs have gone through a long journey of testing and research. We can consider ourselves lucky - only new generation drugs reach our shelves, which can only be produced by serious pharmacological companies.
• Hormone replacement drugs of the modern generation are completely natural - they have a composition of hormones identical to those produced by the female body.
• The dosage of hormones in the drug is minimal. There is no addiction to hormonal drugs. This is just a remedy that helps a woman survive hormonal changes. After discussing with your doctor, medications can be stopped at any time.
• During menopause, the body does not stop producing male hormones. Natural estrogens, which are included in the main composition of all HRT preparations, are female. It is their production that stops during menopause. Taking female hormones neutralizes the effect of male hormones: it will stop hair growth in unnecessary places, allow you to maintain female shapes and proportions, improve the condition of your skin, and prevent snoring.
• The hormones that make up HRT do not lead to obesity. On the contrary, they stop the production of estrogen in adipose tissue. It is not the use of HRT that leads to obesity during menopause, but the age-related prerequisites for this: physical activity decreases, metabolism slows down.
• Many people are afraid to take HRT, believing that they have a bad effect on the gastrointestinal tract. Modern hormonal drugs do not affect the gastrointestinal tract in any way, and for those who are very afraid for their stomach, alternative forms of the drug have been released - patches, gels, ointments and suppositories, which are absorbed through the skin.
• HRT contains components that prevent cancer, rather than provoke it. The hormonal cause of cancer due to HRT use has not been proven.

A woman who takes hormonal medications during menopause must be observed by a doctor: monitor the condition of the endometrium and vaginal mucosa, mammary glands, hormone levels, etc.

The best HRT drugs

If yesterday doctors considered menopause to be a period in a woman’s life that needs to be overcome, today menopause is considered to be a period of lack of hormones that can be given to the body. A doctor should prescribe HRT after preliminary diagnosis, so the site will only introduce its readers to the list of modern drugs, but we will not recommend them for use. All new generation drugs have a low dosage, which allows you to select the optimal safe dose for each woman. It can be lowered or raised.

• We have received good reviews about the drugs “Femoston”, “Angelik”, “Atarax”, “Grandaxin”, “Sigetin”, etc.

Of course, there are many among us who consider themselves to be opponents of everything hormonal. Homeopathic and herbal remedies will come to the aid of such women, although they are less effective than modern HRT drugs.

Of course, menopause is a natural process in our body. And it’s very good that modern women have the opportunity to choose products that help improve their quality of life during this period.

According to experts, new generation HRT drugs are the optimal method of treating menopausal syndrome. The products contain a minimal amount of synthetic hormones, which makes the drugs practically harmless and suitable for long-term use. Let's consider reviews about.

Hormone replacement therapy

For many women, menostasis becomes a very difficult period in life. However, it is completely wrong to regard menopause as a disease, just as it is completely wrong to regard hormone therapy as a treatment for menopause. HRT for menopause with new generation drugs, according to doctors, is only to help the body move more smoothly into the stage of complete cessation of reproductive function, without the risk of developing dangerous pathologies caused by a sharp estrogen deficiency. Not everyone can take synthetic estrogens, and even in the absence of contraindications, gynecologists do not advise some women to resort to hormone therapy.

For example, a woman does not experience severe hot flashes, her hormonal levels are within acceptable limits, and the risks of developing osteoparosis are low - specialists cannot advise such a woman to take HRT, since it is clear that her body copes with hormonal changes on its own and does not require treatment. It’s another matter when a patient comes to the doctor with complaints of a significant decrease in quality of life, frequent and intense hot flashes, nervous exhaustion and the inability to continue their usual lifestyle. Such a woman will be carefully examined, and if there are no contraindications, HRT may be recommended.

Absolute contraindications:

• Uterine bleeding;
• Suspicions of cancer;
• History of oncology;
• Hypertension;
• Atherosclerosis;
• Ischemia;
• Benign neoplasms;
• Diabetes mellitus;
• Liver pathologies;
• Kidney pathologies;
• Pregnancy and lactation.

Important! Treatment with HRT is possible only under the strict supervision of a specialist. Self-medication is strictly prohibited!

Early menopause is a pathology that is dangerous primarily due to the development of complications. Menostasis is considered early if reproductive function begins to fade before the age of 40. Such patients most often encounter severe symptoms of menopause, because, in fact, the body is not yet ready for hormonal changes, and a sharp deficiency of estrogen leads to early hypertension, heart disease, osteoporosis, benign neoplasms, Alzheimer's disease and other diseases.

In the absence of contraindications, women with early menopause should definitely take hormonal pills. It is HRT in this case that will delay menopause for several years and smooth out unpleasant manifestations, and will also prevent the occurrence of the above pathologies. The same can be said for patients with surgical menopause, they also need to take HRT to protect themselves from these diseases.

Important! Before prescribing HRT for early menopause, the cause of the deviation must be identified.

Non-hormonal drugs taken during menopause to relieve symptoms

Hormone-free treatments are alternative methods for relieving menopausal symptoms. Today, there are a lot of herbal medicines on sale that have an estrogen-like effect and, while not being synthetic analogues of sex substances, can also eliminate the unpleasant symptoms of menostasis. Phytohormones are quite effective with long-term use, but in order to feel the first positive changes in well-being, they need to be taken for at least 2-3 months.

Phytohormones are not drugs; they have virtually no contraindications and are easily tolerated by patients. Many ladies today choose herbal remedies for menopause, and experts agree with this choice, but only if the patient does not require serious hormonal treatment. The choice of treatment always remains with the patient, but experts insist that if you are prescribed certain pills, it is better to follow the doctor’s recommendations so as not to encounter unpleasant complications in the future.

Important! Non-hormonal therapy also requires the supervision and control of a doctor, because dietary supplements also have contraindications and side effects.

Many reviews can really be alarming. Ladies on social networks and forums share their sad stories when hormones, in their opinion, cause the development of cancer, fibroids, cysts and other dangerous diseases, but gynecologists insist that with an adequate approach, hormone replacement therapy cannot cause these diseases. Let's consider the most common myths about, which often become a reason for refusing to take funds from this group:

• HRT causes cancer. This is of course the scariest and most widespread myth. However, according to official statistics, the incidence of cancer due to hormone therapy is approximately 1 in 5,000 diseases. Moreover, more than half of the cases occur in women with a genetic predisposition to cancer, and another 30% are discovered when they take medications on their own without prior examination and observation.
• Hormone therapy causes obesity. This is a fundamentally incorrect statement; on the contrary, with the right medication and dosage, medications in this group prevent excess weight gain. You just need to know that fat reserves during menopause are just the body’s reaction to a lack of estrogen. The body, thus, tries to compensate for the deficiency of the sex hormone, because fat synthesizes one of the types of estrogens.
• Hormone therapy is forever. Completely false. Patients who claim that it is impossible to stop taking hormones should simply contact an experienced doctor. Both entry and exit from hormone replacement therapy should be smooth, by changing the dosage and schedule of taking the medication.

In addition to this, there are a lot of myths that are passed on from mouth to mouth and are filled with horrific details, but experts advise paying attention to the advantages that treatment can give, namely:

• Absence of hot flashes and other manifestations of menostasis. Thanks to replacement therapy, the body does not face estrogen deficiency, which means that all organs and systems continue to function properly.
• Prevention of long-term complications of menostasis. Today, only hormone replacement treatment can guarantee the prevention of osteoparosis, hypertension, heart attack and stroke due to a lack of sex hormones.
• Great appearance. Patients taking replacement therapy do not experience rapid aging and look much younger than their peers who refuse treatment. It should be noted that youth is preserved not only on the face, but also in the internal organs, blood vessels, reproductive system, etc.
• Cheerfulness and stable mood. The absence of depression, irritability and apathy allows ladies to lead a normal lifestyle and continue to enjoy everyday little things. Such women are sociable and cheerful, they enjoy life and can afford to do what they love.
• Completeness of sexual life. One of the problems of menostasis is decreased libido and vaginal dryness, which often become a reason for a complete refusal of physical intimacy. Hormone replacement therapy eliminates these abnormalities and allows you to lead a normal sex life, which undoubtedly has a positive effect on self-esteem, family relationships, health, etc.

Important! Despite all the positive aspects of replacement therapy, this treatment cannot be used as an anti-aging agent or applied in advance, even before the onset of unpleasant symptoms.

List of new generation HRT drugs

Reviews about hormone replacement therapy drugs for menopause are quite varied, but patients and doctors highlight the most effective medications of the new generation, namely:

• Klimonorm. The product contains two synthetic analogues of the sex hormones estrogen and histagene, which helps to avoid hormonal imbalance, which in some cases becomes the impetus for the development of oncology.
• . This is a new generation two-phase combination drug that effectively relieves the main symptoms of menopause and is a prevention of long-term complications of menopause.
• . The tablets contain the active substances estradiol and drospirenone. The drug is prescribed for both early and timely menostasis as a prevention of long-term complications, and a drug that significantly improves the well-being of a woman during menopause.
• Levial. Active ingredient: tibolone. This medication is gaining more and more popularity, because it rarely causes side effects and perfectly fights all manifestations of menopause. According to gynecologists, this is a drug of the 21st century.

With the onset of premenopause, a woman’s body begins to experience menopausal symptoms associated with a deficient level of estrogen.

Particular discomfort is caused by manifestations such as increased sweating, rapid gain of extra pounds, disturbances in the rhythm of the heartbeat, a feeling of dryness on the vaginal mucosa, and urinary incontinence. Hormonal medications for menopause will help eliminate all unpleasant menopausal symptoms.

All hormonal drugs are divided into 2 main groups:

1. Estrogen-containing medications, prescribed mainly after hysterectomy (surgical removal of the uterus).
2. Combined products containing progesterone, which protects the endometrium, as well as estrogen.

Hormonal pills for menopause are an effective way to get rid of the severe consequences of menopause. The basis of treatment with hormone replacement therapy is the systematic intake of hormones, observation by a specialist and periodic examination of the whole body to identify pathologies associated with menopause.

It is also necessary before taking HRT drugs to make sure that it is suitable for the body and there are no contraindications. Hormone replacement therapy for menopause should only be prescribed by a qualified specialist.

Let's take a closer look at why hormone therapy is prescribed and its positive aspects.

The positive side of hormone therapy

With the onset of menopause in women, involutional changes begin in the body, characterized by the extinction of hormonal levels, the functionality of the ovaries, changes in the structure of tissues in the brain, leading to a decrease in the production of progesterones, and then estrogens, and the appearance of corresponding symptoms, manifested in the form of:

• Menopausal syndrome. In premenopause, it occurs in 35% of the female population, in 39-42% in women with the onset of menopause, in 19-22% after 12 months from the onset of menopause and in 3-5% after 4-5 years after the menopause.

The manifestation of menopausal syndrome is associated with the formation of hot flashes and a sudden sensation of heat, increased sweating followed by chills, psycho-emotional instability, increased blood pressure and its spasmodic nature. Also, an increase in the rhythm of the heartbeat, the appearance of a feeling of numbness at the tips of the fingers, pain in the heart area, sleep disturbance and the appearance of insomnia, depression and other associated symptoms.

• Disorders of the female genitourinary system, manifested in the form of decreased libido against the background of decreased testosterone levels, dryness on the mucous surfaces in the vaginal area, urinary incontinence, especially during sudden sneezing, coughing or fright. You may also experience pain during urination.
• Dystrophic changes in the skin and their appendages, accompanied by the formation of diffuse alopecia, dry skin, increased fragility of the nail plates, and the appearance of deeper wrinkles.
• Disorders of metabolic processes in the body: this type of pathological changes is accompanied by a decrease in appetite and a simultaneous increase in the mass of the subcutaneous fat layer. Also, fluid from the body begins to be excreted at a slow pace, which leads to the formation of pastiness in the face and the appearance of swelling of the legs.
• The development of late manifestations related to the formation of osteoporosis, which occurs against the background of a decrease in the level of calcium in the skeletal system of the body, as well as hypertension, ischemia, Alzheimer's disease and other equally serious pathologies.

Consequently, all menopausal changes occurring in a woman’s body can occur with the development of certain symptoms with varying degrees of severity.

Hormone replacement therapy for menopause is an effective method that helps prevent, eliminate or significantly reduce dysfunction of all organ systems and reduce the risk of serious pathological processes occurring against the background of hormonal deficiency.

The main principles of hormone replacement therapy are:

1. Prescription of drugs, the main composition of which is similar to female sex hormones.
2. Taking small doses corresponding to the level of endogenous estradiols, especially in the proliferative stage.
3. Treatment with various combinations of estrogen and progesterone to help prevent the occurrence of endometrial hyperplasia.
4. After a hysterectomy (surgical removal of the uterus), it is possible to take medications containing only estrogens.
5. Prophylactic use of hormonal drugs, aimed at eliminating the occurrence of pathologies such as osteoporosis and cardiac ischemia, should be at least 5 years.

The main active component of hormonal drugs is estrogens. When adding gestagens, a kind of prevention of the hyperplastic process on the mucous membranes of the uterus and control of its condition is carried out. Let's look at the list of the most effective hormonal drugs.

HRT drugs

Taking HRT during menopause and new generation drugs should only be prescribed by a qualified specialist.

Klimonorm

This medicine belongs to the group of antimenopausal drugs. This drug contains two active components - estrogen and gestagen, the main action of which is aimed at eliminating menopausal symptoms and preventing the occurrence of endometrial cancer and hyperplasia.

The unique composition of the drug and adherence to a special dosage regimen in combination provide a chance of restoring the menstrual cycle in women who have not undergone a hysterectomy.

The active component estradiol contained in Klimonorm completely replaces the lack of natural estrogen in a woman’s body during menopause. This helps eliminate vegetative and psychological problems that arise during menopause due to a decrease in testosterone and sexual activity. When taken correctly, the drug can reduce the rate of formation of deep wrinkles and increase the collagen content in the skin. Moreover, the drug reduces blood cholesterol levels and the risk of gastrointestinal pathologies.

If the menstrual cycle is not completed and even rare menstrual discharge occurs, treatment should begin on the fifth day after the start of menstruation. If amenorrhea develops at the beginning of the menopausal period, treatment can be started at any time, provided there is no pregnancy.

One package of the drug is designed for a 3-week course of treatment. To achieve the desired result, you must take hormones according to the prescribed treatment regimen. When taking increased doses of the drug, adverse reactions of the body may occur, manifested by stomach upset, vomiting and bleeding not associated with the menstrual cycle. You can get rid of the symptoms of an overdose with the help of systematic treatment prescribed by your doctor.

Femoston

Hormone replacement therapy during the postmenopausal period involves taking this two-phase combination drug if the woman has no contraindications. The two active components that make up this drug, estradiol and progesterone, have a similar effect on the body as natural female sex hormones.

Together, estradiol and progesterone contribute to:

• Elimination of vegetative symptoms;
• Elimination of psycho-emotional disorders;
• Prevention of the development of osteoporosis, cancer of the uterus and hyperplasia.

The tableted drug Femoston must be taken at the same time period once a day. Treatment should be carried out according to the prescribed regimen. In the first two weeks, it is recommended to take hormones in white tablets. For the next two weeks of course treatment, you need to take gray tablets.

For women with a predominant menstrual cycle, treatment is prescribed from the first day of menstruation. For those who have irregularities in the menstrual cycle, a course of treatment with the drug “Progestogen” is initially prescribed, then Femoston is taken, according to a special treatment regimen. Women who have no menstrual cycle at all can start taking the drug at any time.

To obtain the desired result, female hormones in tablets must be taken, strictly following the treatment regimen, this is the only way to improve overall well-being and delay the onset of old age.

Klimadinon

This drug belongs to the group of herbal medicines containing phytohormones. Prescribed for the treatment of menopausal symptoms and elimination of vegetative-vascular disorders, when there are obvious contraindications and hormones cannot be taken during menopause.

The treatment regimen and duration of treatment are prescribed depending on the individual characteristics of the woman’s body.

Angelique

Angelique, like Klimonorm, are medications for menopause in women that help get rid of unpleasant symptoms and improve overall well-being.

Angeliq is used for:

• Normalization of general well-being;
• Eliminating unpleasant symptoms of hot flashes and reducing the frequency of their occurrence;
• Prevention of osteoporosis;
• Increasing testosterone levels, and, consequently, normalizing sexual activity.

Do not take this medicine if you have the following conditions:

• The presence of bleeding from the vagina of unknown etiology;
• Development of a cancerous tumor in the mammary glands;
• For diabetes, hypertension and venous thrombosis.

Angelique contains the necessary hormones during menopause, which are an excellent solution for improving well-being and restoring hormonal imbalances, especially for women over 45-46 years old.

Klimara

This is a hormonal drug, produced in the form of a patch, which contains estradiol in a dose of 3.8 mg. The patch is glued to a certain area of ​​the skin, after which the active component begins to be released and the woman’s general well-being improves. It is recommended to wear one patch for no more than a week. On the last day of the week, it is necessary to replace the used patch with a new one, making sure to change the place for its fixation.

Under the influence of the patch, the level of testosterone in the body increases, which has a positive effect on the psycho-emotional state and increased libido. There are no special contraindications to the use of the patch, but before using it you should consult a specialist.

During menopause, female hormones decrease under the influence of age-related changes and the transition period, worsening the woman’s condition. Therefore, it is necessary to use HRT drugs that can, in a short period of time, relieve a woman of disorders of the autonomic system, decreased testosterone levels and the ensuing consequences: changes in the psycho-emotional state. Among other things, hormonal drugs are generally well absorbed and have no adverse reactions.

In order to find out what to drink during menopause, you need to undergo a complete diagnosis of the body’s condition and consult with a specialist.

Spontaneous intake of hormonal drugs can be not only useless for the body, but also dangerous, entailing irreversible consequences. Therefore, you should take hormonal medications only as prescribed by your doctor.

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