Menopause: do not give up hormone replacement therapy
Do I need to be afraid of hormones?
Mila Martynova, ABC magazineWhat woman doesn't want to live longer and feel younger than her years?
We dare to assume that anyone. However, one of the main medicines that help to realize this desire remains "persona non grata" for many.
The most frequent questions of our readers are answered by an expert – Vera Petrovna Smetnik, MD, Professor of the Department of Gynecological Endocrinology of the Scientific Center of Obstetrics, Gynecology and Perinatology, President of the Russian Menopause Association.
If menopause is inevitable, then why help the body from the outside?Menopause is not a disease, it is a physiological period, but it all depends on when it came.
If, for example, at the age of 40, a woman stopped receiving ovarian hormones so necessary for her health 10 years earlier. So it is necessary to replace them, to make up for them. We give natural hormones in low doses to slow down the development of diseases and old age.
Are they needed? Is it possible to live without thyroid or pancreatic hormones, adrenal glands?
And why do you have to live without sex hormones? Why then wear glasses, because age–related weakening of vision and hearing is also a physiology. But we want a higher quality of life, so we use glasses and hearing aids. We live in the era of substitution technologies.
A woman spends a third of her life in postmenopause, she should be ready for this, know what is happening to her, and what opportunities exist to help herself during this period.
How do sex hormones affect a woman's health? They protect her from a lot of diseases.
First of all, from heart attacks and strokes – the leading cause of death worldwide. After all, sex hormones have many application points in the body – it is not only the reproductive, but also the central nervous, bone, and cardiovascular systems. This explains the colossal range of symptoms during menopause or in women who, due to various circumstances, had their ovaries removed.
When menopause occurs, the level of your own sex hormones decreases sharply, the very "age-related diseases" (atherosclerosis, osteoporosis, genitourinary and other disorders) begin, the onset of which can be delayed by timely HRT.
For example, Alzheimer's disease is 4.7 times more common in women than in men. But the incidence rate decreases if a woman receives HRT for at least 3 years. Even more chances to protect herself from this disease and dementia (dementia) if she receives hormones from 3 to 10 years or more.
23 large studies have already been carried out with the participation of more than 39,000 patients and it has been found that when hormone therapy is performed before the age of 60, the mortality rate decreases by 30%. Therefore, HRT is not only an improvement in the quality of life, but also a reserve for increasing its duration.
When should I start HRT?There are two types of hormone therapy.
In premenopause, when the ovaries still produce their own hormones, but they are no longer enough, low-dose drugs are prescribed, they maintain a menstrual-like state, which is the prevention of uterine cancer.
If menstruation has already stopped, tests and ultrasound show that premenopause has occurred, a different type of hormones is required.
But in the case when more than 10 years have passed since the persistent cessation of menstruation, HRT is not indicated – it can have the opposite effect.
Also, according to all recommendations, it is too late to start hormone therapy if a woman is 65 years old.
Is a medical examination required before the appointment of HRT?Necessarily.
This is a whole list of studies, including laboratory tests, ultrasound, mammography, as well as densitometry, if a woman is at risk for developing osteoporosis. It all depends on the age and state of her health, the presence of concomitant diseases.
Can they interfere with hormone therapy? If a woman has a liver, pancreas, gallstone disease, high blood pressure, migraine, then we recommend only parenteral therapy (hormonal gels, patches on the skin, vaginal preparations) to reduce the load on the liver.
Why do many still do not trust such drugs?
We are a special country in which the word "hormone" has an incredibly negative meaning. Myths about hair growth and weight gain while taking such medications are still alive. Moreover, they exist even among the medical community.
Modern drugs for the correction of menopausal disorders came to us quite late – before perestroika in Russia they were not purchased at all. And so far, very little attention has been paid to this issue.
So it turns out that, for example, in Switzerland, for 1 million women aged 45-65 years, 153,846 receive HRT, in Russia for 21 million – only 130,769. That is, we have women who need HRT 21 times more, and those who receive it – almost 23 thousand less. Are we that scared of hormones? Why do we consider them such enemies?
I really hope that together we will be able to teach our women that menopause is not the end of life, but only a transitional stage. It requires a radical revision of the image and lifestyle. But all difficulties can be overcome if you have a positive attitude.
Portal "Eternal youth" http://vechnayamolodost.ru25.06.2012