HRT for menopause drugs of a new generation

For many women, hormone replacement therapy for menopause becomes a real salvation. New generation drugs reduce the intensity of menopausal manifestations, stabilize estrogen and progesterone levels. Moreover, women who "sit" on HRT stay young longer and face complications much less often (type 2 diabetes mellitus, hyperplasia, breast cancer, etc.).

But not everything is so simple, because estrogen drugs, even the most modern ones, are not possible for everyone. And their uncontrolled use can lead to serious consequences. Therefore, before taking hormones for menopause, weigh the pros and cons. And we will help you with this.

Do I need hormone replacement therapy

After 50 years, treatment with hormonal drugs for menopause is aimed at maintaining the health of a woman. However, without understanding exactly how the hormonal background fluctuates during menopause, you are unlikely to be able to find the right drug.

First of all, you need to know what phases the period of extinction of reproductive function is divided into:

1. Preclimax (average duration 5-10 years)
2. Menopause (begins one year after the last menstrual period)
3. Postmenopause (begins 5 years after the last menstruation and ends closer to 70-75 years).

The body experiences the greatest stress during the first two periods of menopause.

Ovarian performance declines day by day and estrogen / progesterone levels drop rapidly.

And also the hormonal revolution causes compensatory reactions: the pituitary gland tries to develop as much as possible more LH and FSH, and the sensitivity of hormone-dependent receptors important for reproductive function decreases. Thanks to compensatory mechanisms, the body keeps "afloat" for some time, suppressing the symptoms of menopause without outside help.

But every day the situation is getting worse: the production of sex hormones continues to decline, the increased activity of the pituitary gland becomes ineffective, and estrogen deficiency develops. It is during this period that the symptoms of climacteric syndrome are manifested in all their glory: menstruation comes from case to case, and the main body systems react to hormonal imbalance.

The manifestations are varied (there are about 30 symptoms of menopause in total), but the most often hit are:

1. Cardiovascular system - blood pressure jumps to abnormal levels, and many women suddenly join the ranks hypertensive patients, tachycardia develops, brain activity decreases, the risk of heart attacks increases significantly, strokes.
2. Nervous system - hot flashes are repeated more and more often, migraine attacks last for several days, difficulties in falling asleep appear, the psycho-emotional background is unstable. The woman becomes hysterical, may become depressed, etc.
3. Endocrine system - thyroid pathology, type 2 diabetes mellitus, on the sides and hips begins accumulate fat, and without competent menopausal (under the supervision of a doctor) hormone therapy may develop obesity.
4. Genitourinary system - the mucous walls of the vagina become thinner, the volume of secretion decreases (which negatively affects the quality of sexual life), there is a frequent urge to urinate, some patients complain of leakage or urinary incontinence, painful urination.
5. Skin and its appendages - an insufficient amount of collagen leads to degenerative changes: drying out of the skin, delamination of the nail plates, deepening of skin folds, formation age wrinkles.

Moreover, hormonal imbalance increases the risk of developing gynecological pathologies and malignant neoplasms. Agree that this is more than enough to turn from a full of strength, blooming woman into a hysterical, constantly unwelling person and stop enjoying life.

So is HRT needed for menopause? Of course, this is the only sure way to eliminate acute conditions provoked by age-related hormonal changes. But only a doctor who is familiar with the course of menopause, the characteristics of the patient's body, can prescribe adequate therapy.

The reason for the appointment of HRT should be:

• early menopause;
• surgical menopause;
• the likelihood of developing cardiovascular pathologies;
• genetic predisposition to endocrine, metabolic disorders, softening of bone tissue.

Also, hormonal drugs help to normalize the psycho-emotional background, disturbed in menopause. It is an excellent preventive measure against nervous and mental disorders.

If there are menopausal symptoms, it is better not to hesitate to visit the gynecologist. Otherwise, the condition will be aggravated by softening of bone tissue, Alzheimer's disease and other late manifestations of menopause.

The benefits of HRT

Hormonal drugs of a new generation relieve a woman from symptoms manifested in menopause, prevent the development of osteoporosis and other complications. But this does not mean at all that each patient is prescribed HRT according to the same template.

The use of hormonal agents is prescribed only after a detailed diagnosis of the patient (but also in the process of HRT, a woman must undergo an annual examination by a gynecologist). In the process of diagnostic measures, the gynecologist assesses the condition of the mammary glands, the anatomical features of the organs of the reproductive system. The selection of the drug is based on the following points:

• general condition of the body;
• body weight of the patient;
• the severity of climacteric manifestations;
• survey results.

The specialist evaluates the magnitude of the problem and determines which hormone is needed in this case. Only if everything is done correctly, and the patient strictly observes medical recommendations, can one hope for a positive result. Today, medicine offers two tactics for HRT:

• short-term use is prescribed for mild menopause, without acute symptoms (the course of treatment is no more than 2 years);
• long-term - for severe menopause, accompanied by systemic manifestations, deterioration of health (lasts 2-4 years, in exceptional cases up to 12 years).

Attention! With HRT, you cannot independently refuse the prescribed drug in favor of another. This can only be done by a doctor who has the results of hormone tests on hand.

Having studied the reviews of specialists about the new generation of HRT drugs prescribed for severe menopause, we have compiled a list of the advantages of this type of therapy:

1. Elimination of a specific hormone deficiency.
2. Inhibition of aging processes.
3. Weakening of the severity of symptoms (menopause is less painful).
4. The female body gently adapts to menopause and new hormonal status (no sudden changes).
5. The use of HRT is carried out strictly under the supervision of the attending physician, who can adjust the treatment regimen, if required.
6. The drugs are selected on an individual basis.

Do not rely on the efficacy and safety of HRT by taking medications uncontrollably. Reviews of friends, advice from a pharmacist or your own intuition are not the best advisors in this matter. What suited one lady with menopause may be contraindicated for another (hence the increase in sugar, the development of malignant neoplasms, etc.).

The basics of HRT:

1. Only preparations similar to natural hormones.
2. Low dosages corresponding to the concentration of endogenous estradiol in premenopausal women (up to 5-7 days of the cycle).
3. Various combinations of progestogens / estrogens (to eliminate the risks of endometrial hyperplasia).
4. The minimum duration of HRT used to prevent osteoporosis and heart disease is from 5 years.

Trust a specialist to make sure that hormonal drugs can work without unpleasant consequences.

Contraindications to hormone treatment

For all its merits, new-generation hormonal preparations are not allowed for everyone. They have a whole range of contraindications and, if used uncontrolled, can lead to fatal consequences. That is why not a single competent doctor prescribes HRT without a preliminary examination of the patient.

Unfortunately, the phrase "medical error" is found more and more often, and no one is safe from a visit to an illiterate gynecologist. Such a would-be specialist, without hesitation, will prescribe hormones, and then, when the patient develops an oncological tumor, he will just shrug his shoulders in bewilderment. But fate will not tempt, and we will get acquainted with the conditions in which the use of hormonal drugs is prohibited:

1. Bleeding of an unexplained cause.
2. Neoplasms of a benign or malignant nature (any tumors begin to grow under the influence of estrogen drugs).
3. Crayfish.
4. Cardiovascular diseases.
5. Blood clotting disorder, tendency to form blood clots, thrombosis, thromboembolism.
6. Renal or hepatic pathology (acute or chronic course).
7. Diabetes mellitus (a precomatose state with very high or very low blood sugar).
8. Diseases with an autoimmune nature.
9. Individual intolerance to hormone-containing drugs.

Attention! Ignoring contraindications to HRT, you will not only waste time on pointless treatment, but also get severe, sometimes incompatible with life, complications.

Side effects

When agreeing to HRT with menopause, carefully read the instructions. According to patient reviews, hormone replacement therapy is accompanied by many side effects. Especially often women complain of the following symptoms:

• decreased skin elasticity, swelling;
• insufficient amount or excess of vaginal secretions, menstrual bleeding;
• the appearance of headaches;
• chronic fatigue, general weakness;
• dyspeptic disorders: abdominal pain, vomiting, diarrhea, constipation, etc.;
• hypersensitivity of the mammary glands;
• muscle spasms;
• acne, seborrhea.

The listed reactions are manifested individually or in combination. But in any case, the presence of unpleasant symptoms during menopause is the basis for a visit to the attending physician and correction of the therapeutic program.

Age matters

It is believed that the likelihood of side effects with menopause is directly proportional to the age of the patient. How else to explain the fact that patients over 60 years of age are prescribed HRT much less frequently than younger women.

The table compiled according to the recommendations of experts shows how menopausal hormone therapy affects the health of women of different ages:

Health status	Age
Up to 60 years old	Over 60 years old
Menopausal manifestations	Low dosages of HRT (duration of treatment does not exceed 2 years)	HRT - effective (transdermal estrogen)
Osteoporosis Estrogen; estrogen + progesterone	No tendency to fracture (-)	No fracture tendency
Cardiovascular disease Estrogen; estrogen + progesterone	_	_
Mammary cancer Estrogen estrogen + progesterone	Does not affect +	_ +
Colon cancer Estrogen + Progesterone estrogen	Risks are minimal Does not affect	Risks are reduced +
Endometrial cancer of the uterus Estrogen + Progesterone estrogen	_ +	_ +
Lungs' cancer Estrogen; estrogen + progesterone	_	_
Ovarian cancer Estrogen; estrogen + progesterone	+	+
Diabetes Estrogen; estrogen + progesterone	Unlikely	Does not affect
Decreased brain activity Estrogen; estrogen + progesterone	Unlikely	maybe
Stroke Estrogen Estrogen + Progesterone	Does not affect There are risks	Does not affect +
Death Estrogen Estrogen + Progesterone	_ Does not affect	+ Does not affect

Choosing the right drugs

HRT preparations are divided into homeopathic (plant-based) and synthetic (a complex of chemical components). According to the method of reception, they are:

• oral: tablets, capsules, pills;
• for external use: candles, creams, plasters, gels;
• transdermal: injections;
• subcutaneous implants.

For women with stomach or kidney problems, it is better to replace the tablets with implants or local remedies. This is very convenient, especially in the case of concurrent administration of other drugs.

The following are in special demand with menopause:

Gel with hormones "Divigel"

This hormonal gel is often prescribed to women with menopause and premenopause. The product is applied to the abdomen or buttocks once a day. It is quickly absorbed, but it is better to refrain from bathing procedures for an hour after application. Otherwise, the effectiveness of the gel will decrease.

Patch with estradiol for menopause

1. Effectively eliminates hormone deficiency.
2. It is worn on the skin under clothes for a week, after which it is replaced with a new one.
3. The active substance is absorbed into the body through the skin.
4. Side effects are extremely rare.

Pay attention to the plasters "Klimara" and "Dermestil".

Tablet means

The list of the best drugs includes:

• Femoston.
• Klimonorm.
• Klimadinon.
• Angelique.
• Triaclim.

Do not rush to purchase the listed funds and calculate the dose yourself. First, discuss your condition with your doctor and undergo a comprehensive examination. A competent, balanced approach is the way to an effective and safe solution to a problem.

Reviews of experts

I am a therapist with 30 years of experience. And for quite some time I have been observing a pattern - as soon as a woman approaches the age mark of 45–47, she becomes a frequent guest in my office. Complaints about everything: insomnia, loss of energy, shortness of breath, stool disorders, etc. Recently acquired the manual of the author Madyanov I. IN. “Menopausal hormone therapy. To help the therapist and general practitioner. " Everything is written in human language and will help you understand the characteristics of HRT. The publication covers the following issues in detail:

• manifestations of menopause;
• the effectiveness and safety of hormonal drugs;
• features of HRT in the presence of concomitant pathologies.

Now I know exactly what to recommend to my patients of climacteric age.

BUT. IN. Mirova / general practitioner /

Many women with menopause firmly believe that hormone replacement therapy without weight gain is an invention of enterprising pharmacists. This is wrong. On the contrary, well-chosen drugs inhibit the growth of extra pounds, prevent the development of obesity. This is very important, because the growth of body fat increases the risk of cancer several times. I am unequivocally for the fact that it is necessary to drink hormonal drugs with menopause.

M. WITH. Pavlova / gynecologist-endocrinologist /

Reviews of women

Svetlana 57 years old

When menstrual irregularities and constant headaches began, I immediately went to the antenatal clinic. The doctor examined me in full and then said that I needed replacement of the missing hormones. Otherwise, the state of health may deteriorate. I started taking medications and never regretted it.

Anna 61 years old

The climax was early, and at first I was going through it hard. At the first sign, I went to a thematic forum and picked up a drug with a suitable composition (from the combined ones). But after a few days, I fully enjoyed the list of side effects: acidity, heartburn, bloating, etc. I decided to see a doctor, where they advised me to use another dosage form - a patch. Gradually I got better, even my mood improved.

Sofia Ignatievna 55 years old

I want to tell you about my sister. Her climax began early, but it is hereditary (our mother had it when she was 39). Immediately on the skin terrible rashes went, even appeared on the heels. She suffered a lot, but she was not prescribed HRT anyway. This was explained by the presence of a polyp in the gallbladder. I think that the doctors simply did not have enough knowledge, and the person gradually turned into a disabled person. Is it normal?

With the first "bells" of menopause, when natural hormones are not enough, do not delay the visit to the doctor. Timely and correctly selected HRT will prevent serious changes in the female body, improve her physical and psycho-emotional state during menopause.