HRT side effects. Hormone replacement therapy: description

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. Partnew 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 indeed it is. 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 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. In 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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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.

The whole truth about hormone replacement therapy

I take the liberty to describe the benefits and fears of prescribing hormone replacement therapy (HRT). I assure you - it will be interesting!

Menopause, according to modern science, is not health, it is a disease. Characteristic specific manifestations for it are vasomotor instability (hot flashes), psychological and psychosomatic disorders (depression, anxiety, etc.), urogenital symptoms - dry mucous membranes, painful urination and nocturia - “night trips to the toilet”. Long-term effects: CVD (cardiovascular disease), osteoporosis (low bone density and fractures), osteoarthritis and Alzheimer's disease (dementia). As well as diabetes and obesity.

HRT in women is more complex and multifaceted than in men. If a man needs only testosterone for replacement, then a woman needs estrogens, progesterone, testosterone, and sometimes thyroxine.

HRT uses smaller doses of hormones than hormonal contraceptives. HRT drugs do not have contraceptive properties.

All the materials below are based on the results of a large-scale clinical study of HRT in women: Womens Health Initiative (WHI) and published in 2012 in the consensus on hormone replacement therapy of the Research Institute of Obstetrics and Gynecology. IN AND. Kulakova (Moscow).

So, the main postulates of HRT.

1. You can start taking HRT for another 10 years after the cessation of your menstrual cycle.
(taking into account contraindications!). This period is called the “window of therapeutic opportunity.” Over 60 years of age, HRT is not usually prescribed.

How long is HRT prescribed? - "As much as needs" To do this, in each specific case it is necessary to determine the purpose of using HRT in order to determine the timing of HRT. The maximum period for using HRT: “last day of life – last pill.”

2. The main indication for HRT is vasomotor symptoms of menopause(these are menopausal manifestations: hot flashes), and urogenital disorders (dyspariunia - discomfort during sexual intercourse, dry mucous membranes, discomfort during urination, etc.)

3. With the right choice of HRT, there is no evidence of an increase in the incidence of breast and pelvic cancer, the risk may increase with a duration of therapy of more than 15 years! HRT can also be used after treatment of stage 1 endometrial cancer, melanoma, and ovarian cystadenomas.

4. When the uterus is removed (surgical menopause) - HRT is received in the form of estrogen monotherapy.

5. When HRT is started on time, the risk of cardiovascular diseases and metabolic disorders is reduced. That is, during hormone replacement therapy, normal metabolism of fats (and carbohydrates) is maintained, and this prevents the development of atherosclerosis and diabetes mellitus, since the deficiency of sex hormones in postmenopause aggravates existing ones and sometimes provokes the onset of metabolic disorders.

6. The risk of thrombosis increases when using HRT with a BMI (body mass index) = more than 25, that is, if you are overweight!!! Conclusion: excess weight is always harmful.

7. The risk of thrombosis is higher in women who smoke.(especially when smoking more than 1/2 packs per day).

8. It is desirable to use metabolically neutral gestagens in HRT(this information is more for doctors)

9. Transdermal forms (external, that is, gels) are preferable for HRT, they exist in Russia!

10. Psycho-emotional disorders often prevail during menopause(which does not allow one to discern a psychogenic illness behind their “mask”). Therefore, HRT can be given for 1 month for trial therapy for the purpose of differential diagnosis with psychogenic diseases (endogenous depression, etc.).

11. In the presence of untreated arterial hypertension, HRT is possible only after stabilization of blood pressure.

12. Prescribing HRT is possible only after hypertriglyceridemia has normalized**(triglycerides are the second, after cholesterol, “harmful” fats that trigger the process of atherosclerosis. But transdermal (in the form of gels) HRT is possible against the background of elevated triglyceride levels).

13. In 5% of women, menopausal symptoms persist for 25 years after the cessation of the menstrual cycle. HRT is especially important for them to maintain normal well-being.

14. HRT is not a method of treating osteoporosis, it is a method of prevention(it should be noted that this is a cheaper method of prevention than the cost of treating osteoporosis itself).

15. Weight gain often accompanies menopause., sometimes this is an additional + 25 kg or more, this is caused by a deficiency of sex hormones and related disorders (insulin resistance, impaired carbohydrate tolerance, decreased insulin production by the pancreas, increased production of cholesterol and triglycerides by the liver). This is collectively called menopausal metabolic syndrome. Timely prescribed HRT is a way to prevent menopausal metabolic syndrome(provided that it was not there before, before menopause!)

16. Based on the type of menopausal manifestations, it is possible to determine which hormones a woman lacks in her body, even before taking blood for a hormonal analysis. Based on these signs, menopausal disorders in women are divided into 3 types:

a) type 1 - only estrogen-deficient: weight is stable, no abdominal obesity (at the abdominal level), no decreased libido, no depression and urinary disorders and decreased muscle mass, but there are menopausal hot flashes, dry mucous membranes (+ dyspariunia), and asymptomatic osteoporosis;

b) type 2 (only androgen-deficient, depressive) if a woman has a sharp increase in weight in the abdominal area - abdominal obesity, increasing weakness and decreased muscle mass, nocturia - “night urge to go to the toilet”, sexual disorders, depression, but no hot flashes and osteoporosis according to densitometry (this is an isolated lack of “male” hormones);

c) type 3, mixed, estrogen-androgen deficiency: if all the previously listed disorders are expressed - hot flashes and urogenital disorders are pronounced (dysparunia, dry mucous membranes, etc.), a sharp increase in weight, decreased muscle mass, depression, weakness - then there is not enough both estrogen and testosterone, both of which are required for HRT.

It cannot be said that any of these types is more favorable than the other.
**Classification based on materials from Apetov S.S.

17. The question of the possible use of HRT in the complex treatment of stress urinary incontinence in menopause should be decided individually.

18. HRT is used to prevent cartilage degradation and, in some cases, to treat osteoarthritis. An increase in the incidence of osteoarthritis with multiple joint lesions in women after menopause indicates the involvement of female sex hormones in maintaining the homeostasis of articular cartilage and intervertebral discs.

19. Estrogen therapy has been shown to benefit cognitive function (memory and attention).

20. Treatment with HRT prevents the development of depression and anxiety, which is often implemented with menopause in women predisposed to it (but the effect of this therapy occurs provided that HRT therapy is started in the first years of menopause, or better yet, premenopause).

21. I no longer write about the benefits of HRT for a woman’s sexual function, aesthetic (cosmetological) aspects– prevention of “sagging” of the skin of the face and neck, prevention of worsening wrinkles, gray hair, tooth loss (from periodontal disease), etc.

Contraindications to HRT:

Main 3:
1. History of breast cancer, current or suspected; If there is a hereditary history of breast cancer, a woman needs to undergo a genetic test for the gene for this cancer! And if the risk of cancer is high, HRT is no longer discussed.

2. Venous thromboembolism in history or at present (deep vein thrombosis, pulmonary embolism) and arterial thromboembolic disease at present or in history (for example: angina pectoris, myocardial infarction, stroke).

3. Liver diseases in the acute stage.

Additional:
estrogen-dependent malignant tumors, for example, endometrial cancer or if this pathology is suspected;
bleeding from the genital tract of unknown etiology;
untreated endometrial hyperplasia;
uncompensated arterial hypertension;
allergy to active substances or to any of the components of the drug;
cutaneous porphyria;
dysregulated type 2 diabetes mellitus

Examinations before prescribing HRT:

Taking an anamnesis (to identify risk factors for HRT): examination, height, weight, BMI, abdominal circumference, blood pressure.

Gynecological examination, collection of smears for oncocytology, ultrasound of the pelvic organs.

Mammography

Lipidogram, blood sugar, or sugar curve with 75 g of glucose, insulin with calculation of the HOMA index

Additionally (optional):
analysis for FSH, estradiol, TSH, prolactin, total testosterone, 25-OH-vitamin D, ALT, AST, creatinine, coagulogram, CA-125
Densitometry (for osteoporosis), ECG.

Individually – Doppler ultrasound of veins and arteries

About the drugs used in HRT.

In women 42-52 years old with a combination of regular cycles with cycle delays (as a phenomenon of premenopause), who need contraception, who do not smoke!!!, you can use contraception rather than HRT - Jess, Logest, Lindinet, Mercilon or Regulon / or use an intrauterine system - Mirena (in the absence of contraindications).

Etrogens cutaneous (gels):

Divigel 0.5 and 1 g 0.1%, Estrogel

Combined E/G drugs for cyclic therapy: Femoston 2/10, 1/10, Climinorm, Divina, Trisequence

Combined E/H drugs for continuous use: Femoston 1/2.5 conti, Femoston 1/5, Angelique, Klmodien, Indivina, Pauzogest, Klimara, Proginova, Pauzogest, Ovestin

Tibolone

Gestagens: Duphaston, Utrozhestan

Androgens: Androgel, Omnadren-250

Alternative treatments include
herbal preparations: phytoestrogens and phytohormones. Data on the long-term safety and effectiveness of this therapy are insufficient.

In some cases, a one-time combination of hormonal HRT and phytoestrogens is possible. (for example, with insufficient relief of hot flashes by one type of HRT).

Women receiving HRT should visit their doctor at least once a year. The first visit is scheduled 3 months after the start of HRT. The doctor will prescribe the necessary examinations for monitoring HRT, taking into account the characteristics of your health!

Important! Message from the site administration about questions on the blog:

Dear readers! By creating this blog, we set ourselves the goal of giving people information on endocrine problems, diagnostic methods and treatment. And also on related issues: nutrition, physical activity, lifestyle. Its main function is educational.

Within the framework of the blog, in answering questions, we cannot provide full-fledged medical consultations; this is due to both the lack of information about the patient and the doctor’s time spent in order to study each case. Only general answers are possible in the blog. But we understand that not everywhere it is possible to consult with an endocrinologist at your place of residence; sometimes it is important to get another medical opinion. For such situations, when a deeper dive and study of medical documents is needed, at our center we have a format for paid correspondence consultations on medical documentation.

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Sincerely, Administration of the Medical Center "XXI Century"

As a woman ages, the level of estrogen in a woman's body begins to decrease. This leads to a number of symptoms that cause discomfort. This is an increase in subcutaneous fat, hypertension, dry genital mucosa, and urinary incontinence. Medications can help eliminate and reduce the risk of complications associated with menopause to avoid such an unpleasant condition. Such drugs include “Klimonorm”, “Klimadinon”, “Femoston”, “Angelik”. New generation HRT should be carried out with extreme caution and can only be prescribed by a qualified gynecologist.

Release form of the drug "Klimonorm"

The medicine belongs to the class of antimenopausal drugs. It is made in the form of two types of dragees. The first type of dragee is yellow. The main substance in the composition is estradiol valerate 2 mg. The second type of dragee is brown. The main components are estradiol valerate 2 mg and levonorgestrel 150 mcg. The medicine is packaged in blisters of 9 or 12 pieces each.

With the help of this medication, HRT is often performed during menopause. New generation drugs have good reviews in most cases. Side effects do not develop if you follow your doctor’s recommendations.

Effect of the drug "Klimonorm"

"Klimonorm" is a combination drug that is prescribed to eliminate the symptoms of menopause and consists of estrogen and gestagen. Once in the body, the substance estradiol valerate is converted into estradiol of natural origin. The substance levonorgestrel added to the main drug is the prevention of endometrial cancer and hyperplasia. Thanks to the unique composition and special dosage regimen, it is possible to restore the menstrual cycle in women with a non-removed uterus after treatment.

Estradiol completely replaces natural estrogen in the body at the moment when menopause occurs. Helps cope with vegetative and psychological problems that arise during menopause. You can also slow down the formation of wrinkles and increase the collagen content in the skin when carrying out HRT during menopause. The drugs help lower total cholesterol and reduce the risk of intestinal diseases.

Pharmacokinetics

When taken orally, the medicine is absorbed in the stomach in a short period. In the body, the drug is metabolized to form estradiol and estrol. Already within two hours the maximum activity of the drug in plasma is observed. The substance levonorgestrel is almost 100% bound to blood albumin. Excreted in urine and slightly in bile. Particular attention should be paid to selecting medications for HRT during menopause. Level 1 drugs are considered potent and can significantly improve the condition of the fairer sex after 40 years. Medicines from this group also include the drug “Klimonorm”.

Indications and contraindications

The drug can be used in the following cases:

• hormone replacement therapy for menopause;
• involutional changes in the skin and mucous membrane of the genitourinary system;
• insufficient estrogen levels during menopause;
• preventive measures for osteoporosis;
• normalization of the monthly cycle;
• therapeutic process for amenorrhea of ​​primary and secondary type.

Contraindications:

• bleeding not associated with menstruation;
• breast-feeding;
• hormone-dependent precancerous and cancerous conditions;
• mammary cancer;
• liver diseases;
• acute thrombosis and thrombophlebitis;
• hypotension;
• diseases of the uterus.

HRT is not always indicated during menopause. New generation drugs (the list is presented above) are prescribed only if menopause is accompanied by a significant deterioration in the woman’s well-being.

Dosage

If you still have your period, then treatment should begin on the fifth day of the cycle. For amenorrhea and menopause, the treatment process can begin at any time of the cycle, unless pregnancy is excluded. One package of the medicine “Klimonorm” is designed for 21 days of use. The product is drunk according to the following algorithm:

• for the first 9 days the woman takes yellow tablets;
• the next 12 days - brown pills;

After treatment, menstruation appears, usually on the second or third day after taking the last dose of the medicine. There is a break for seven days, and then you need to drink the next package. The pills should be taken without chewing and washed down with water. It is necessary to take the drug at a certain time, without missing it.

It is imperative to adhere to the HRT regimen during menopause. New generation drugs may also have negative reviews. You will not be able to achieve the desired effect if you forget to take the pills in a timely manner.

In case of an overdose, unpleasant phenomena such as stomach upset, vomiting and bleeding not associated with menstruation may occur. There is no specific antidote for the drug. In case of overdose, symptomatic treatment is prescribed.

Medicine "Femoston"

The medication belongs to the group of antimenopausal drugs. Available in the form of tablets of two types. In the package you can find a white dragee with a film shell. The main substance is estradiol at a dose of 2 mg. The first type also includes gray tablets. The composition contains estradiol 1 mg and dydrogesterone 10 mg. The product is packaged in blisters of 14 pieces each. The second type includes pink tablets containing 2 mg estradiol.

Replacement therapy is often carried out with the help of this remedy. When it comes to HRT for menopause, medications are selected with special attention. Femoston reviews have both positive and negative. Good statements still prevail. The medication can eliminate many menopausal symptoms.

Action

"Femoston" is a two-phase combination drug for the treatment of postmenopause. Both components of the drug are analogues of the female sex hormones progesterone and estradiol. The latter replenishes the supply of estrogen during menopause, removes symptoms of a vegetative and psycho-emotional nature, and prevents the development of osteoporosis.

Dydrogesterone is a progestogen that reduces the risk of developing uterine hyperplasia and cancer. This substance has estrogenic, androgenic, anabolic and glucocorticoid activity. When it enters the stomach, it is quickly absorbed and then completely metabolized. If HRT is indicated for menopause, the drugs “Femoston” and “Klimonorm” should be used first.

Indications and contraindications

The medication is used in the following cases:

• HRT during menopause and after surgery;
• prevention of osteoporosis, which is associated with menopause

Contraindications:

• pregnancy;
• lactation;
• breast cancer;
• malignant tumors that are hormone-dependent;
• porphyria;
• thrombosis and thrombophlebitis;
• hypersensitivity to components;
• diabetes;
• hypertension;
• endometrial hyperplasia;
• migraine.

HRT will help improve your well-being during menopause. Reviews of the drugs are mostly positive. However, they should not be used without first consulting a doctor.

Dosage

Femoston tablets containing estradiol in a dose of 1 mg are taken once a day at the same time. Treatment is carried out according to a special scheme. In the first 14 days you need to take white tablets. In the remaining 14 days - a medicine of a gray shade.

Pink tablets containing 2 mg estradiol are taken for 14 days. For women whose menstrual cycle has not yet been disrupted, treatment should begin on the first day of bleeding. For patients with irregular cycles, the drug is prescribed after two weeks of treatment with Progestagen. For everyone else, if you don’t have your period, you can start taking the medicine any day. You need to follow the treatment regimen to get positive results from HRT during menopause. New generation drugs will help keep a woman feeling good and prolong her youth.

The drug "Klimadinon"

The medicine belongs to the means for improving well-being during menopause. It has a phytotherapeutic composition. Available in the form of tablets and drops. The tablets are pink with a brown tint. Contains dry cohosh extract 20 mg. The drops contain liquid cohosh extract 12 mg. The drops have a light brown tint and the smell of fresh wood.

Indications:

• vegetative-vascular disorders associated with menopausal symptoms.

Contraindications:

• hormone-dependent tumors;
• hereditary lactose intolerance;
• alcoholism;
• hypersensitivity to components.

It is necessary to carefully study the instructions before starting HRT during menopause. Preparations (patch, drops, pills) should be used only on the recommendation of a gynecologist.

The medicine "Klimadinon" is prescribed one tablet or 30 drops twice a day. It is advisable to carry out therapy at the same time. The course of treatment depends on the individual characteristics of the body.

The drug "Angelique"

Refers to drugs that are used to treat menopause. Available in the form of gray-pink tablets. The drug contains estradiol 1 mg and drospirenone 2 mg. The product is packaged in blisters, 28 pieces each. A specialist will tell you how to properly carry out HRT during menopause. New generation drugs should not be used without prior consultation. can have both benefit and harm.

The medication has the following indications:

• hormone replacement therapy during menopause;
• prevention of osteoporosis during menopause.

Contraindications:

• bleeding from the vagina of unknown origin;
• mammary cancer;
• diabetes;
• hypertension;
• thrombosis.

Dosage of the medicine "Angelique"

One package is designed for 28 days of use. You should take one tablet daily. It is better to drink the medicine at the same time, without chewing and with water. Therapy should be carried out without skipping. Neglecting the recommendations will not only not bring a positive result, but can also provoke vaginal bleeding. Only correct adherence to the regimen will help normalize the menstrual cycle during HRT during menopause.

New generation drugs (“Angelik”, “Klimonorm”, “Klimadinon”, “Femoston”) have a unique composition, thanks to which it is possible to restore female

"Klimara" patch

This medication comes in the form of a patch containing 3.8 mg estradiol. The oval-shaped product is glued to an area of ​​skin hidden under clothing. During the use of the patch, the active component is released, improving the woman’s condition. After 7 days, the product must be removed and a new one applied to a different area.

Side effects from the use of the patch are quite rare. Despite this, the hormonal drug should be used only after consultation with the doctor.

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 women experience 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 cease to be 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 begin to fight 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 is 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.

• Firstly, 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.

Hormone replacement therapy (HRT) is used to balance the levels of estrogen and progesterone in a woman's body during menopause.

HRT is also called hormone therapy or menopausal hormone therapy. This type of treatment eliminates other symptoms characteristic of menopause. HRT may also reduce the risk of developing osteoporosis.

Hormone replacement is also used in male hormone therapy and in the treatment of individuals who have undergone gender reassignment surgery.

In this article, we will focus on studying information about hormone replacement therapy used to relieve symptoms in women during pregnancy.

Fast Facts About Hormone Replacement Therapy

1. Hormone replacement therapy is an effective way to relieve symptoms and menopause.
2. This type of treatment can reduce the intensity of hot flashes and reduce the risk of osteoporosis.
3. Studies have found a connection between HRT and cancer, but at present this connection has not been fully studied.
4. HRT can rejuvenate your skin, but it cannot reverse or slow down the aging process.
5. If a woman is considering using hormone replacement therapy, she should first discuss it with a doctor who is familiar with her medical history.

Benefits of hormone replacement therapy

Menopause can be uncomfortable and increase health risks for women, but hormone replacement therapy usually eases the unpleasant symptoms of menopause and reduces its harmful effects.

Progesterone and estrogen are two important hormones for the female reproductive system.

Estrogen stimulates the release of eggs, and progesterone prepares the uterus for the implantation of one.

As the body ages, the number of eggs released naturally decreases.

As egg production decreases, estrogen secretion also decreases.

Most women begin to observe these changes in themselves in the second half of the forties. During this period, menopause begins to manifest itself with hot flashes or other problems.

Perimenopause

Women are still experiencing symptoms for some time, although changes are already occurring. This period is commonly called perimenopause, and its duration can range from three to ten years. On average, perimenopause lasts four years.

Menopause

When perimenopause ends, menopause occurs. The average age at which this phenomenon occurs in women is 51 years.

Postmenopause

12 months after the last menstruation, a woman enters her period. Symptoms usually last for another two to five years, but it can last ten years or more.

Women also have an increased risk of osteoporosis after menopause.

Besides the natural aging process, menopause is also caused by the removal of both ovaries and cancer treatment.

Smoking also speeds up the onset of menopause.

Consequences of menopause

Changes in hormonal levels can cause serious discomfort and increase health risks.

The consequences of menopause include:

• vaginal dryness;
• decreased bone density or osteoporosis;
• problems with urination;
• hair loss;
• sleep disorders;
• hot flashes and night sweats;
• psychological depression;
• decreased fertility;
• difficulty concentrating and memory;
• breast reduction and accumulation of fat deposits in the abdominal area.

Hormone replacement therapy may reduce or eliminate these symptoms.

Hormone replacement therapy and cancer

Hormone replacement therapy is used to relieve menopausal symptoms and protect against osteoporosis and cardiovascular disease.

However, the benefits of this type of treatment were called into question after two studies, the results of which were published in 2002 and 2003. HRT has been found to be associated with endometrial, breast and ovarian cancer.

This has caused many people to stop using this type of treatment and it is now less widely practiced.

Further studies of this issue cast doubt on the above studies. Critics note that their results were not clear-cut, and because different combinations of hormones can have different effects, the results did not fully show how dangerous or how safe HRT might be.

In the case of breast cancer, the combination of progesterone and estrogen causes one case per thousand women per year.

More recent research has suggested that the benefits of hormone replacement therapy may outweigh the risks, but the jury is still out on this point.

Other studies suggest that hormone replacement therapy can:

• improve muscle function;
• reduce the risk of heart failure and heart attacks;
• reduce mortality in young postmenopausal women;
• show effectiveness in preventing skin aging in some women and when used carefully.

It is now believed that HRT is not as dangerous for women as previously stated. This type of therapy is officially approved in many developed countries for the treatment of menopause symptoms, prevention or treatment of osteoporosis.

However, any woman considering hormone replacement therapy should make this decision carefully and only after speaking with a doctor who understands the individual risks.

More data is needed to understand the link between HRT and cancer, so research is ongoing.

It is important to understand that human aging is a natural process. Although hormone replacement therapy can protect a woman from some age-related changes, it cannot prevent aging.

Who should not use HRT?

HRT should not be used in the treatment of women who have a history of:

• uncontrolled hypertension or high blood pressure;
• heavy;
• thrombosis;
• stroke;
• heart diseases;
• endometrial, ovarian or breast cancer.

It is currently believed that the risk of developing breast cancer increases if hormone replacement therapy is used for more than five years. The risk of stroke and blood clotting problems is not considered high for women aged 50 to 59 years.

This type of treatment should not be used by women who are pregnant or may become pregnant.

One of the most common misconceptions about hormone replacement therapy is that it allegedly causes weight gain. Women often gain weight around menopause, but research has shown that this is not necessarily due to HRT.

Other possible causes of excess weight gain include decreased physical activity, redistribution of body fat due to changes in hormonal levels, and increased appetite as a result of falling estrogen levels.

A healthy diet and regular exercise will help you stay in shape.

Types of HRT used during menopause

Hormone replacement therapy is carried out using tablets, patches, creams or vaginal rings

HRT involves the use of different combinations of hormones and taking different forms of the corresponding drugs.

• Estrogen HRT. Used for women who do not need progesterone after having a hysterectomy, when their uterus or uterus and ovaries were removed.

• Cyclic HRT. It can be used by women who are menstruating and have perimenopausal symptoms. Typically, such cycles are carried out monthly with doses of estrogen and progesterone, which are prescribed at the end of the menstrual cycle for 14 days. Or it could be daily doses of estrogen and progesterone for 14 days every 13 weeks.

• Long-term HRT. Used during postmenopause. The patient has been taking doses of estrogen and progesterone for a long time.

• Local estrogen HRT. Includes the use of pills, creams and rings. It can help solve urogenital problems, reduce vaginal dryness and irritation.

How does a patient go through the process of hormone replacement therapy?

The doctor prescribes the smallest dose possible to treat symptoms. Their quantitative content can be found by trial and error.

Ways to take HRT include:

• creams and gels;
• vaginal rings;
• pills;
• skin applications (plasters).

When treatment is no longer required, the patient gradually stops taking the dose.

Alternatives to Hormone Replacement Therapy

Alternative methods to reduce menopausal symptoms include using a ventilator

Women experiencing perimenopause can use alternative methods to reduce symptoms.

These include:

• reducing the amount of caffeine, alcohol and spicy foods consumed;
• to give up smoking;
• regular exercise;
• wearing loose clothing;
• sleep in a well-ventilated, cool room;
• use of a fan, use of cooling gels and cooling pads.

Some SSRI antidepressants (SSRIs - with selective serotonin reuptake inhibitors) help eliminate hot flashes. Antihypertensive drugs, clonidine, can also help in this regard.

Ginseng, black cohosh, red clover, soybeans and capsicum are said to be effective for menopausal symptoms. However, reputable health organizations do not recommend regular treatment with herbs or supplements, since no studies have established their benefits.

Hormone replacement therapy is an effective treatment for excessive sweating and hot flashes, but you should discuss its safety with your doctor before trying HRT.