Menopause: hormone replacement therapy

Written by: Dr. Andrés Calvo Pérez
Edited by: Roser Bernés Ubasos


Are there reasons to recommend or not hormone replacement therapy in menopause?

All current evidence and expressed by the scientific societies of menopause again put the hormone replacement therapy for menopausal syndrome (hot flashes, irritability, insomnia, malaise, inhibited sexual desire, etc ...) in the therapeutic framework for the woman who needs to. This is done for a suitable time, usually not more than five years postmenopause or not above age 55, as long as no formal contraindications such as thromboembolic risk or hormonodependiente actual cancer, and is prescribed and monitored by a specialist in Gynecology .


What type of hormone treatment may be prescribed?

It should consist of a combination treatment of estrogen and progesterone. The dose is recommended to be the minimum necessary to relieve symptoms. In women who have no uterus treatment would only estrogen.


Does hormone therapy cause cancer?

The answer to this question overall is: NO. Only demonstrated increased incidence of cancer hormonodependiente, some breast cancers, after more than five years of use. However, and this is important to highlight it, only replacement therapy estrogen is protective for breast cancer after more than three to five years of treatment.


Is there any way to know which women could be harmful before starting hormone therapy in menopause?

Recently discovered genetic factors linked to processing enzymes estrogen metabolites estrus-oncogenic. If this mutation would increase the susceptibility of developing hormone-associated thrombosis or hormonal treatment cancers.

You can study these genes and their mutations to decide who can have this increased susceptibility to estrogen-oncogenic when prescribing HRT.


They have developed new treatments?

As novel treatment options have been created:

Modulator new Selective Estrogen Receptor (SERM) is indicated as oral therapy for the treatment of vaginal dryness and as alternative to the classic treatment vaginal. This drug acts as an agonist in vaginal epithelium, protector of bones and breast and has a neutral effect on the endometrium and the cardiovascular system. It is also a safe option for women with breast cancer.

Furthermore a combination of low dose equine estrogens and other family medicine with the indication SERM treatment of symptoms resulting from estrogen deficiency in post-menopausal women with a uterus (> 12 months without) is present. Has a dual action thus serves for protection of osteoporosis bone level and treatment of hot flashes. It provides the advantage of not requiring add progesterone.

*Translated with Google translator. We apologize for any imperfection

By Dr. Andrés Calvo Pérez
Obstetrics & Gynecology

Dr. Andres Perez Calvo is a leading gynecologist is currently Head of the Hospital of Manacor, Mallorca. It has an extensive academic background, with lots of courses taken, and a doctorate rated 'Cum Laude' that studies the relationship between menopause and quality of life of women of Mallorca. His professional experience is extensive, with Medical Director and Head of Service, in addition to having worked as a volunteer in 5 countries. He is a member of gynecological associations de Mallorca, teaching at the University of the Balearic Islands (UIB).

*Translated with Google translator. We apologize for any imperfection

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