What is hormonal replacement therapy

Substitute hormonal treatment helps relieve menopause symptoms caused by estrogen decline. Although it is effective and sure if indicated and supervised correctly, it is not suitable for all: it must be valued individually, especially in women with a history of cancer or thromboembolic risk.

Menopause is the cessation of ovary activitythat during the fertile life of women has a reproductive function (ovules production) and endocrine (estrogen production and progestogens). This cessation occurs in a physiological way, on average in our country, between 50 and 52 years. The THS substitute hormonal treatment is a therapy in which these hormones are administered to “restore lost balance.”

What consequences does hormonal change in menopause have?

This hormonal change, especially for the estrogen deficitcan cause diverse symptomatology to 80% of women, but in 30% symptoms can be very severe and severely affect your quality of life. But even in asymptomatic women the estrogen deficit has a long -term impact causing osteoporosis and cardiovascular disease. And if we consider that the life expectancy of women in our environment is 86 years means More than a third of his life will be in postmenopausal statehence treatments have been developed to alleviate the symptomatology of menopause and prevent the long -term effects of it.

These symptoms affect different levels:

• Neurovegetative symptoms: Safocos, sweating, palpitations, insomnia
• Psychological symptoms: emotional lability, depressive trend, irritability, nervousness, decrease in libido, tiredness, loss of concentration and memory
• Genitourinary local symptoms: atrophy, pain with sexual intercourse and urinary dysfunctions
• Skin symptoms: greater dehydration and sagging skin
• Silence long term symptoms: Osteoporosis and cardiovascular disease

All these symptoms are revealed if we restore estrogens whose absence has been the cause of them. Then we will ask ourselves, why aren’t all women give estrogen, if we avoid all that list of unpleasant symptoms? Because the woman’s body is designed to have estrogen during limited phase of her life, and prolong them over time can have side effects, so you have to assess it individually.

Controversial treatment?

A few decades Cardiovascular risk, venous thromboembolism and breast cancer increased. This created a great stir worldwide and stopped using radically. Subsequently, it was possible to verify that there were many biases in this study that had not been taken into account and gradually recovered its use until at the present time it is considered a safe treatment whenever it is indicated correctly, it is supervised and limited in time.

In any case, monitoring by an expert gynecologist in menopause is important. Mapfre’s health insurance, have a large medical picture of specialists.

Calculate your price

There are certain contraindications, such as patients with a history of certain types of breast, endometrium cancer, risk of thromboembolic disease and certain autoimmune diseases, since the treatment can increase the incidence of all of them. The rest can benefit from the effects of THS:

• Significant disappearance or reduction of hot flashes
• Significant improvement of skin and mucous hydrationespecially vaginal and urinary and pain symptomatology with sexual intercourse
• Significant improvement of mood and insomnia alterations
• Long -term reduction of the risk of bone fracture by osteoporosis

Each case must be valued individually treating women who do not present contraindication keeping in mind the following premises:

• Treat any woman with early menopause until the physiological age of menopause
• Treat women with symptomatology that affects their quality of life, in this indication it is proposed 2-3 years and Window period without treatment to assess reappearance of symptomswith the minimum effective dose
• Combined treatment with estrogens and progestogens Every woman with uterus, because the progestogen counteracts the proliferative effect on the endometrium of estrogen that without the opposition of gestagen could favor endometrium cancer. Only women operated, without uterus, can do therapy only with estrogens.
• In patients indicated by the treatment for prevention of osteoporosis can prolong the treatment 7-10 years
• Hormonal treatment must be initiated in the 10 years after the beginning menopause. It seems that after years of hormonal deficit its effect is not so beneficial, and before the age of 60.
• The drugs used are Natural and seminatural estrogens, combined or not with progestogens or a molecule called mixed estrogenic, gestagenic and androgenic action. And that can be administered by different routes: oral, transdermal (patches, gel, aerosol) or vaginal, with small differences from the medical point of view in terms of passing through the liver or the ability to alter the profile of triglycerides or cholesterol, but that except for medical indication by some concomitant pathology can be allowed to choose the patient’s comfort.

So with these considerations, THS is considered safe for indicated patients and under the necessary supervision, that gynecologists should offer and that patients can take without fear.

What you should know …

• The THS substitute hormonal treatment is a therapy to “restore the lost balance” that occurs when you enter menopause, especially at the estrogen deficit level.
• The woman’s body is designed to have estrogen during a limited phase of her life, and prolong them over time can have side effects, so you have to assess it individually.
• There are certain contraindications, such as patients with a history of certain types of breast, endometrium cancer, risk of thromboembolic disease and certain autoimmune diseases, since the treatment can increase the incidence of all of them. The rest can benefit from the effects of THS.

Posted by Dr. Natalia García Montaner