Hormone replacement therapy is safe and effective for women who started it early, that is before the age of 60. HRT reduces the risk of diabetes, atherosclerosis and hypertension. However, for this to be the case, hormone therapy must be selected individually.
The average woman enters perimenopause at age 51, and the last period usually occurs between the ages of 45 and 55. Late menopause is when the last period occurs between the ages of 55 and 60. Early age affects women who have stopped menstruating between the ages of 40 and 45. But regardless of whenmenopausecomes, every woman then faces the dilemma of whether to startHRT( hormone replacement therapy). Many women are afraid of hormones because they are convinced that they bring more losses to he alth than benefits, e.g. that they promote cancer and thromboembolism. But the conclusions of the research do not confirm this. Instead, they prove that there is no one optimal form of hormone therapy for all women. Treatment must be selected individually.
HRT used before the age of 60 inhibits various diseases
It is already known that the use of estrogens does not increase the risk of coronary artery disease in he althy women after recent menopause. After the publication of the results of the Women's He alth Initiative (WHI) study in the United States, which emphasized that HRT promotes coronary heart disease, the collected data was re-analyzed. HRT turned out to be bad for women over the age of 70. When used before the age of 60, it inhibits - and in many cases even reverses - the process of vascular calcification, improves the structure and function of blood vessels, can lower the level of triglycerides in the blood and reduce the risk of type 2 diabetes. Atherosclerosis, hypertension and abdominal obesity are diseases and problems that can arise. it is precisely the deficiency of estrogens that is conducive to it. As a result, it increases the risk of coronary artery disease and heart attacks in postmenopausal women, one of the leading causes of mortality during this period. Hormone therapy, on the other hand, causes beneficial changes in lipids (it lowers the concentration of total cholesterol and LDL fraction, and increases the concentration of HDL fraction).
Better oral HRT than patch hormones
Also proven to be betterthe effects are achieved when hormone therapy is administered orally than when it is applied, for example, from patches. As a result, HRT prevents atherosclerosis, improves blood circulation and blood supply to tissues. As a result, the risk of heart disease is reduced by 35-50%. But if started too late - many years after your last period - it can increase your risk of blockages and clots. It has been proven that such a risk can be caused by high doses of estrogens - taking small, individually selected doses does not carry such a risk. But beware: the use of hormone therapy in obese and very advanced women increases the risk of thromboembolism and stroke by 2-3 times. In women immediately after the menopause, the therapy does not increase the risk of stroke, however, introduced after the age of 60 may be its cause. Most women are more concerned about breast cancer than other types of cancer. This view was reinforced by the aforementioned WHI studies, which were in fact carried out in a group of women over 65 years of age. It is now believed that the risk of breast and endometrial cancer may increase after 7 years of estrogen-only use. But the risk can be minimized by administering progestogens at the same time. There has also been an end to disagreement that breast cancer is caused only by hormone therapy. Today, no one doubts that menstruation before the age of 11, late pregnancies (over 35), obesity (BMI between 30-35), excessive drinking of alcohol and a diet rich in saturated fatty acids are also of great importance here.
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HRT protects against osteoporosis
Osteoporosis occurs more often in women who have a premature (before the age of 40) and early menopause. Therefore, along with lifestyle changes, gymnastics, quitting smoking, weight control and supplementing vitamin D deficiency, hormone therapy is introduced, usually in small and very small doses, smaller than those given in standard therapy. What does it do? A woman loses bone mass more slowly, she is better protected against fractures in the hip joint and vertebrae. However, this does not apply to women over 60 years of age. In them, hormone therapy to prevent bone fractures (including the femoral neck) must be selected individually, taking into account many other diseases.
Who is HRT patched for?
Many women choose patch therapy when choosing hormone therapy. They are comfortable - they are glued on every few days, they are durable, they will not come off, for example, during a bath. These modern preparations very precisely release the hormones they contain, maintaining their concentration in the blood serumat a certain, equal level. They also have a beneficial effect on the lipid metabolism ( although not as strong as in the case of oral therapy). Transdermally applied estrogens cause a significant reduction in the concentration of harmful LDL fraction and thus in total cholesterol in the blood. However, they do not cause significant changes in the level of HDL and triglycerides.
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