Hormone replacement therapy alleviates the side effects of menopause: hot flashes, irritability, and difficulty concentrating. It is used when symptoms interfere with daily functioning. What do you need to know about hormone replacement therapy before asking your gynecologist for a prescription?
Only 3-7 percent Polish women usehormone replacement treatment . But HRT is an outdated name, today it is called HLM - hormonal treatment of menopause, because it is used to treat ailments related to the menopause. Most women have such mild ovarian decline symptoms that they do not need this therapy. And the others often do not want to use it because they have heard that it is the cause of cancer.
The results of a survey conducted 10 years ago in the USA contributed to this opinion. With time, it turned out that the research was poorly performed and misinterpreted, and the conclusions drawn were hasty. However, information on this subject is penetrating the public with resistance. The reluctance remained, but some women still choose HLM. But not all of them will receive approval from the doctor to use it.
This will be useful to youWhen is the best time to start hormone therapy?
Hormone therapy is most beneficial when it is started early, before the age of 50, or shortly after the onset of menopausal symptoms. It is true that it can also be undertaken later, but it must be done before the age of 60. The second important rule of such treatment is to use the lowest possible doses of hormones, because then the side effects and potential risks are minimal. Dosages can be increased only after 12 weeks of treatment, if there is no treatment effect.
You want to start hormone replacement therapy - you need to undergo a series of tests
Hormonal treatment is not undertaken without justification. They are considered when symptoms such as: hot flushes, sweating, irritability, depression, decreased concentration, sleep disorders, atrophic changes in the genitourinary system are intensified.
A special questionnaire filled in by the patient helps in assessing how much they deteriorate the quality of life. And, to her surprise, she can show that there is no indication to start the therapy. Because the high nuisance of symptoms is not enough for a doctor to issue a prescription for drugshormonal. He must first rule out contraindications to HLM.
That is why he conducts a thorough interview, takes a cytology, orders gynecological ultrasound, mammography (or breast ultrasound), sometimes densitometry (bone density) and many laboratory tests, e.g. determination of the concentration of selected hormones, glucose, cholesterol, triglycerides, tests liver, CRP acute phase protein, blood clotting, urinalysis. Only on the basis of the results of these tests, the doctor and the patient can decide to start the therapy.
How long can a hormone treatment last?
Every year, the doctor orders checkups and considers together with the patient whether to continue the therapy or to stop it. If the benefits obtained are greater than the side effects, you can continue to use it. However, after five years (then the risk of breast cancer slightly increases), you should consider whether continuing hormone therapy makes sense. For many women, the symptoms of the menopause either subside or milder over time that do not interfere with everyday life. Therefore, to check it, it makes sense to stop taking hormones for a month - if there is no significant deterioration in well-being, it is a sign that the woman has already had the most difficult period of the menopause and no further hormone supplementation is needed.
Other methods of relieving menopausal symptoms
But what to do when symptoms that make life difficult for a woman appear after hormone withdrawal? There are two options. If there are no contraindications, you can return to hormonal drugs even after many months and use it for as long as needed. The second option is to use natural preparations with phytoestrogens or with black cohosh extract, which alleviate the symptoms of menopause.
In the case of excessive nervousness, sleep disorders, and significant depressed mood, the doctor may prescribe tranquilizers and antidepressants. However, when there are problems with the genitourinary system (urinary incontinence, vaginal dryness, frequent infections of the urethra and bladder), she will suggest vaginal globules with hormones. They work locally, so they do not affect the entire body of a woman.
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