Menopausal hormone therapy – a course on individuality
Keywords:menopausal hormone therapy, estradiol valerate, levonorgestrel, klimonorm
Actuality of menopausal hormone therapy is due to demographic realities and expectations, the changing social role of women. According to WHO projections, by 2050 the number of elderly people in developed countries will be twice as much as the children; most of the world’s population will be women over the age of 45 years. The growing social role of women and the pursuit of active longevity put before medicine two important tasks: relief of menopause symptoms and the prevention of related conditions, that threaten the lives or severely reducing its quality.
Menopausal hormone therapy is now recognized as the most effective treatment for vasomotor and urogenital atrophy syndromes, effective prevention of osteoporosis, cardiovascular diseases in postmenopausal women. Timely and individualized approach is the main condition for its effectiveness and safety.
The article suggests various options for medical support for premenopausal women, depending on the hormonal changes. Emphasis is placed on cyclic estrogen-progestin therapy.
Contrary to the traditional passion for “natural” progestins, the authors have shown the benefits of “synthetic” hormones in combination: estradiol valerate and levonorgestrel (hormonal contraceptive klimonorm).
Residual androgenic activity of levonorgestrel turns into advantage if the clinical picture is dominated by fatigue, asthenia, decreased libido, pain in bones and joints, osteoporosis.
As a 19-norsteroid it provides protection from endometrial proliferative processes, which makes it possible for safe use of menopausal hormone therapy in women with hyperplasia and endometrial polyps in the history. The seven-day break in the cyclic intake provides a reliable control of the menstrual cycle, which improves adherence to treatment. Klimonorm may also be recommended to women with ovarian failure syndrome undergoing surgery ovariectomy.
Thus, rejection of the templates in menopausal hormone therapy, an individualized approach may maximize the therapeutic and prophylactic preparations effects, reduce the number of adverse reactions and complications, and increase the number of its supporters among doctors and patients.
- Pan Gi Mun. Message on the International Day of Older Persons. Available from: [http://www.un.org/ru/sg/messages/2013/ olderpersonsday.shtml], last accessed Apr. 23, 2016.
- Cleve, A., Fritzemeier, K.H., Haendler, B., et al. “Pharmacology and clinical use of sex steroid hormone receptor modulators.” Handb Exp Pharmacol 214 (2012): 543–87.
- Tatarchuk, T.F., Yefymenko, O.A. “The modern view of hormone therapy.” Reproductive Endocrinology 2.4 (2012): 34–9.
- Plaksina, N.D., Simonovskaia, H.Y. “Features of nonhormonal correction of vasomotor paroxysms at postmenopause.” Status Praesens 2.19 (2014): 60–5.
- Khamoshina, M.B., Bril, Y.A. Menopausal disorders: variability of therapeutic approaches. Moscow. Status Praesens (2014): 20 p.
- Balan, V.E. “Principles of hormone replacement therapy for urogenital disorders.” Consilium Medicum 5.7 (2003): 413–7.
- Nisar, N., Sohoo, N.A. “Frequency of menopausal symptoms and their impact on the quality of life of women: a hospital based survey.” J Pak Med Assoc 59.11 (2009): 752–6.
- Arounassalame, B. “The quality of life during and after menopause among rural women.” J Clin Diagn Res 7.1 (2013): 135–9.
- Ceylan, B., Ozerdoğan, N. “Menopausal symptoms and quality of life in Turkish women in the climacteric period.” Climacteric 6 (2014): 1–18.
- Radzinskyi, V.E., Khamoshina, M.B., Melnikova, G.G. “Modern approach to the treatment and prevention of metabolic disorders associated with surgical menopause.” Doctor.Ru 6.50 (2009): 21–7.
- Smetnik, V.P. “Premature menopause.” Attending Doctor 10 (2004). Available from: [http://www.lvrach.ru/2004/10/4531850], last accessed Apr. 23, 2016.
- Manukhin, I.B., Studenaya, L.B., Gevorkyan, M.A. “Hormonal therapy of menopausal disorders in perimenopausal women with uterine myoma and endometriosis internal.” Gynecology 3 (2008): 11–3.
- Kuznetsova, I.V., Yakokutova, M.V. “Klimonorm use for preventive treatment of dysfunctional uterine bleeding in premenopause.” Gynecology 2 (2006): 27–9.
- Markun, T.A. “Menopause. The drug choice for hormone replacement therapy.” Available from: [http://bono-esse.ru/blizzard/Gyn/ Menopauza/klimax_0.html], last accessed Apr. 23, 2016.
- Kuznetsova, I.V., Yakokutova, M.V. “Fat and carbohydrate metabolism in women using different modes of hormone replacement therapy.” Russian Medical Journal 19 (2008): 1265.
- National consensus on the management of patients in menopause. Reproductive endocrinology 1.27 (2016): 8–25.
- Tatarchuk, T.F., Yefymenko, O.A. “Principles of diagnosis, prevention and treatment of menopausal disorders.” Journal of Ukrainian Medical Elite 4.10 (2009): 24–9.
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