Menopausal hormone therapy – a course on individuality

М. Ю. Сергиенко, Ю. Я. Круть, В. Г. Сюсюка

Abstract


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.


Keywords


menopausal hormone therapy; estradiol valerate; levonorgestrel; klimonorm

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DOI: https://doi.org/10.18370/2309-4117.2016.28.75-79

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