During the premenopausal period, estrogen production by the ovaries decreases significantly, and with the onset of menopause – practically stops. At the same time, the production of follicle-stimulating and luteinizing hormones by the pituitary gland increases according to the feedback mechanism. Changes in the hormonal balance can lead to dysfunction of some organs and systems, which is clinically manifested by the development of menopausal syndrome.
According to statistical studies, climacteric syndrome occurs in 75% of women in the period of perimenopause. In 20% of them, this condition significantly impairs the quality of life. For more information about the typical manifestations of menopausal syndrome, as well as the principles of prescribing hormone replacement therapy for this condition, read on estet-portal.com in this article.
What are the typical clinical manifestations of menopausal syndrome
On average, manifestations of climacteric syndrome disturb a woman for one or two years after their appearance, but in some cases – 10 years or more.
Climacteric syndrome can significantly impair the quality of life of patients and is an indication for hormone therapy.
It is necessary to highlight the following symptoms of the pathological course of menopause:
1. Hot flashes, redness and sweating – the most typical symptoms of the pathological course of menopause. They are most pronounced in cases of a sharp drop in estrogen levels (for example, after removal of the ovaries);
2. Sleep disorders: for many women, this is the most significant symptom that worsens the quality of life;
3. Mental disorders: irritability, apathy, depression, possibly even the development of psychoses;
4. Sexual disorders: decreased libido and dyspareunia. The latter may be due to thinning of the vaginal mucosa;
5. Urological disorders: pollakiuria, recurrent urinary tract infections, incontinence;
6. Disorders in the musculoskeletal system: arthralgia and myalgia, osteoporosis.
The above symptoms reflect the hormonal imbalance of the body against the background of the pathological course of menopause and are an indication for the appointment of hormone therapy.
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Key aspects of hormone replacement therapy for menopausal syndrome
To reduce the severity of the manifestations of menopausal syndrome and improve the quality of life of women, hormone replacement therapy is used today.
It is necessary to highlight the following principles of hormone replacement therapy for menopausal syndrome:
1. The use of estrogen monotherapy is permissible only in the case of hysterectomy, since it can lead to the development of endometrial hyperplasia. Therefore, progesterone analogues must be added to the treatment regimen for menopausal syndrome.
2. If less than one year has elapsed since menopause, hormone replacement therapy should be started with cyclic combination hormone therapy that mimics the natural menstrual cycle.
3. After 12 months from the onset of menopause, continuous combination hormone therapy should be prescribed;
4. HRT begins with a low dose of estrogen, such as estradiol at a dose of 1 mg, which must be combined with low doses of progesterone. The dosage of drugs should be adjusted subsequently according to the clinical effectiveness of therapy and the occurrence of side effects of drugs.
The choice of hormone replacement therapy regimen and dosages of drugs should take into account the individual characteristics of the woman in each individual case.
Evidence-based medicine in the treatment of menopausal syndrome
Today, there are many alternative pharmacological drugs, the effectiveness of which has not been proven in clinical trials. Unfortunately, many women choose to use alternative medicine, which can lead to delayed hormone therapy and worsening menopause.
The doctor in his practice should be guided by the principles of evidence-based medicine.
According to international protocols for the treatment of gynecological diseases, the appointment of drugs such as phytoestrogens is not appropriate due to the lack of evidence for their effectiveness. Thank you for staying with estet-portal.com. Read other interesting articles in the "Gynecology" section. You may also be interested in: Quality of life for a woman during menopause.
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