A modern woman is usually quite well aware that as she approaches the age of "well over forty", certain irreversible changes occur in her body that have a strong impact on her quality of life, but this is not so much a reason to be sad as to go for advice to a doctor - a gynecologist. Thanks to the media, many patients have heard a lot about hormone replacement therapy and that it is quite possible to alleviate the unpleasant symptoms of an approaching menopause with its help, but they have many doubts and fears about this.
Natalia Nikolaevna Lelyukh told estet-portal.com about what kind of doubts most often disturb women during the premenopausal period and how to choose the right therapy for the patient that will improve her quality of life during this difficult period.
Do patients often come to an appointment with the assumption that they are menopausal and need to take some action?
In my practice, there are two types of calls: the first – according to the passport, the second – on complaints. The first category includes women who are doing well, have no complaints, but they want to "warn" and "arm" before the onset of "velvet age". In this case, you have to work more as a psychologist and physiotherapist. Although, in the presence of predisposing factors for the pathological course of menopause, drug correction can already be carried out if the patient wants it. The second group of women – those are the ones who come complaining. Here the traditional medical work already begins: to listen to complaints, understand where they come from, and try to cope with them, again only with the consent and participation of the woman.
On the basis of what complaints of the patient can it be assumed that she really approached the menopause?
First of all, the rhythm and nature of menstruation changes. Most often we are dealing with "skipping" cycles and more meager selections. Also, leadership in the debut manifestations of menopause is held by vascular symptoms: hot flashes, excessive sweating, dizziness. Both those and other manifestations are associated with hormonal changes in the body of a woman. It must be remembered that they come gradually and normally should not change the quality of a woman's life as a whole.
Are patients usually aware of HRT and to what extent? What features of this type of therapy should they be told about at the appointment?
Thanks to access to information on the Internet, patients can know more about drugs than a doctor. This is not bad, since they have to take these drugs, they may have to deal with side effects and suffer from allergies. At the appointment, the doctor is obliged to tell about the effect of the drug, to precisely exclude the presence of contraindications for taking it in this particular woman.
Also, without fail, the doctor must inform the patient about all the possible side effects of taking the selected drug and indicate exactly in which cases she needs to see a doctor.
What health problems can a woman solve with HRT?
HRT can remove hot flashes and normalize blood pressure, with early appointment this type of therapy can delay the time of the likely risk of developing heart attacks, normalize the cycle and metabolic processes on the mucous membranes.
The patient should be warned that HRT does not improve memory or prevent aging.
What types of HRT are usually prescribed in Ukraine and in other countries?
And there is no particular difference between Ukraine and abroad. The range of medicines is approximately the same. These are combined preparations, these are monopreparations, as well as transdermal patches, injections, creams and ointments. The selection of the remedy is carried out individually, depending on the anamnesis (previous life) of the patient and the desired effect.
For which patients HRT should not be prescribed?
These are patients with oncological diseases of the genital area, after radical therapy of which less than 5 years have passed and if the cancer is hormonally dependent. This is breast cancer, this is diabetes, as well as long-term smoking and uncompensated diseases of the liver, kidneys and cardiovascular system. These are venous thrombosis of various origins and thrombophlebitis.
Are there any complications from HRT and how to deal with them?
Of course, complications are possible. The patient should know that if something went "wrong", you need to run to the doctor who prescribed the drug to her and solve the troubles that have arisen.
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