Menopause hormone replacement therapy

Post-menopausal hormone replacement therapy Periodontal disease... 

Lacey JV, Mink PJ, Lubin JH, et al. Menopausal hormone replacement therapy and risk of ovarian cancer. JAMA 2002 288 3343-3341. 

Marsden, J., The menopause, hormone replacement therapy and breast cancer, J. Steroid Biochem. Mol. Biol, 83, 123,2002. 

Estrogens do not cause vitamin Bg deficiency. However, there is evidence that high doses of vitamin Bg may overcome some of the side effects of estrogenic steroids used in contraceptives and as menopausal hormone replacement therapy. At very high levels of intake, supplements may cause sensory nerve damage. 

Estrogens and progestins are diminished in menopausal or ovarectomized women. In hormone replacement therapy (HRT), these hormones are substituted to alleviate hot flushes, mood changes, sleep disorders, and osteoporosis. 

There is much interest in the possible hormonal effects of phytoestrogens in both men and women. The majority of studies conducted in women have examined the ability of phytoestrogens to alleviate menopausal symptoms. Whilst hormone replacement therapy is recommended for women experiencing menopausal symptoms, there remains some uncertainty as to whether HRT can increase the risk of breast cancer. As a result of these concerns, investigations into natural alternatives such as phytoestrogens have received considerable attention. 

Many women seek medical treatment for the relief of menopausal symptoms, primarily hot flashes however, the role of hormone-replacement therapy (HRT) has changed dramatically over the years. HRT has long been prescribed for relief of menopausal symptoms and, until recent years, has been purported to protect women from CHD. The original reason behind recommending HRT in postmenopausal women revolved around a simple theory If the hormones lost during menopause were replaced through drug therapy, women would be protected from both menopausal symptoms and chronic diseases that often follow after a woman experiences menopause. Recent studies have disproved this theory. 

Hormone-replacement therapy remains the most effective treatment for vasomotor symptoms and vulvovaginal atrophy and should be considered for women experiencing these symptoms. The goals of treatment are to alleviate or reduce menopausal symptoms and to improve the patient s quality of life while minimizing adverse effects of therapy. The appropriate route of administration should be chosen based on individual patient symptoms and should be continued at the lowest dose for the shortest duration consistent with treatment goals for each patient. 

Osteoporosis Oral calcium supplementation (1000-5000 mg/day) Oral vitamin D Calcifediol (1000 lU/day) Calcitriol (0.5 mcg/day) Hormone-replacement therapy Calcitonin or oral bisphosphonates If daily intake less than 1000 mg elemental calcium Documented deficiency If kidney functioning If kidney not functioning Post-menopausal women without contraindications Documented loss in bone mineral density greater than 3% Data lacking for bisphosphonates in patients with Rl... 

Estrogen enhances Candida adherence to vaginal epithelial cells and yeast-mycelial transformation this is supported by the fact that infection rates are lower before menarche and after menopause (except in women taking hormone replacement therapy), while rates are higher during pregnancy... 

Chap. 47 - Hormone-Replacement Therapy in Menopause Universal Program Number 014-999-07-062-H04... 

Hormone therapy has proven highly effective in controlling the menopausal syndrome, especially severe hot flushes (MacLennan et al. 2004), even at doses significantly lower than those used until now (Speroff et al. 2000 Utian et al. 2001). Women s Health Initiative studies found that hormone replacement therapy, when administered as a primary prevention intervention for CVD in older women, increases the risk of heart disease and breast cancer. Even if a protective effect on fracture and colon cancer was observed, the risk-benefit ratio led to a recommendation of this treatment only for the short-term relief of menopausal symptoms (Rossouw et al. 2002 Anderson et al. 2004). The role of early administration of ovarian hormones to young postmenopausal women in the prevention of cardiovascular disease or late dementia remains... 

McCoy, N. L. The menopause and sexuality. 1992. In The Menopause and Hormonal Replacement Therapy ed. R. Sitruk-Ware and W.H. Utian. New York Marcel Dekker, pp. 73—100. 

HRT (hormone replacement therapy) administration of estrogens to women or androgens to men who, due to menopause or age, have decreased levels of these plasma steroids. 

The clinical problems that arise in the menopause are hot flushes, sweating, depression, decreased libido, increased risk of cardiovascular disease and osteoporosis. The latter results in increased incidence of hip, radial and vertebral fractures. Oestrogen is one factor controlling synthesis of active vitamin D and osteoporosis is in part due to a deficiency of vitamin D. Not surprisingly, to reduce these problems, administration of oestrogen is recommended (known as hormone replacement therapy or HRT). HRT reduces some of the risk factors for coronary artery disease since it reduces blood pressure and decreases the blood level of LDL-cholesterol and increases that of HDL-cholesterol. However, there is considerable debate about whether HRT increases the risk of breast or endometrial cancer. 

Hormone replacement therapy provides relief from vasomotor symptoms, decreases the risk of osteoporosis and decreases the risk of cardiovascular disease in post-menopausal women. 

This combination product is on example of a combined hormone replacement therapy that increases the risk of stroke slightly and, with long-term use, increases the risk of ovarian cancer slightly. Hormone replacement therapy alleviates symptoms of menopause and can be used as a prophylaxis of osteoporosis. 

Harris, R. Z., Tsunoda, S. M., Mroczkowski, R, Wong, H., and Benet, L. Z. (1996) The effects of menopause and hormone replacement therapies on prednisolone and erythromycin pharmacokinetics. Clin. Pharmacol. Then 59,429-435. 

Estrogen is uricosuric and that is most probably the reason why premenopausal women do not have primary gout. Estrogen hormone replacement therapy in post-menopausal women lowered serum uric acid (SUA). Consequently, the prevalence of primary gout in these subjects is similar to what is seen in pre-menopausal women. 

---