Home Prosthetics and implantation Take HRT with a small or large dose. The whole truth about hormone replacement therapy

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Take HRT with a small or large dose. The whole truth about hormone replacement therapy

Despite the fact that menopause is a physiological process, many women need medication correction to make it easier to survive this period of life. Changes in hormonal levels during menopause, which are based on stopping the synthesis of estrogen, negatively affect the ability to work, appearance, physical health and the psycho-emotional state of the lady. Then special medications for menopause can help.

Experts prescribe to many women menopausal age drug therapy, giving preference to homeopathic remedies, antidepressants, dietary supplements and other drugs that do not contain hormones. Limiting the use of hormonal drugs is justified by the fact that they have a large number of side effects.

In this topic, we want to tell you how and when experts recommend taking non-hormonal medications during menopause for hot flashes, depression, fluctuations blood pressure and others unpleasant symptoms that may appear in a woman during this period of life. We will also look at in what cases and what hormonal medications a gynecologist can prescribe, as well as how to take them correctly to avoid undesirable consequences for good health.

Hormone replacement therapy to relieve menopausal symptoms is used by specialists in many European countries, as it has been proven to be highly effective and safe. But domestic gynecologists are afraid to alleviate menopause in women with the help of hormone replacement drugs, since they have an impressive list of side effects.

But in the process of clinical observations, European doctors established a number of conditions to minimize the risk of side effects, namely:

timely prescription and withdrawal of hormonal drugs during menopause;
presence of indications for hormone therapy;
the use of microdoses of drugs that will not cause undesirable effects;
selection of drugs and its dosage, based on the results of a blood test for sex hormones;
prescribing medications that contain exclusively natural hormones;
strict adherence by the patient to the recommendations of the treating doctor.

But many patients still refuse hormonal medications for the following reasons:

consider the use of hormone therapy unnatural, since menopause is a physiological process;
do not want to take hormonal drugs because they consider them unnatural;
afraid to gain weight;
afraid of addiction;
are afraid of hair appearing in unwanted places;
think that hormonal drugs damage the gastric mucosa;
believe that taking medications with sex hormones increases the risk of developing malignant neoplasms in the female body.

But these are all just prejudices, since by observing the conditions that we talked about earlier, you can avoid negative consequences for good health.

Thus, if the body does not have enough of its own sex hormones, then it needs foreign hormones, since hormonal imbalance leads to disruption of the functioning of all organs and systems.

Indications for the use of hormonal drugs during menopause

Hormonal drugs are prescribed in the following situations:

pathological menopause, which developed as a result of removal of the uterus, taking chemotherapy drugs or radiation treatment;
menopause occurring in women under 40 years of age;
too pronounced signs of menopause;
the development of complications and diseases that appeared against the background of menopause (hypertension, atherosclerosis, polycystic ovary syndrome, dry vaginal mucosa, urinary incontinence and others);
the patient’s desire to eliminate unpleasant symptoms.

Hormonal drugs for menopause in women: side effects and contraindications

increased fatigue;
emotional lability;
swelling;
weight gain;
flatulence;
mastopathy;
breast tumors;
severe symptoms of premenstrual syndrome;
painful menstruation;
anovulatory menstrual cycle;
development of benign tumors in the uterus and appendages;
uterine bleeding;
increased risk.

The correct selection of the dose, strict adherence to the specialist’s prescriptions, regularity of administration and the combination of estrogens with allows you to avoid the above-mentioned side effects.

The following conditions are absolute contraindications to hormonal drugs:

allergy to the components of the hormonal drug;
malignant neoplasms of the mammary glands and female genital organs, including a history of;
metrorrhagia;
thrombophilia;
stroke;
myocardial infarction;
varicose veins and blood clots in the veins of the lower extremities;
increased blood coagulation;
third stage hypertension;
severe liver diseases (cirrhosis, liver failure, hepatitis);
autoimmune diseases (scleroderma, systemic lupus erythematosus and others).

Relative contraindications include:

endometriosis;
uterine fibroids;
migraine;
epilepsy;
precancerous diseases of the uterus and mammary glands;
calculous cholecystitis and cholelithiasis.

The best drugs for menopause: list, description, price

The most best reviews gynecologists and patients about the latest generation of combined hormonal drugs, which contain both estrogen and progesterone.

HRT for menopause includes new generation drugs:

Angelica – 1300 rubles;
Klimen - 1280 rubles;
Femoston – 940 rubles;
Climinorm – 850 rubles;
Divina – 760 rubles;
Ovidon – the drug is not yet commercially available;
Climodien – 2500 rubles;
Activel - the drug is not commercially available;
Cliogest – 1780 rubles.

The listed drugs perform the following tasks:

eliminate anxiety, improve mood, activate memory and improve sleep;
increase the tone of the bladder sphincter muscles;
retain calcium in bone tissue;
prevent the development of periodontal disease;
restore the endometrium;
eliminate dryness of the mucous membranes of the genital organs;
normalize blood cholesterol levels.

These drugs are available in the form of dragees and tablets. One blister, where each tablet is numbered, is enough for 21 days of use. After a woman takes the last pill, she needs to take a break for seven days and only then start a new blister. Each tablet has its own dose of hormones, which corresponds to the day of the cycle.

Femoston, Aktivel, Kliogest, as well as the drug Angeliq are produced in 28 tablets in a blister, seven of which are pacifiers, that is, they do not contain hormones.

Estrogens

Preparations that contain only estrogens are produced mainly in the form of gels, creams, patches or implants that are placed under a woman’s skin.

The most effective for menopause are the following gels and ointments with estrogens:

Divigel – 620 rubles;
Estrogel – 780 rubles;
Octodiol – the drug is not commercially available;
Menorest - the drug is not commercially available;
Proginova - 590 rubles.

Among estrogen patches, the following have performed well:

Estraderm - the drug is not commercially available;
Alora – 250 rubles;
Klimara – 1214 rubles;
Estramon – 5260 rubles;
Menostar.

Gels and ointments are quite convenient to use, since they only need to be applied once a day to the skin of the shoulders, abdomen or lower back.

Hormonal patches are an even more convenient dosage form because they need to be changed once every seven days.

Implants that are sutured under the skin last six months, releasing a small dose of estrogen into the blood every day.

Gels, ointments, creams, patches and implants have a number of advantages over oral or injectable forms hormonal drugs, namely:

ease of dosage selection;
gradual penetration of estrogen into the blood;
the hormone enters directly into the blood without passing through the liver;
maintaining a balance of different types of estrogens;
minimal risk of occurrence side effects;
can be used even if there are contraindications to the use of estrogens.

Progestins

To avoid the development of side effects, estrogens are prescribed in combination with progesterone. But if hysterectomy was performed, then the patient is indicated for estrogen monotherapy.

Preparations with progesterone are mainly prescribed from the 14th to 25th day of the menstrual cycle.

There are many progestins on the modern pharmaceutical market, but a number of drugs have the best effectiveness.

Tablets and dragees:

Duphaston – 550 rubles;
Utrozhestan – 4302 rubles;
Norkolut – 130 rubles;
Iprozhin - 380 rubles.

Gels and vaginal suppositories:

Utrozhestan;
Crinon – 2450 rubles;
Progestogel – 900 rubles;
Prajisan - 260 rubles;
Progesterone gel.

Intrauterine hormonal systems:

Mirena – 12,500 rubles.

IN Lately specialists and patients prefer the Mirena intrauterine device, which is not only a contraceptive, but also contains progesterone and gradually releases it into the uterus.

Instructions for the use of hormonal agents

The choice of hormone therapy regimen, selection of the drug and its dosage should be handled exclusively by a gynecologist. Medicines are prescribed based on the results of a study of a woman’s hormonal levels, as well as taking into account her overall health status. Self-medication can lead to irreversible consequences!

Treatment for menopause begins when the first signs of a lack of sex hormones appear. The duration of treatment depends on the severity of menopause symptoms and can take from one to three years, and sometimes up to ten years.

Most experts believe that taking hormonal drugs should be stopped by the age of sixty, as cancer may develop.

Rules for taking hormonal drugs:

vaginal suppositories and tablets should be taken at the same time of day, as prescribed by the treating doctor.
basically all hormones are prescribed daily or cyclically, that is, 21 days with seven-day breaks;
if the patient forgot to take the drug, then the usual dose should be taken within the next 12 hours, and the next tablet at the appointed time;
It is strictly forbidden to change the dose of the drug or the drug itself;
You cannot take the hormone for life;
During hormone therapy, you need to regularly visit a gynecologist - once every six months.

Treatment of menopause with non-hormonal drugs

Experts today have differing opinions about the advisability of hormone therapy. In addition, many women refuse to take hormone-containing drugs because they are afraid of their side effects, do not have the financial ability to constantly buy them, or for other reasons.

In such cases, you can use treatment for menopause without hormones, which consists of the use of phytohormones, homeopathic medicines, dietary supplements, etc.

Homeopathic remedies for menopause

Homeopathy for menopause is very popular. The effect of homeopathic remedies is based on the activation of the body’s natural mechanisms. Patients are prescribed small doses of substances that, in large doses, can lead to negative consequences.

Homeopathic medicines will help eliminate symptoms of menopause such as:

hyperhidrosis (increased sweating);
menopausal vertigo (dizziness);
hot flashes during menopause;
dryness of the vaginal mucous membranes;
mood swings;
and others.

The benefits of homeopathy for menopause include the following:

natural origin of components;
relatively low cost;
practically absent side effects, only allergies to the components of the product;
safety of use in the elderly.

Let's look at the most effective homeopathic remedies, used for menopause.

Remens – 580 rubles. The drug consists of soybean phytohormones, which activate the synthesis of sex hormones at the level of the hypothalamus and pituitary gland. Remens effectively relieves a woman of hot flashes during menopause and prevents the appearance of vaginitis. In addition, with the help of Remens you can prevent urinary incontinence and cystitis during menopause.
Estrovel - 385 rubles. This drug contains phytoestrogens from soy and wild yam, as well as a complex of vitamins and microelements. Estrovel allows you to reduce the number and intensity of hot flashes and sweating.
Feminal – 670 rubles. This drug contains liquid extracts of nettle, oregano, celandine, hawthorn, shepherd's purse herb, centaury, St. John's wort, thyme, celandine and calendula. Feminal helps get rid of hot flashes, excessive sweating, psycho-emotional lability and dizziness during menopause, and women do not recover from this medicine.
Climaxin – 120 rubles. This preparation consists of sepia, lachesis and black cohosh. The action of Climaxin is aimed mainly at regulating vegetative vascular disorders(insomnia, irritability, palpitations, increased sweating, dizziness) during menopause.
Klimakt-Hel – 400 rubles. This drug perfectly eliminates the symptoms caused by menopause.

Herbal remedies for menopause

Herbal preparations for menopause contain phytoestrogens - substances that can act as female sex hormones and eliminate the symptoms of aging female body.

Plant estrogens are analogs of female sex hormones obtained from soy products. For example, the innovative Italian formula Flavia Night contains phytoestrogens - genistein and daidzein, which have a mild substitutive effect during menopause and menopause and help a woman cope with hot flashes, sweating and poor health.

Flavia Night also contains melatonin to normalize sleep, vitamin D and calcium to strengthen bone tissue, vitamins B6, B9 and B12 to normalize metabolism and alpha-linolenic acid for antioxidant protection.

Flavia Night is a unique Italian formula designed specifically for active women who want to lead a vibrant life rather than experience the symptoms of menopause. Just one capsule before bed will help a woman get through this difficult time. Flavia Night - works while you rest.

Another effective and popular drug for menopause symptoms is Inoclim, which is biological additive based on phytoestrogens.

Inoclim effectively combats such menopausal symptoms, such as a feeling of heat in the body, vaginal dryness, increased sweating, and also prevents the development of complications.

The drug has virtually no contraindications or side effects. Inoclim is not prescribed only to those who are allergic to the substances that make up its composition.

Thus, we have looked at what medications to take during menopause to alleviate its symptoms. But drug therapy can and should be supplemented with the correct and balanced diet, drinking enough fluids, playing sports, taking vitamins and mineral complexes. Also, do not forget about the positive emotions that communication with loved ones, hobbies or handicrafts can give you.

Watch a video about medications for menopause.

The whole truth about hormone replacement therapy

I take the liberty to describe the benefits and fears of prescribing hormone replacement therapy (HRT). I assure you - it will be interesting!

Menopause, according to modern science, is not health, it is a disease. Characteristic specific manifestations for it are vasomotor instability (hot flashes), psychological and psychosomatic disorders (depression, anxiety, etc.), urogenital symptoms - dry mucous membranes, painful urination and nocturia - “night trips to the toilet”. Long-term effects: CVD (cardiovascular disease), osteoporosis (low bone density and fractures), osteoarthritis and Alzheimer's disease (dementia). And diabetes and obesity.

HRT in women is more complex and multifaceted than in men. If a man needs only testosterone for replacement, then a woman needs estrogens, progesterone, testosterone, and sometimes thyroxine.

HRT uses smaller doses of hormones than hormonal contraceptives. HRT drugs do not have contraceptive properties.

All the materials below are based on the results of a large-scale clinical study of HRT in women: Womens Health Initiative (WHI) and published in 2012 in the consensus on hormone replacement therapy of the Research Institute of Obstetrics and Gynecology. IN AND. Kulakova (Moscow).

So, the main postulates of HRT.

1. You can start taking HRT for another 10 years after the cessation of your menstrual cycle.
(taking into account contraindications!). This period is called the “window of therapeutic opportunity.” Over 60 years of age, HRT is not usually prescribed.

How long is HRT prescribed? - "As much as needs" To do this, in each specific case it is necessary to determine the purpose of using HRT in order to determine the timing of HRT. The maximum period for using HRT: “last day of life – last pill.”

2. The main indication for HRT is vasomotor symptoms of menopause(these are menopausal manifestations: hot flashes), and urogenital disorders (dyspariunia - discomfort during sexual intercourse, dry mucous membranes, discomfort during urination, etc.)

3.When making the right choice HRT has no evidence of an increase in the incidence of breast and pelvic cancer, the risk may increase with a duration of therapy of more than 15 years! HRT can also be used after treatment of stage 1 endometrial cancer, melanoma, and ovarian cystadenomas.

4. When the uterus is removed (surgical menopause) - HRT is received in the form of estrogen monotherapy.

5. When HRT is started on time, the risk is reduced cardiovascular diseases and metabolic disorders. That is, during hormone replacement therapy, normal metabolism of fats (and carbohydrates) is maintained, and this prevents the development of atherosclerosis and diabetes mellitus, since the deficiency of sex hormones in postmenopause aggravates existing ones and sometimes provokes the onset of metabolic disorders.

6. The risk of thrombosis increases when using HRT with a BMI (body mass index) = more than 25, that is, if you are overweight!!! Conclusion: excess weight is always harmful.

7. The risk of thrombosis is higher in women who smoke.(especially when smoking more than 1/2 packs per day).

8. It is desirable to use metabolically neutral gestagens in HRT(this information is more for doctors)

9. Transdermal forms (external, that is, gels) are preferable for HRT, they exist in Russia!

10. Psycho-emotional disorders often prevail during menopause(which does not allow one to discern a psychogenic illness behind their “mask”). Therefore, HRT can be given for 1 month as a trial therapy to differential diagnosis With psychogenic diseases (endogenous depression etc.).

11. In the presence of untreated arterial hypertension, HRT is possible only after stabilization of blood pressure.

12. Prescribing HRT is possible only after hypertriglyceridemia has normalized**(triglycerides are the second, after cholesterol, “harmful” fats that trigger the process of atherosclerosis. But transdermal (in the form of gels) HRT is possible against the background of elevated triglyceride levels).

13. In 5% of women, menopausal symptoms persist for 25 years after the cessation of the menstrual cycle. HRT is especially important for them to maintain normal well-being.

14. HRT is not a method of treating osteoporosis, it is a method of prevention(it should be noted that this is a cheaper method of prevention than the cost of treating osteoporosis itself).

15. Weight gain often accompanies menopause., sometimes this is an additional + 25 kg or more, this is caused by a deficiency of sex hormones and related disorders (insulin resistance, impaired carbohydrate tolerance, decreased insulin production by the pancreas, increased production of cholesterol and triglycerides by the liver). It is called in general terms– menopausal metabolic syndrome. Timely prescribed HRT is a way to prevent menopausal metabolic syndrome(provided that it was not there before, before menopause!)

16. Based on the type of menopausal manifestations, it is possible to determine which hormones a woman lacks in her body, even before taking blood for a hormonal analysis. Based on these signs, menopausal disorders in women are divided into 3 types:

a) type 1 - only estrogen-deficient: weight is stable, no abdominal obesity (at the abdominal level), no decreased libido, no depression and urinary disorders and decreased muscle mass, but there are menopausal hot flashes, dry mucous membranes (+dysparium), and asymptomatic osteoporosis;

b) type 2 (only androgen-deficient, depressive) if a woman has a sharp increase in weight in the abdominal area - abdominal obesity, increasing weakness and decreased muscle mass, nocturia - “night urge to go to the toilet”, sexual disorders, depression, but no hot flashes and osteoporosis according to densitometry (this is an isolated lack of “male” hormones);

c) type 3, mixed, estrogen-androgen deficiency: if all the previously listed disorders are expressed - hot flashes and urogenital disorders are pronounced (dysparunia, dry mucous membranes, etc.), sharp increase weight, loss of muscle mass, depression, weakness - there is a lack of both estrogen and testosterone, they are both required for HRT.

It cannot be said that any of these types is more favorable than the other.
**Classification based on materials from Apetov S.S.

17. Question about the possible use of HRT V complex therapy Stress urinary incontinence in menopause must be addressed individually.

18. HRT is used to prevent cartilage degradation and, in some cases, to treat osteoarthritis. An increase in the incidence of osteoarthritis with multiple joint lesions in women after menopause indicates the involvement of female sex hormones in maintaining the homeostasis of articular cartilage and intervertebral discs.

19. Estrogen therapy has been shown to benefit cognitive function (memory and attention).

20. Treatment with HRT prevents the development of depression and anxiety, which is often implemented with menopause in women predisposed to it (but the effect of this therapy occurs provided that HRT therapy is started in the first years of menopause, or better yet, premenopause).

21. I no longer write about the benefits of HRT for a woman’s sexual function, aesthetic (cosmetological) aspects– prevention of “sagging” of the skin of the face and neck, prevention of worsening wrinkles, gray hair, tooth loss (from periodontal disease), etc.

Contraindications to HRT:

Main 3:
1. History of breast cancer, current or suspected; If there is a hereditary history of breast cancer, a woman needs to undergo a genetic test for the gene for this cancer! And when high risk cancer - HRT is no longer discussed.

2. Venous thromboembolism in history or currently (deep vein thrombosis, pulmonary embolism) and current or history of arterial thromboembolic disease (eg, angina, myocardial infarction, stroke).

3. Liver diseases in the acute stage.

Additional:
estrogen dependent malignant tumors, for example, endometrial cancer or if this pathology is suspected;
bleeding from the genital tract unknown etiology;
untreated endometrial hyperplasia;
uncompensated arterial hypertension;
allergy to active substances or to any of the components of the drug;
cutaneous porphyria;
dysregulated type 2 diabetes mellitus

Examinations before prescribing HRT:

Taking an anamnesis (to identify risk factors for HRT): examination, height, weight, BMI, abdominal circumference, blood pressure.

Gynecological examination, collection of smears for oncocytology, ultrasound of the pelvic organs.

Mammography

Lipidogram, blood sugar, or sugar curve with 75 g of glucose, insulin with calculation of the HOMA index

Additionally (optional):
analysis for FSH, estradiol, TSH, prolactin, total testosterone, 25-OH-vitamin D, ALT, AST, creatinine, coagulogram, CA-125
Densitometry (for osteoporosis), ECG.

Individually – Doppler ultrasound of veins and arteries

About the drugs used in HRT.

In women 42-52 years old with a combination of regular cycles with cycle delays (as a phenomenon of premenopause), who need contraception, who do not smoke!!!, you can use contraception instead of HRT - Jess, Logest, Lindinet, Mercilon or Regulon / or use an intrauterine system - Mirena (in the absence of contraindications).

Etrogens cutaneous (gels):

Divigel 0.5 and 1 g 0.1%, Estrogel

Combination drugs E/G for cyclic therapy: Femoston 2/10, 1/10, Climinorm, Divina, Trisequence

Combined E/H drugs for continuous use: Femoston 1/2.5 conti, Femoston 1/5, Angelique, Klmodien, Indivina, Pauzogest, Klimara, Proginova, Pauzogest, Ovestin

Tibolone

Gestagens: Duphaston, Utrozhestan

Androgens: Androgel, Omnadren-250

Alternative treatments include
herbal preparations: phytoestrogens and phytohormones. Data on the long-term safety and effectiveness of this therapy are insufficient.

In some cases, a one-time combination of hormonal HRT and phytoestrogens is possible. (for example, with insufficient relief of hot flashes by one type of HRT).

Women receiving HRT should visit their doctor at least once a year. The first visit is scheduled 3 months after the start of HRT. The doctor will prescribe the necessary examinations for monitoring HRT, taking into account the characteristics of your health!

Important! Message from the site administration about questions on the blog:

Dear readers! By creating this blog, we set ourselves the goal of giving people information on endocrine problems, diagnostic methods and treatment. And also on related issues: nutrition, physical activity, lifestyle. Its main function is educational.

Within the framework of the blog, in answering questions, we cannot provide full-fledged medical consultations; this is due to both the lack of information about the patient and the doctor’s time spent in order to study each case. Only answers are possible on the blog general plan. But we understand that not everywhere it is possible to consult with an endocrinologist at your place of residence; sometimes it is important to get another medical opinion. For those situations where a deeper dive is needed, studying medical documents, in our center we have a format of paid correspondence consultations on medical documentation.

How to do it? Our center’s price list includes a correspondence consultation on medical documentation, costing 1,200 rubles. If this amount suits you, you can send scans of medical documents, video recordings, detailed description, everything that you consider necessary for your problem and questions that you want answered. The doctor will see if the information provided can give a full conclusion and recommendations. If yes, we will send the details, you will pay, and the doctor will send a report. If the documents provided cannot give an answer that could be considered as a doctor’s consultation, we will send a letter stating that in this case Absentee recommendations or conclusions are impossible, and, of course, we will not take payment.

Best regards, administration Medical center"XXI Century"

According to experts, new generation HRT drugs are the optimal method of treating menopausal syndrome. The products contain a minimal amount of synthetic hormones, which makes the drugs practically harmless and suitable for long-term use. Let's consider reviews about.

Hormone replacement therapy

For many women, menostasis becomes a very difficult period in life. However, it is completely wrong to regard menopause as a disease, just as it is completely wrong to regard hormone therapy as a treatment for menopause. HRT for menopause with new generation drugs, according to doctors, is only to help the body move more smoothly into the stage of complete cessation of reproductive function, without the risk of developing dangerous pathologies caused by a sharp estrogen deficiency. Not everyone can take synthetic estrogens, and even in the absence of contraindications, gynecologists do not advise some women to resort to hormone therapy.

For example, a woman does not experience strong hot flashes, her hormonal background within acceptable standards, and the risks of developing osteoparosis are low - experts cannot advise such a lady to take HRT, since it is clear that her body copes with hormonal changes on its own and does not require treatment. It’s another matter when a patient comes to the doctor with complaints of a significant decrease in quality of life, frequent and intense hot flashes, nervous exhaustion and the inability to continue the usual way of life. Such a woman will be carefully examined, and if there are no contraindications, HRT may be recommended to her.

Absolute contraindications:

Uterine bleeding;
Suspicions of cancer;
History of oncology;
Hypertension;
Atherosclerosis;
Ischemia;
Benign neoplasms;
Diabetes;
Liver pathologies;
Kidney pathologies;
Pregnancy and lactation.

Important! Treatment with HRT is possible only under the strict supervision of a specialist. Self-medication is strictly prohibited!

Early menopause is a pathology that is dangerous primarily due to the development of complications. Menostasis is considered early if reproductive function begins to fade before the age of 40. Such patients most often encounter severe symptoms of menopause, because, in fact, the body is not yet ready for hormonal changes, and a severe estrogen deficiency leads to early hypertension, heart disease, osteoporosis, benign neoplasms, Alzheimer's disease and other diseases.

In the absence of contraindications, women with early menopause should definitely take hormonal pills. It is HRT in this case that will delay menopause for several years and smooth out unpleasant manifestations, and will also prevent the occurrence of the above pathologies. The same can be said for patients with surgical menopause, they also need to take HRT to protect themselves from these diseases.

Important! Before prescribing HRT for early menopause, the cause of the deviation must be identified.

Non-hormonal drugs taken during menopause to relieve symptoms

Treatment without hormones is alternative methods relief of menopausal symptoms. Today, there are a lot of herbal medicines on sale that have an estrogen-like effect and, while not being synthetic analogues of sex substances, can also eliminate the unpleasant symptoms of menostasis. Phytohormones are quite effective with long-term use, but in order to feel the first positive changes in well-being, they need to be taken for at least 2-3 months.

Phytohormones are not drugs; they have virtually no contraindications and are easily tolerated by patients. Many ladies today choose herbal remedies for menopause, and experts agree with this choice, but only if the patient does not require serious hormonal treatment. The choice of treatment always remains with the patient, but experts insist that if you are prescribed certain pills, it is better to follow the doctor’s recommendations so as not to encounter unpleasant complications in the future.

Important! Not hormone therapy also requires the supervision and control of a doctor, because dietary supplements also have contraindications and side effects.

Many reviews can really be alarming. Ladies in in social networks and on forums they share their sad stories when hormones, in their opinion, cause the development of cancer, fibroids, cysts and others dangerous diseases, but gynecologists insist that with an adequate approach, hormonal replacement therapy cannot cause these diseases. Let's consider the most common myths about, which often become a reason for refusing to take funds from this group:

HRT causes cancer. This is of course the scariest and most widespread myth. However, according to official statistics The incidence of cancer while taking hormone therapy is approximately 1 in 5,000 diseases. Moreover, more than half of the cases occur in women with a genetic predisposition to cancer, and another 30% are discovered when they take medications on their own without prior examination and observation.
Hormone therapy causes obesity. This is a fundamentally incorrect statement; on the contrary, with the correct medication and dosage selected, medications in this group prevent the excess weight. You just need to know that fat reserves during menopause are just the body’s reaction to a lack of estrogen. The body, thus, tries to compensate for the deficiency of the sex hormone, because fat synthesizes one of the types of estrogens.
Hormone therapy is forever. Completely false. Patients who claim that it is impossible to stop taking hormones should simply contact an experienced doctor. Both entry and exit from hormone replacement therapy should be smooth, by changing the dosage and schedule of taking the medication.

In addition to this, there are a lot of myths that are passed on from mouth to mouth and are filled with horrifying details, but experts advise paying attention to the advantages that treatment can give, namely:

Absence of hot flashes and other manifestations of menostasis. Thanks to replacement therapy, the body does not face estrogen deficiency, which means that all organs and systems continue to function properly.
Prevention of long-term complications of menostasis. Today, only hormone replacement treatment can guarantee the prevention of osteoparosis, hypertension, heart attack and stroke due to a lack of sex hormones.
Beautiful appearance . Patients taking replacement therapy do not experience rapid aging and look much younger than their peers who refuse treatment. It should be noted that youth is preserved not only on the face, but also in internal organs, blood vessels, reproductive system, etc.
Cheerfulness and stable mood. The absence of depression, irritability and apathy allows ladies to lead a normal lifestyle and continue to enjoy everyday little things. Such women are sociable and cheerful, they enjoy life and can afford to do what they love.
Completeness of sexual life. One of the problems of menostasis is decreased libido and vaginal dryness, which often become a reason for a complete refusal of physical intimacy. Hormone replacement therapy eliminates these abnormalities and allows normal life. sex life, which undoubtedly has a positive effect on self-esteem, family relationships, health status, etc.

Important! Despite all the positive aspects of replacement therapy, this treatment cannot be used as an anti-aging agent or used in advance, even before the onset of unpleasant symptoms.

List of new generation HRT drugs

Reviews about hormone replacement therapy drugs for menopause are quite varied, but patients and doctors highlight the most effective medications of the new generation, namely:

Klimonorm. The product contains two synthetic analogues of the sex hormones estrogen and histagene, which helps to avoid hormonal imbalance, which in some cases becomes an impetus for the development of oncology.
. This is a new generation two-phase combination drug that effectively relieves the main symptoms of menopause and is a prevention of long-term complications of menopause.
. The tablets contain active substances estradiol and drospirenone. The drug is prescribed for both early and timely menostasis as a prevention of long-term complications, and a drug that significantly improves the well-being of a woman during menopause.
Levial. Active ingredient: tibolone. This medication is gaining more and more popularity, because it rarely causes side effects and perfectly fights all manifestations of menopause. According to gynecologists, this is a drug of the 21st century.

Menopause, even with a mild course, is perceived as an inevitable evil. Well-being worsens, and in different directions, and disturbing thoughts come to mind more often. But few people try to fight this with the help of medications, or women, due to incompetence, choose inappropriate remedies themselves.

Meanwhile, menopausal hormone therapy can work a miracle, turning an elderly, tired woman into a healthy and full of energy.

Read in this article

Why is HRT needed?

Many women have a prejudice against menopausal hormone therapy that its harm far outweighs its positive effect. The fears are unfounded; the body has functioned for many years thanks to these components. They ensured normal metabolism and the functioning of all systems. Rather, it serves to cause disease, ultimately leading to premature aging and even death.

This does not mean that analogues of substances can be taken independently and uncontrolled. In each case, the choice should be based on many parameters of the body of a particular woman. It also depends on the stage.

In postmenopause, that is, a year from the last menstruation and later, different means are needed than in its initial phase. The final stage of menopause can be described using several features:

Work deteriorates of cardio-vascular system. Blood does not circulate as actively throughout the body, becoming more viscous. The vessels are less elastic and deposits appear on them. Hot flashes provoke heart failure, increasing the likelihood of heart attack and stroke;
Arises. Vegetative-vascular disorders caused by the disappearance of the influence of sex hormones lead to increased neuropsychological excitability and rapid fatigue. Hot flashes also interfere with sleep;
Atrophic processes in the genital and urinary organs develop, manifested by discomfort, burning of the mucous membrane, and itching. This provokes an inflammatory and infectious nature, as well as problems with urination;
The risk of injury and fractures increases due to (weakening of bone tissue as a result of loss), changes in the joints are noticed.

This is a general list of manifestations that menopause “bestows”. At this age, individual symptoms may also appear.

But even with their minimal presence, HRT in postmenopause improves well-being and quality of life, prolonging it. Medicines for menopause:

Normalize lipid spectrum blood no worse than statins intended for this purpose;
Reduce the risk of cardiovascular diseases by 30%;
Have a positive effect on carbohydrate metabolism;
Prevents bone destruction.

In short, hormone therapy is one of the main methods.

Is it shown to everyone?

The products used for HRT are based on estrogen, progesterone, or only the first substance. They affect the body comprehensively. Estrogens allow the endometrium to grow, while progesterone reduces this effect.

In some diseases, the struggle between hormones can lead to the development of illnesses. Therefore, HRT is not prescribed if:

Acute hepatitis;
Thrombosis;
Breast tumors or reproductive organs;
Meningioma.

What to do before taking hormonal drugs?

Taking into account contraindications and possible unexpected manifestations, menopausal hormonal therapy, necessary for protection against diseases, is prescribed only based on the results of the examination. It should include:

Ultrasound of reproductive organs;
Blood test for biochemistry;
Oncocytology examination of material taken from the cervix;
Ultrasound of the mammary glands and mammography;
Studying hormonal status with detection of the concentration of TSH, FSH, estradiol, prolactin, glucose;
Blood clotting test.

In addition to these studies, which are mandatory for all, it is advisable for some to conduct:

Lipidogram, that is, a cholesterol test;
Densitometry, which reveals bone density.

Features of HRT at the final stage of menopause

Hormone replacement therapy in postmenopause is prescribed not only taking into account the existing symptoms of the condition that need to be relieved and potential threats. Such features of the female body as the presence of reproductive organs are important.

If the uterus is preserved, when exposed to estrogen-containing drugs, the mucous membrane is likely to grow, that is, creating a danger of endometrial cancer. Therefore, in this case, the doctor will give preference to products with progestins and androgens to relieve the threat. Some women have their uterus removed if processes that are dangerous to health occur in it. Hormone replacement therapy in such conditions will be estrogen.

The timing of treatment depends on what signs of menopause or probable ones need to be eliminated. Palpitations, hot flashes will require less time to use the drugs. To prevent and treat osteoporosis, more long treatment. Stopping it on your own is just as dangerous as starting it.

Prolongation beyond the required period, exceeding dosages are fraught with an increased risk of tumor formation, thrombosis, heart attack, and stroke. Therefore, the entire therapy process is accompanied by supervision from a specialist.

Estrogen therapy for menopause

In such a fragile state as this, HRT preparations must contain the required minimum of hormones. The following products contain only estrogens and are suitable for use 12 months after the last menstrual period and later:

Premarin. In addition to reducing vegetative-vascular manifestations, it fights the loss of calcium and phosphorus in the bones, lowers low-density lipoproteins in the blood, increases the volume of HDL, and improves glucose excretion. Take the drug in cycles of 21 days, then take a week break. Prolonged use is also possible. 0.3-1.25 mcg per day is prescribed, decreasing or increasing the dose depending on how you feel;
Proginova. In fact, it is estradiol valerate, a synthetic analogue of what was previously produced by the ovaries. The drug preserves bone tissue dense, preventing osteoporosis, maintains the tone of the mucous membranes in the urogenital area. Take 1 tablet, without crushing, cyclically or continuously;
Dermestril. It exists in several dosage forms (tablets, spray, injection solution, patch). Eliminates vasomotor signs of menopause, inhibits the removal of calcium from bones and the clogging of blood vessels with cholesterol;
Klimara. , containing estradiol gamihydrate, which is released and enters the blood in portions of 50 mcg. Its effect extends to the relief of all symptoms of menopause, but it is necessary to fix the drug on the body not near the pelvic organs and mammary glands;
Estrofem. The main substance is estradiol, which prevents the development of osteoporosis, cardiovascular diseases and atrophic vaginitis. Requires continuous use of 1 tablet per day. If after 3 months of use the effect of relieving severe symptoms of postmenopause is insufficient, the doctor may change the dosage;
Ovestin. Estriol, which forms its basis, suppresses the leaching of calcium from bones. The drug also reduces the possibility of inflammation of the vagina and other reproductive organs, thanks to the restoration of the mucous membrane. Available in the form of suppositories, tablets and vaginal cream. Take 4-8 mg orally per day. Long-term use of high doses is undesirable; it is necessary to strive to reduce them.

If the listed drugs are prescribed to a woman with a preserved uterus, they are combined with gestagen-containing drugs or containing androgens.

Combined drugs for postmenopausal HRT

Combined HRT drugs postmenopause forces you to use savings when necessary. The estrogens they contain perform their task, as in monophasic products. But their Negative influence neutralized by the work of gestagens or androgens. Experts make a choice among such means from the following names:

Climodien. It combines estradiol valerate with dienogest. The latter promotes endometrial atrophy, preventing its thickening and penetration into muscle layer uterus and Normalizes the ratio of “bad” and “good” cholesterol, reducing the risk of cardiovascular diseases. Climodien is taken continuously as long as there is a need for therapy, one tablet per day;
Cliogest. This is a “combination” of estriol and norethisterone acetate. The drug is indispensable in the prevention and treatment of osteoporosis, prevents the development of cardiac and urogenital ailments. Possible problems with the endometrium when taking estriol do not arise, thanks to norethisterone, which has gestagenic and slightly androgenic effects. For daily continuous use within the course of treatment, 1 tablet is sufficient. Similar to Kliogest in composition and effect on the body are the drugs Pauzogest, Eviana, Aktivel, Revmelid;
Livial. His active substance is tibolone, which simultaneously has the properties of estrogen, androgens and gestagens. Thanks to this, the product keeps the endometrium quite thin, helps conserve calcium, and normalizes the condition of blood vessels. Last quality reduces the risk of heart disease, restores blood supply to the brain;
Femoston 1/5. The product is a combination of estradiol and dydrogesterone. Saves from osteoporosis, vascular disorders, returns libido, thanks to the normalization of the mucous membranes of the genital and urinary organs. Does not allow pathological changes in the endometrium. A low dose of estrogen makes it possible to use it for a long time without threatening consequences. Take Femoston once a day.

Homeopathy

Substitution in postmenopause can consist not only of taking hormonal drugs. The following have a similar effect on the signs of menopause:

Klimadinon;
Inoclim;
Klimonorm;
Qi-Clim.

They are quite effective in preventing complications of menopause and do not have such contraindications as hormones. However, they should only be used on the recommendation of a doctor.

Menopausal, correctly chosen hormonal therapy can not only prevent ischemic disease heart disease, osteoporosis and colon cancer. It has been proven to reduce the risk age-related disorders vision, Alzheimer's disease. The drugs also help maintain external youthfulness.

Release form of the drug "Klimonorm"

The medicine belongs to the class of antimenopausal drugs. It is made in the form of two types of dragees. The first type of dragee has yellow. The main substance in the composition is estradiol valerate 2 mg. The second type of dragee - Brown. The main components are estradiol valerate 2 mg and levonorgestrel 150 mcg. The medicine is packaged in blisters of 9 or 12 pieces each.

With the help of this medication, HRT is often performed during menopause. New generation drugs have good reviews in most cases. Side effects do not develop if you follow your doctor’s recommendations.

Effect of the drug "Klimonorm"

"Klimonorm" is a combination drug that is prescribed to eliminate the symptoms of menopause and consists of estrogen and gestagen. Once in the body, the substance estradiol valerate is converted into estradiol of natural origin. The substance levonorgestrel added to the main drug is the prevention of endometrial cancer and hyperplasia. Thanks to the unique composition and special dosage regimen, it is possible to restore the menstrual cycle in women with a non-removed uterus after treatment.

Estradiol completely replaces natural estrogen in the body at the moment when menopause occurs. Helps cope with vegetative and psychological problems that arise during menopause. You can also slow down the formation of wrinkles and increase the collagen content in the skin when carrying out HRT during menopause. The drugs help lower total cholesterol and reduce the risk of intestinal diseases.

Pharmacokinetics

When taken orally, the medicine is absorbed in the stomach in a short period. In the body, the drug is metabolized to form estradiol and estrol. Already within two hours the maximum activity of the drug in plasma is observed. The substance levonorgestrel is almost 100% bound to blood albumin. Excreted in urine and slightly in bile. WITH special attention It is worth choosing medications for HRT during menopause. Level 1 drugs are considered potent and can significantly improve the condition of the fairer sex after 40 years. Medicines from this group also include the drug “Klimonorm”.

Indications and contraindications

The drug can be used in the following cases:

hormone replacement therapy for menopause;
involutional changes in the skin and mucous membrane of the genitourinary system;
insufficient estrogen levels during menopause;
preventive measures for osteoporosis;
normalization of the monthly cycle;
healing process with amenorrhea of primary and secondary type.

Contraindications:

bleeding not associated with menstruation;
breast-feeding;
hormone-dependent precancerous and cancerous conditions;
mammary cancer;
liver diseases;
acute thrombosis and thrombophlebitis;
hypotension;
diseases of the uterus.

HRT is not always indicated during menopause. New generation drugs (the list is presented above) are prescribed only if menopause is accompanied by a significant deterioration in the woman’s well-being.

Dosage

If you still have your period, then treatment should begin on the fifth day of the cycle. For amenorrhea and menopause, the treatment process can begin at any time of the cycle, unless pregnancy is excluded. One package of the medicine “Klimonorm” is designed for 21 days of use. The product is drunk according to the following algorithm:

for the first 9 days the woman takes yellow tablets;
the next 12 days - brown pills;

After treatment, menstruation appears, usually on the second or third day after taking the last dose of the medicine. Within seven days go by break, and then you need to drink the next package. The pills should be taken without chewing and washed down with water. It is necessary to take the drug at a certain time, without missing it.

It is imperative to adhere to the HRT regimen during menopause. New generation drugs may also have negative reviews. You will not be able to achieve the desired effect if you forget to take the pills in a timely manner.

In case of an overdose, unpleasant phenomena such as stomach upset, vomiting and bleeding not associated with menstruation may occur. There is no specific antidote for the drug. In case of overdose, symptomatic treatment is prescribed.

Medicine "Femoston"

The medication belongs to the group of antimenopausal drugs. Available in the form of tablets of two types. You can find dragees in the package white with film cover. The main substance is estradiol at a dose of 2 mg. The first type also includes tablets gray. The composition contains estradiol 1 mg and dydrogesterone 10 mg. The product is packaged in blisters of 14 pieces each. The second type includes pink tablets containing 2 mg estradiol.

Replacement therapy is often carried out with the help of this remedy. When it comes to HRT for menopause, medications are selected with special attention. Femoston reviews have both positive and negative. Nice sayings still prevail. Medicine allows you to eliminate many menopausal symptoms.

Action

"Femoston" is a two-phase combination drug for the treatment of postmenopause. Both components of the drug are analogues of the female sex hormones progesterone and estradiol. The latter replenishes the supply of estrogen during menopause, removes symptoms of a vegetative and psycho-emotional nature, and prevents the development of osteoporosis.

Dydrogesterone is a progestogen that reduces the risk of developing uterine hyperplasia and cancer. This substance has estrogenic, androgenic, anabolic and glucocorticoid activity. When it enters the stomach, it is quickly absorbed and then completely metabolized. If HRT is indicated for menopause, the drugs “Femoston” and “Klimonorm” should be used first.

Indications and contraindications

The medication is used in the following cases:

HRT during menopause and after surgery;
prevention of osteoporosis, which is associated with menopause

Contraindications:

pregnancy;
lactation;
breast cancer;
malignant tumors that are hormone-dependent;
porphyria;
thrombosis and thrombophlebitis;
hypersensitivity to components;
diabetes;
hypertension;
endometrial hyperplasia;
migraine.

HRT will help improve your well-being during menopause. Reviews of the drugs are mostly positive. However, they should not be used without first consulting a doctor.

Dosage

Femoston tablets containing estradiol in a dose of 1 mg are taken once a day at the same time. Treatment is carried out according to a special scheme. In the first 14 days you need to take white tablets. In the remaining 14 days - a medicine of a gray shade.

Pink tablets containing 2 mg estradiol are taken for 14 days. For women whose menstrual cycle has not yet been disrupted, treatment should begin on the first day of bleeding. For patients with irregular cycle the drug is prescribed after two weeks of treatment with Progestagen. For everyone else, if you don’t have your period, you can start taking the medicine any day. You need to follow the treatment regimen to get positive results from HRT during menopause. New generation drugs will help keep a woman feeling good and prolong her youth.

The drug "Klimadinon"

The medicine belongs to the means for improving well-being during menopause. It has a phytotherapeutic composition. Available in the form of tablets and drops. The tablets are pink with a brown tint. Contains dry cohosh extract 20 mg. The drops contain liquid cohosh extract 12 mg. The drops have a light brown tint and the smell of fresh wood.

Indications:

vegetative-vascular disorders associated with menopausal symptoms.

Contraindications:

hormone-dependent tumors;
hereditary lactose intolerance;
alcoholism;
hypersensitivity to components.

It is necessary to carefully study the instructions before starting HRT during menopause. Preparations (patch, drops, pills) should be used only on the recommendation of a gynecologist.

The medicine "Klimadinon" is prescribed one tablet or 30 drops twice a day. It is advisable to carry out therapy at the same time. The course of treatment depends on individual characteristics body.

The drug "Angelique"

Refers to drugs that are used to treat menopause. Available in the form of gray-pink tablets. The drug contains estradiol 1 mg and drospirenone 2 mg. The product is packaged in blisters, 28 pieces each. A specialist will tell you how to properly carry out HRT during menopause. New generation drugs should not be used without prior consultation. can have both benefit and harm.

The medication has the following indications:

hormone replacement therapy during menopause;
prevention of osteoporosis during menopause.

Contraindications:

bleeding from the vagina of unknown origin;
mammary cancer;
diabetes;
hypertension;
thrombosis.

Dosage of the medicine "Angelique"

One package is designed for 28 days of use. You should take one tablet daily. It is better to drink the medicine at the same time, without chewing and with water. Therapy should be carried out without skipping. Neglecting the recommendations will not only not bring a positive result, but can also provoke vaginal bleeding. Only correct adherence to the regimen will help normalize the menstrual cycle during HRT during menopause.

New generation drugs (“Angelik”, “Klimonorm”, “Klimadinon”, “Femoston”) have a unique composition, thanks to which it is possible to restore female

"Klimara" patch

This medication comes in the form of a patch containing 3.8 mg estradiol. The oval-shaped product is glued to an area of skin hidden under clothing. During the use of the patch, the active component is released, improving the woman’s condition. After 7 days, the product must be removed and a new one applied to a different area.

Side effects from the use of the patch are quite rare. Despite this, the hormonal drug should be used only after consultation with the doctor.