HORMONAL THERAPEUTIC POSSIBILITIES IN PERIMENOPAUSE AND BEYOND
AbstractBACKGROUND Women spent 1/3 of their lifespan in the period of postmenopause. However, menopausecaused short term, medium term and long term consequences. The possibilities of the treatment of short and medium-term consequences of the menopause are numerous, as well aspreventive measures for long-term consequences.Protocols and time needed to use hormonal replacement therapy (HRT) were changedsignificantly, after the results of RCT have been pusblished in the literature. Since the termination of the WHI in 2002, the use of HRT was decreased, worldwide. Unfortunately, dueto the misinterpretation of the results of WHI and MWS, women refused to use HRT evenfor the cessation of severe climacteric complains. Nowdays, HRT was used for the protection of osteoporosis and for the treatment of climacteric syndrome. If started early enoughafter menopause, cardioprotection still remain a »window of opportunity«. Duration andmode of action have to be tailored according to particular woman. To adjust the properdose, lowest effective dose has to be started adding progestagen concerning presence of theuterus, if necessary. Sequential-continous or cyclic regimen of HRT has to be use duringperimenopause, while continous-combined regimen is used in postmenopause. No matterof the estrogen dose, progestagen has to be added in the presence of the uterus. CONCLUSIONS Above all, HRT still remains a therapy of choice for climacteric syndrome and preventionof long-term consequences of menopause. The most important thing is to start as close to the last menstrual period as possible, starting with the lowest possible dose. The duration oftherapy is individualized, dependent of the particular need of a certain woman
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