GST pills for women titles. Modern pharmacological market of hormone replacement therapy drugs

Minasyan Margarita

Every woman, approaching the threshold of middle age, notices the changes that occur to her. This is due to the fact that by the age of 45, the gradual extinction of the reproductive function begins. This period, called menopause, is characterized, and as a result - fundamental changes in the work of all systems and organs. At this moment, the body especially needs our support, and often a healthy lifestyle and proper nutrition not enough here. Medications come to the rescue, which not only eliminate discomfort, but also solve the problem at the root. The most effective and common method in this case is hormone replacement therapy. It is effective on anyone, but it has a number of features and contraindications, so it is not suitable for everyone. What is HRT for menopause and new generation drugs, what are the features hormonal drugs you will find out in this article.

Features and indications for the use of HRT

HRT has been successfully used by specialists in menopause for about 20 years. It is widely spread in Europe, while compatriots treat it with some apprehension, trusting more natural remedies, phytohormones or homeopathy.

This kind of therapy is used only after a thorough diagnosis and exclusion of a number of diseases.

Hormone replacement therapy for menopause is based on treatment with substances similar to hormones, in particular, female hormones. During menopause, the endocrine glands reduce the production of hormones such as estrogen and progesterone. Due to their deficiency, the body fails, showing various symptoms. In this case, hormonal substances are introduced from the outside in order to support and eliminate the deficiency of these hormones. Thus, the body does not see much difference and continues to function in its usual mode. Hormone treatment can be short-term, when menopause is not complicated by pronounced disorders (course 1-2 years), and long-term, when serious changes and disturbances in the psycho-emotional state occur, the work of the endocrine glands, the cardiovascular system is affected. In the second case, treatment can last several, up to ten years.

Hormone replacement therapy is used:

1. With standard menopause at all its stages: in premenopause, during menopause to relieve symptoms and prevent the development of cardiovascular diseases, osteoporosis, in postmenopause - to avoid the development of neoplasms and tumors, maintain the body and improve the quality of life.
2. With early menopause to avoid premature stop of reproductive function and normalization of the menstrual cycle.
3. With and removal of the ovaries in order to maintain hormonal background and avoiding the consequences of a sharp restructuring of the body.
4. As a prevention of age-related diseases and tumors.
5. In some cases they are used as contraceptives(with a certain combination of hormones).

In the menopause, HRT is prescribed when the following symptoms appear:

• Psycho-emotional disorders in the form of climacteric neuroses, sudden mood swings, irritability, stress, apathy, insomnia, drowsiness.
• Atrophy of the genital organs.
• Violations of thermoregulation, manifested by hot flashes, chills, palpitations, a sharp change in temperature, hyperhidrosis.
• Complications in the work of the cardiovascular system: jumps in blood pressure, headaches and heart pain, dizziness, shortness of breath.
• Pain in the lower abdomen, in the lower back, in the limbs.
• Painful bleeding.
• Deterioration in the quality of sexual life, decreased libido, dryness in the vagina and other mucous membranes.
• Circulatory disorders.

Mechanism of action

The mechanism of action of new generation hormonal drugs is due to their composition. They can contain both natural hormones and synthetic ones, and lovers of everything natural will like phytohormones.

These medicines may contain hormones a certain kind, or their combined form.

Some drugs for menopause contain only estrogen. As a rule, the active substance in them is estradiol valerate, which, when ingested, turns into natural estradiol. He, in turn, fully simulates the action of estrogen, helping to avoid psycho-emotional and vegetative menopausal disorders.

Most often, such drugs are found in a combined form, i.e. with the addition of progestogen-like substances, dydrogesterone or levonorgestrel.

The addition of progestogens is very important for such therapy, since they help estrogens to have a sparing effect, preventing tumors (uterine fibroids, endometriosis) from developing due to excessive amounts of estrogen hormones.

A combination of estrogens with androgens can also be used.

In order to choose an effective remedy and not harm the body, you must definitely contact a specialist to diagnose and prescribe a suitable medication in the correct dosage. New generation drugs include microdoses of hormonal substances, but the slightest excess or deficiency in a certain situation can not only harm the body, but also provoke the development of unpleasant diseases.

The normal functioning of the hormonal system is ensured by the coordinated work of three components: the hypothalamus, pituitary gland and ovaries. The first component is responsible for the synthesis of GnRg (gonadotropin-releasing hormone), which promotes the formation of FSH and LH (follicle-stimulating and luteinizing hormones) by the pituitary gland. FSH and LH help the ovaries produce the sex hormones estrogens, progestins, and estrogens. slightest violation The work of this system leads to hormonal "slides" - an overabundance or deficiency of certain hormones, as a result of which the work of the whole organism fails. substitution hormone therapy with menopause, it prevents such violations, maintaining the coordinated work of this system.

Advantages and disadvantages of hormone replacement therapy

Advantages

The main advantage of this type of treatment is its effectiveness. After all, the action is not aimed at temporary relief. discomfort but on solving the problem at the deepest level. Hormonal drugs stop the symptoms of menopause not at the periphery, but at the very root level - the level of hormone synthesis.

New generation drugs involve the use of only substances that are identical to natural hormones. Therefore, the body does not perceive them as foreign substances, and in most cases responds positively to the use of these agents.

Such therapy has a complex effect and helps to get rid of a number of symptoms, and sometimes even without feeling discomfort even once.

HRT is not only a treatment, but also a prevention of a number of diseases, especially cardiovascular diseases, osteoporosis, and some tumors.

Anticlimacteric medicines that contain hormones are available in various convenient forms, both internal and external. It can be tablets, creams, patches, injections. It is possible to use hormone therapy both in menopause, and in premenopause, and in postmenopause. The sooner you start taking these drugs, the greater the chance to protect yourself from menopausal disorders in the future.

disadvantages

Along with the advantages, hormone replacement has some disadvantages. Hormonal regulation is a very delicate mechanism, intervention in which is fraught with irreversible consequences. That is why it is very important before applying such treatment to undergo complete diagnostics such systems as the gastrointestinal tract, thyroid gland, mammary glands, conduct all kinds of blood tests, incl. on hormones, be sure to take a smear from the cervix, monitor blood pressure for a certain time, and it is also important to take into account heredity.

The hormonal background changes quite quickly, therefore, during the examination and appointment, one scheme for the use of drugs may be relevant, and at the time of the start of the use of drugs, the clinical picture may change radically.

Statistics show that menopausal hormone therapy is used only in 25% of cases due to a number of contraindications and side effects, which is also a significant disadvantage.

• uterine and vaginal bleeding of unknown origin, especially in postmenopausal women;
• tumors of the genital organs and mammary glands or suspicion of them;
• diseases of the uterus and mammary glands;
• kidney and liver diseases;
• renal, adrenal and liver failure;
• thrombosis and thromboembolism;
• lipid metabolism disorders;
• ovarian endometriosis;
• mastopathy;
• diabetes;
• bronchial asthma, epilepsy;
• pregnancy and breastfeeding.

This list is not exhaustive. If you have any other disease, you should consult a doctor before using it, since hormones affect the work of every cell in the body.

Another significant disadvantage of these medications is the many side effects:

• Soreness and enlargement of the mammary glands.
• Neoplasms in the endometrium.
• Weight gain.
• Various allergic manifestations - itching, redness, rashes.
• Spasms in the muscles.
• Gastrointestinal disorders: nausea, vomiting, diarrhea, flatulence.
• Excessive appetite or, conversely, its absence.
• The development of hormone-dependent tumors.

From this we can conclude that before deciding on hormone replacement treatment, one should compare the possible risk with the expected benefit, take into account all contraindications and not exclude the hereditary factor and predispositions.

Preparations

Foreign and domestic manufacturers offer a wide range of HRT preparations. They are presented as complex and mono-means. For the convenience of consumers, experts have provided for various forms of these medicines: tablets, dragees, injections, hormonal patches, creams, essences.

Combined drugs that combine estrogen and progesterone include:

Klimonorm. There are two types of pills. The main active substance of the first tablets is estradiol valerate, the second - levonorgestrel. Klimonorm successfully stops the manifestations of menopause at all its stages.

The combination of estradiol and dydrogesterone. Improves the quality of life in menopause, prevents the development of cardiovascular, bone diseases. There are often discussions about which or Femoston is better. It all depends on the clinical picture of the patient and the characteristics of her body. Both drugs are effective, have the same contraindications and are in the same price category.

Another famous remedy is Angelique. Contains estradiol and drospirenone. Like Femoston, it is aimed at eliminating the problems that arise during menopause and has a rejuvenating effect. You can get acquainted with the opinion of doctors and, you can follow the link.

Estrogen-only medications are mainly used after hysterectomy. These are tablets such as Triaclim, Estrofem, Estrimax; vaginal suppositories and creams - Estriol (they are usually used without the use of hormonal tablets, as monopreparations); creams for external use - Divigel, Estrogel, Proginova.

Utrozhestan, Norkolut tablets can be attributed to preparations containing only progesterone; . In most cases, such medications are combined with estrogen-containing ones.

For most women, the menopause is filled with unpleasant symptoms that interfere with the usual course of life. Therefore, with timely access to specialists, a woman is prescribed hormone replacement therapy using new generation drugs. Which is able to relieve the symptoms of pathological menopause and reduce possible risks complications.

Klimonorm is one of the new generation HRT drugs

Action HRT in the climax. New generation drugs to eliminate symptoms. Consequences of taking drugs

The only way to eliminate the symptoms of pathological menopause, doctors consider the use of hormone replacement therapy drugs. Z gt are analogues of female sex steroid hormones. They can be divided on the:

• HRT containing only estrogen.
• HRT combined action, which contain estrogen and progesterone.

Application gzt possibly not only during the period of natural menopause, but also during artificial menopause. In any of these cases, the use of drugs should be under the supervision of a specialist, because they have absolute contraindications:

• If a histological examination of the breast confirmed the presence of cancer cells.
• Contraindications are not only breast cancer, but also cancer of any endometrium.
• melanomas.
• Vascular disease of the upper or lower extremities. Thrombophlebitis.
• Any diseases that are autoimmune in nature.
• Pathological changes in the liver.
• Diseases biliary ducts.
• Any abnormalities in the work of the cardiovascular system.
• The presence in the body of estrogen-dependent tumors (endometriosis, uterine fibroids).

Cyclo-Proginova, like other drugs, has a number of contraindications

How do new generation drugs work?

Since all disorders during menopause in a woman's body are associated with insufficient production of estrogen and an excess of progesterone, the use of drugs gzt helps to fill the shortage and normalize well-being.

Application gzt new generation eliminates the symptoms of pathological menopause:

• Tides. short term boost upper body temperature, accompanied by increased sweating, heart palpitations, and feelings of anxiety.
• Dryness of all mucous membranes. During menopause, women experience a decrease general level sex hormones in the blood, which leads to problems in: urinary system; excretory and reproductive organs. The mucous membranes dry out, thin out, which leads to the appearance of unpleasant symptoms (incontinence, itching in the perineum, exacerbation of healed STD).
• High blood pressure, tachycardia.
• Systematic disorder of the central nervous system, expressed by mood swings.

The tides are the brightest symptom of a pathological menopause, which manifests itself as a failure in the thermoregulation of the body by the hypothalamus. This failure contributes lack of estrogen, which easily eliminated by appointment gzt.

Klimen normalizes the cycle of menstruation

The consequences of the use of drugs

Since hormone replacement therapy preparations contain a high content of estradiol, long-term use without consulting a doctor is fraught with the occurrence of estrogen-dependent neoplasms.

Therefore, if any symptoms of a pathological menopause occur, you should not prescribe therapy yourself. The best solution would be:

• Take tests for the level of sex hormones in the blood.
• Check thyroid gland to a function.
• Seek appropriate treatment from a gynecologist.

What medications are HRT drugs. Trade names and uses

In pharmacies you can find more than 50 types of drugs used in under different trade names. They can be divided into several groups, which differ only in the way they are introduced:

• Orally. Tablets for oral administration.
• Intramuscular injections.
• Transdermal topical preparations.
• intravaginal introductions.

The method of administration of the drug into the body is selected individually, taking into account the severity of the course of the disease or personal preferences. The most common form of drug administration is oral.

Your doctor may offer you a list of drugs with the same pharmacological properties but different brand names. Because of which you can independently choose a hormone replacement therapy drug based on your own budget.

Femoston is available in the form of tablets.

The most common remedies that help eliminate the symptoms of pathological menopause:

Hormone replacement therapy for menopause plays an important role in regulating the pathological changes that occur in the female body during this critical period.

Despite the existence of a number of myths about the great danger of such an event, numerous reviews suggest otherwise.

What hormones are missing?

The result of the development of menopause is a sharp decline the ability of the ovaries to produce progesterone, and subsequently estrogen, due to the degenerative shutdown of the follicular mechanism and changes in the brain nervous tissues. Against this background, the sensitivity of the hypothalamus to these hormones decreases, which leads to a decrease in the production of gonadotropin (GnRg).

The response is an increase in the work of the pituitary gland in terms of the production of luteinizing (LH) and follicle-stimulating (FSH) hormones, which are designed to stimulate the production of lost hormones. Due to excessive activation of the pituitary gland, the hormonal balance is stabilized for a certain period of time. Then, the lack of estrogen affects, and the functions of the pituitary gland gradually slow down.

Decreased production of LH and FSH leads to a decrease in the amount of GnRh. The ovaries slow down the production of sex hormones (progestins, estrogens and androgens), up to the complete cessation of their production. It is a sharp decrease in these hormones that leads to menopausal changes in the female body..

Read about the norm of FSH and LH during menopause.

What is hormone replacement therapy

Hormone replacement therapy for menopause (HRT) is a treatment that introduces drugs similar to sex hormones, the secretion of which is slowed down. The female body recognizes these substances as natural, and continues to function normally. This ensures the necessary hormonal balance.

The mechanism of action of drugs is determined by the composition, which can be based on real (animal), plant (phytohormones) or artificial (synthesized) ingredients. The composition may contain hormones of only one specific type or a combination of several hormones.

In a number of products, estradiol valerate is used as an active substance, which in a woman's body turns into natural estradiol, which exactly imitates estrogen. Combined options are more common, where in addition to the indicated ingredient, progestogen-forming components are contained - dydrogesterone or levonorgestrel. There are also drugs with a combination of estrogens and androgens.

The combined composition of the new generation of drugs helped to reduce the risk of tumor formations that may occur due to an excess of estrogens. The progestogen component reduces the aggressiveness of estrogen hormones, making their effect on the body more gentle.

There are 2 main treatment regimens for hormone replacement therapy:

1. Short term treatment. Its course is designed for 1.5-2.5 years and is prescribed for a mild menopause, without obvious failures in the female body.
2. Long term treatment. With the manifestation of pronounced violations, incl. in the organs of internal secretion, cardiovascular system or psycho-emotional nature, the duration of therapy can reach 10-12 years.

Indications for the appointment of HRT may be such circumstances:

1. Any phase of menopause. The following tasks are set - premenopause - normalization of the menstrual cycle; menopause - symptomatic treatment and reduced risk of complications; postmenopause - the maximum relief of the condition and the exclusion of neoplasms.
2. Premature menopause. Treatment is needed to stop the inhibition of reproductive female functions.
3. After surgical procedures associated with the removal of the ovaries. HRT helps maintain hormonal balance, which prevents sudden changes in the body.
4. Prevention of age-related disorders and pathologies.
5. Sometimes used as a contraceptive measure.

Points for and against

There are many myths around HRT that frighten women, which sometimes causes them to be skeptical about such treatment. To make the right decision, you need to deal with the real arguments of opponents and supporters of the method.

Hormone replacement therapy provides a gradual adaptation of the female body to the transition to other conditions, which avoids serious disturbances in the functioning of a number of internal organs and systems .

In favor of HRT, speaking such positive effects:

1. Normalization of the psycho-emotional background, incl. elimination panic attacks, mood swings and insomnia.
2. Improving the functioning of the urinary system.
3. Inhibition of destructive processes in bone tissues due to the preservation of calcium.
4. Prolongation of the sexual period as a result of increased libido.
5. Normalization of lipid metabolism, which reduces cholesterol. This factor reduces the risk of atherosclerosis.
6. Protection of the vagina from atrophy, which provides normal condition sexual organ.
7. Significant relief of menopausal syndrome, incl. softening of the tides.

Therapy becomes an effective preventive measure to prevent the development of a number of pathologies - cardiac diseases, osteoporosis, atherosclerosis.

The arguments of the opponents of HRT are based on such arguments:

• insufficient knowledge of the introduction into the system of regulation of hormonal balance;
• difficulty in choosing the optimal treatment regimen;
• introduction into natural, natural processes of aging of biological tissues;
• the inability to establish the exact consumption of hormones by the body, which makes it difficult to dose them in preparations;
• unconfirmed real effectiveness in complications in the later stages;
• the presence of side effects.

The main disadvantage of HRT is the risk of such side disorders- pain syndrome in the mammary gland, tumor formations in the endometrium, weight gain, muscle spasms, gastrointestinal problems (diarrhea, gas formation, nausea), changes in appetite, allergic reactions (redness, rashes, itching).

NOTE!

It should be noted that with all the difficulties, HRT proves its effectiveness, which is confirmed by numerous positive reviews. A properly chosen treatment regimen can significantly reduce the likelihood of side effects.

Basic drugs

Among the drugs for HRT, there are several main categories:

Estrogen-based products, names:

1. Ethinylestradiol, Diethylstilbestrol. They are oral contraceptives and contain synthetic hormones.
2. Klikogest, Femoston, Estrofen, Trisequens. They are based on the natural hormones estriol, estradiol and estrone. To improve their absorption in the gastrointestinal tract, hormones are presented in a conjugated or micronized version.
3. Klimen, Klimonorm, Divina, Proginova. The drugs include estriols and estrone, which are ether derivatives.
4. Hormoplex, Premarin. They contain only natural estrogens.
5. Gels Estragel, Divigel and Klimara patches are intended for external use.. They are used in serious pathologies liver, pancreatic diseases, hypertension and chronic migraine.

Means based on progestogens:

1. Duphaston, Femaston. They belong to dydrogesterones and do not give metabolic effects;
2. Norkolut. Based on norethisterone acetate. It has a pronounced androgenic effect and is useful in osteoporosis;
3. Livial, Tibolone. These drugs are effective in osteoporosis and are in many ways similar to the previous drug;
4. Klimen, Andokur, Diane-35. Active substance- cyproterone acetate. It has a pronounced antiandrogenic effect.

Universal preparations containing both hormones. The most common are Angelique, Ovestin, Klimonorm, Triaklim.

List of new generation drugs

Currently, new generation drugs are becoming more widespread. They have such advantages - the use of ingredients that are absolutely identical to female hormones; complex impact; the ability to use in any phase of menopause; the absence of most of these side effects. They are produced for convenience in different forms - tablets, cream, gel, patch, injection solution.

The most famous drugs:

1. Klimonorm. The active substance is a combination of estradiol and levonornesterol. Effective for eliminating the symptoms of menopause. Contraindicated in ectopic bleeding.
2. norgestrol. It is a combined remedy. It copes well with a neurogenic type disorder and autonomic disorders.
3. Cyclo-Proginova. Helps increase female libido, improves the functioning of the urinary system. Can not be used for liver pathologies and thrombosis.
4. Klymen. It is based on cyproterone acetate, valerate, an antiandrogen. Fully restores hormonal balance. When used, the risk of weight gain and depression of the nervous system increases. Allergic reactions are possible.

herbal remedies

A significant group of drugs for HRT are drugs plant origin and the medicinal plants themselves.

Such plants are considered to be quite active suppliers of estrogens.:

1. Soya. With its use, you can slow down the onset of menopause, facilitate the manifestation of hot flashes, and reduce the cardiological effects of menopause.
2. Black cohosh. It is able to alleviate the symptoms of menopause, blocks changes in bone tissue.
3. Red clover. It has the properties of previous plants, and is also able to reduce cholesterol.

On the basis of phytohormones, such preparations are produced:

1. Estrofel. Contains phytoestrogen, folic acid, vitamins B6 and E, calcium.
2. Tibolone. Can be used to prevent osteoporosis.
3. Inoklim, Feminal, Tribustan. Means are based on phytoestrogen. Provide gradually increasing healing effect with climax.

Main contraindications

In the presence of any chronic disease of the internal organs, the doctor should evaluate the possibility of conducting HRT, taking into account the characteristics of the female body.

This therapy is contraindicated in such pathologies.:

• uterine and ectopic nature (especially for unexplained reasons);
• tumor formations in the reproductive system and mammary gland;
• uterine diseases and diseases of the mammary gland;
• serious renal and hepatic pathologies;
• adrenal insufficiency;
• thrombosis;
• lipid metabolism anomalies;
• endometriosis;
• diabetes;
• epilepsy;
• asthma.

How to distinguish bleeding from menstruation, read.

Features of the treatment of surgical menopause

artificial or occurs after the removal of the ovaries, which leads to the cessation of production female hormones . In such circumstances, HRT can significantly reduce the risk of complications.

The therapy includes such schemes:

1. After removal of the ovaries, but the presence of the uterus (if the woman is under 50 years old), cyclic treatment is used in such options - estradiol and cipraterone; estradiol and levonorgestel, estradiol and dydrogesterone.
2. For women over 50 years old - monophasic estradiol therapy. It can be combined with norethisterone, medroxyprogesterone, or drosirenone. Tibolone is recommended.
3. At surgical treatment endometriosis. To eliminate the risk of recurrence, estraradiol therapy is carried out in combination with dienogest, dydrogesterone.

• Hormone therapy drugs for menopause
• Drug regimens
• Side effects of HRT and contraindications to its use

In women for the prevention and correction pathological disorders associated with menopause, various non-drug, drug and hormonal agents are used.
Over the past 15-20 years, specific hormone replacement therapy for menopause (HRT) has become widespread. Despite the fact that for a very long time there were discussions in which an ambiguous opinion was expressed on this issue, the frequency of its use reached 20-25%.

What is HRT

Hormone replacement therapy is a course of treatment to restore the deficiency in the body of sex hormones of the steroid group.

Most women during menopause early stage symptoms of climacteric syndrome appear.

First this:

• increased sweating;
• hot flashes;
• increased fatigue;
• sleep disturbance;
• memory loss.

Later appears:

• urinary incontinence;
• excess weight gain;
• arthritis;
• fragility of bones, nails and dry skin.

To prevent such manifestations, HRT is used. It replenishes sex hormones in a woman's body. This allows the body to function normally. The climax comes without discomfort and consequences.

Experts believe that the patient must complete the intake of hormonal drugs by the age of 60, otherwise the development of oncological diseases is possible.

pros

HRT was previously prescribed to relieve the symptoms of the transition period to menopause. The course was short.

Appointed for:

• sleep disturbance and vaginal dryness;
• night sweats;
• hot flashes and urinary incontinence;
• urethritis and cystitis.

Now new generation drugs can be prescribed for a long time. This is important because at least 5 years of estrogen treatment is required to prevent osteoporosis.

Minuses

At long-term use drugs may increase the risk of myocardial infarction or stroke, coronary disease heart muscle. HRT promotes intravascular coagulation.

If the use of drugs is prescribed for 4-5 years, then there is a risk of developing malignant neoplasms in the ovaries and mammary glands of the patient.

To minimize the negative effects of HRT, women are prescribed taking into account individual characteristics and factors that provoke the development of a malignant tumor, thrombosis and vascular diseases.

Hormone therapy - pros and cons

The negative attitude of individual scientists and practitioners is justified by the following statements:

• the danger of interference in the "fine" system of hormonal regulation;
• inability to develop correct treatment regimens;
• interference with the natural aging processes of the body;
• the impossibility of accurate dosing of hormones depending on the needs of the body;
• side effects of hormone therapy in the form of the possibility of developing malignant tumors, cardiovascular diseases and vascular thrombosis;
• lack of reliable data on the effectiveness of prevention and treatment late complications menopause.

Mechanisms of hormonal regulation

Preservation of the constancy of the internal environment of the body and the possibility of its adequate functioning as a whole is provided by a self-regulating hormonal system of direct and feedback. It exists between all systems, organs and tissues - the cerebral cortex, nervous system, endocrine glands, etc.

The frequency and duration of the menstrual cycle, the onset of menopause are regulated by the hypothalamic-pituitary-ovarian system. The functioning of its individual links, the main of which are the hypothalamic structures of the brain, is also based on the principle of direct and feedback between each other and with the body as a whole.

The hypothalamus constantly secretes gonadotropin-releasing hormone (GnRH) in a certain pulsed mode, which stimulates the synthesis and release of the anterior pituitary gland of follicle-stimulating and luteinizing hormones (FSH and LH)). Under the influence of the latter, the ovaries (mainly) produce sex hormones - estrogens, androgens and progestins (gestagens).

An increase or decrease in the level of hormones of one link, which is also influenced by both external and internal factors, respectively, entails an increase or decrease in the concentration of hormones produced by the endocrine glands of other links, and vice versa. This is what common sense feed-forward mechanism.

Rationale for the need to use HRT

Menopause is a physiological transitional stage in a woman's life, characterized by involutive changes in the body and the extinction hormonal function reproductive system. In accordance with the classification of 1999, during the menopause, starting at 39-45 years and lasting up to 70-75 years, there are four phases - premenopause, menopause, postmenopause and perimenopause.

The main triggering factor in the development of menopause is the age-related depletion of the follicular apparatus and the hormonal function of the ovaries, as well as changes in the nervous tissue of the brain, which leads to a decrease in the production of progesterone and then estrogen by the ovaries, and to a decrease in the sensitivity of the hypothalamus to them, and hence to a decrease in synthesis of GnRg.

At the same time, in accordance with the principle of the feedback mechanism, in response to this decrease in hormones in order to stimulate their production, the pituitary gland “responds” with an increase in FSH and LH. Thanks to this “boosting” of the ovaries, the normal concentration of sex hormones in the blood is maintained, but already with a tense function of the pituitary gland and an increase in the blood content of hormones synthesized by it, which is manifested in blood tests.

However, over time, estrogen becomes insufficient for the corresponding reaction of the pituitary gland, and this compensatory mechanism is gradually depleted. All these changes lead to dysfunction of other endocrine glands, hormonal imbalance in the body with manifestation in the form of various syndromes and symptoms, the main of which are:

• climacteric syndrome occurring in premenopause in 37% of women, in 40% - during menopause, in 20% - 1 year after its onset and in 2% - 5 years after its onset; climacteric syndrome is manifested by a sudden feeling of hot flashes and sweating (in 50-80%), attacks of chills, psycho-emotional instability and unstable blood pressure (often elevated), heart palpitations, numbness of the fingers, tingling and pain in the heart area, memory impairment and sleep disturbances , depression, headache other symptoms;
• genitourinary disorders - decreased sexual activity, dryness of the vaginal mucosa, accompanied by burning, itching and dyspareunia, pain when urinating, urinary incontinence;
• dystrophic changes in the skin and its appendages - diffuse alopecia, dry skin and increased fragility of nails, deepening of skin wrinkles and folds;
• metabolic disturbances, manifested by an increase in body weight with a decrease in appetite, fluid retention in the tissues with the appearance of pastosity of the face and swelling of the legs, a decrease in glucose tolerance, etc.
• late manifestations - a decrease in bone mineral density and the development of osteoporosis, hypertension and coronary heart disease, Alzheimer's disease, etc.

Thus, against the background of age-related changes in many women (37-70%), all phases of the menopause may be accompanied by one or another dominant set of pathological symptoms and syndromes of varying severity and severity. They are caused by a deficiency of sex hormones with a corresponding significant and steady increase in the production of gonadotropic hormones of the anterior pituitary - luteinizing (LH) and follicle-stimulating (FSH).

Hormone replacement therapy for menopause, taking into account the mechanisms of its development, is a pathogenetically substantiated method that allows preventing, eliminating or significantly reducing dysfunction of organs and systems and reducing the risk of developing serious diseases associated with a deficiency of sex hormones.

Indications

New generation HRT drugs reduce the risk possible complications to a minimum.

Assign funds for:

• menopause in women under 40;
• pronounced signs of menopause;
• the desire of the patient to eliminate unpleasant symptoms;
• surgical menopause after removal of the reproductive organs;
• treatment of a malignant tumor after chemotherapy;
• the development of pathologies that appeared against the background of menopause (hypertension, urinary incontinence, atherosclerosis).

HRT with menopause at 40

There are ways to help delay withering and be content with life, preserve the beauty and youth of a woman.

Help is hormone replacement therapy, based on which drugs are prescribed to minimize symptoms:

• sedatives normalize mood and emotional background;
• medications that affect cardiovascular system- lower blood pressure, stabilize the pulse;
• drugs to help cope with urinary incontinence;
• calcium-based medicines that prevent brittle nails and hair;
• ointments and gels, which contain plant and hormonal components, normalize intimate life.

Another option is phytotherapy. It consists in the treatment of herbs and medicines containing their extracts. Such plants have an active effect on the female body. Medicinal extracts and complexes of phytohormones cope with menopause.

How they accept

The choice of the drug, its dosage, scheme and duration of the course is selected only by the gynecologist. It takes into account the results of the study of the hormonal background of the patient and general state her health.

Admission rules:

• medications are taken at the same time of the day (as prescribed by the doctor);
• hormonal agents are prescribed daily or cyclically, that is, 21 days with seven-day breaks;
• you can not independently change the prescribed dosage or the drug itself;
• if the drug is missed, then the usual dose should be taken within 12 hours, and the next pill at the strictly appointed time;
• you can not take hormone replacement drugs for life;
• during treatment, you should visit a gynecologist at least twice a year.

HRT with artificial menopause

Unnatural menopause stops the production of female physiological hormones, especially estrogen.

HRT during this period may also help cure:

• uterine myoma;
• uterine bleeding;
• endometriosis;
• slow down the development of oncological processes.

Artificial climax is divided into:

• surgical;
• ray;
• drug.

Substitution therapy smooths out the uneven transition from normal life to menopause, alleviates the condition, and reduces the risk of complications. When removing the uterus, estrogen monotherapy is prescribed in a cyclic or continuous regimen. Suitable drugs: estradiol gel Estrogel, Divigel. Use them once a week.

With uterine myoma, uterine bleeding appointed:

• monotherapy with gestagens;
• Mirena intrauterine device;
• Utrozhestan, Duphaston, Provera.

The course of therapy is 14 days.

Side effects of hormones

HRT has not only a positive effect on the condition of a woman, but also causes dangerous disorders in her body and side effects.

It could be:

• weakness, headache, fatigue;
• acne and seborrhea;
• muscle spasms in the lower extremities;
• increased appetite;
• weight gain;
• abdominal pain, nausea;
• soreness of the mammary glands, as well as the development of cancerous tumors in them;
• vaginal dryness, menstrual bleeding;
• thrombosis.

Recipes with a hog uterus for HRT

Effective recipes from the upland uterus at home help reduce the severity of menopause symptoms.

1. Water infusion. You need to take 1 tbsp. dry boron uterus and pour into a mug of hot water, wait until it cools down for about 20 minutes. Filter and take half a cup 3 times a day before a snack. Use no longer than 2 weeks.
2. Alcohol tincture. You need to grind 2 tbsp. boron uterus, add alcohol 40 ° 1 cup. Put everything in a container and close tightly. Insist in a dark place for 14 days. After a while, drink 30 drops before a snack 3 times a day. Dilute the tincture with boiled water, slightly warm. The course of treatment is no more than 14 days.
3. Decoction. In 300 ml of boiling water, add 2 tbsp. dry raw materials. Boil for 5 minutes, turn off the heat, cover and leave for 0.5 hours. Drink half a glass 3 times a day before meals. You can also douche with this decoction at night, but only in a warm form.

Contraindications

HRT can not be prescribed for certain diseases.

The list is quite large:

• oncological diseases;
• ovarian endometriosis;
• uterine bleeding;
• bleeding of unknown etiology;
• diabetes mellitus in a complicated form;
• chronic diseases of the liver and kidneys;
• autoimmune pathologies;
• diseases of the heart and blood vessels;
• blood clotting disorders;
• individual intolerance to hormonal drugs.

If the use of hormonal pharmaceuticals is necessary, then a specialist should choose a useful and safe remedy.

Contraindications to the use of GZ-drugs

It is forbidden to carry HRT with:

• the presence of a malignant tumor;
• the presence of acute thromboembolic disease and thrombosis;
• the presence of renal and hepatic insufficiency;
• the presence of diabetes;
• the occurrence of an autoimmune disease;
• bleeding of an unknown nature;
• the presence of high sensitivity to the drugs used;
• high risk of developing epilepsy, bronchial asthma, rheumatism;
• pregnancy or breastfeeding.

Possible Complications

Long-term scientific studies of HRT preparations have shown that serious complications are possible during treatment. The risk persists even after hormone withdrawal.

Estrogen increases the risk of developing endometrial cancer. Drugs containing both progesterone and estrogen provoke the appearance of a malignant tumor in mammary glands Oh. The risk is higher the longer the woman takes the medication. Additionally, hormone treatment increases the density of the mammary glands, which complicates the detection of tumors.

Combination drugs increase the risk of developing ovarian cancer. After discontinuation of treatment, it decreases to normal.

Except oncological diseases, HRT increases the risk of blood clots and gallstones.

Useful properties of sage for HRT

Tea with the addition of Sage improves blood, stimulates vascular tone, and reduces the intensity of sweating.

1. tea drink- Prepared from dried sage leaves. You need to put 2 tsp in a cup. dry leaves of grass, and add boiled water. Wait 0.5 hours to insist. This healing tea is consumed at least 3 times a day, 1 cup. The taste can be changed by adding a little lemon juice and a small spoonful of honey. If you drink such tea with nutmeg, then the effect of therapy from this will increase.
2. Sage infusion. You need 2 tbsp. put dried herbs in a container and pour 600 ml of boiled water into it, put on a small fire. Such a solution should boil no more than 6 minutes. Once cool, take this tincture throughout the day.

Take funds for 3 - 4 weeks, then take a break for 3 weeks.

Sage has beneficial properties:

• astringent;
• anti-inflammatory;
• antibacterial;
• antispasmodic;
• wound healing;
• anti-sweat;
• thermoregulating.

Rating of hormones

Preparations for hormonal therapy for menopause are divided into 2 groups: estrogen-containing and combined (with progesterone). Most medicines have a high rating.

All HRT preparations contain estradiol. It is the leading hormone from the estrogen group. There are separate preparations with gestagen, a hormone that normalizes irregular menstrual cycles. Some also contain the hormone progesterone.

Estrogens

They contain only one hormone - estrogen, which is necessary to support the health of a woman after removal of the uterus.

For therapy use:

• Premarin;
• Triaclim;
• Esterlan;
• Estrimax;
• Estrovel.

To obtain the desired result, tablet hormones should be drunk only according to the scheme prescribed by the doctor.

Progestins

Combination medicines contain estrogen and progesterone. They are prescribed for an unremoved uterus.

• Divina;
• Klymen;
• Klimonorm;
• Ovidon;
• Angelique;
• Femoston.

The blister may contain 21 or 28 tablets.

Features of treatment

Complex of drugs HRT latest generation during menopause, it helps to relieve a woman of the symptoms of menopause, preventing the development of osteoporosis. Treatment is carried out only after a complete diagnosis of the patient. With HRT, this examination is performed every year. During the diagnosis, the gynecologist assesses the condition of the mammary glands, structural features of the uterus and genital organs.

At the onset of menopause, dosage medicines goes down. But their use continues under medical supervision. What drugs can hormone replace the patient's condition, the gynecologist chooses on an individual basis. To date, pharmacies offer various hormonal preparations for the treatment of menopause. This makes it possible to produce optimal choice for any patient. If the woman's uterus is not removed, then the gynecologist prescribes the latest generation remedy, which contains the minimum amount of progestogens and estrogens.

During menopause, the patient may be prescribed several methods of treatment:

• long-term treatment is aimed at getting rid of serious pathologies in the cardiovascular system, central nervous system. HRT lasts 3-5 years, rarely up to 12 years;
• short-term therapy is aimed at getting rid of the symptoms of menopause, which is not complicated by severe depression, hormonal drugs are used for 1-2 years.

The type of HRT is determined taking into account the complications and the degree of symptoms. If a woman follows all the doctor's prescriptions, she will be able to achieve a positive effect in a short time. With help the latest drugs hormone replacement therapy for menopause helps to reduce nervous excitement, hot flashes, restores mucous membranes, and relieves pain.

Is it possible to replace hormones with phytohormones

When using HRT, you may experience allergic reaction or signs of individual intolerance to drugs. To avoid unpleasant symptoms, doctors recommend plant hormones. They also relieve the symptoms of menopause.

Hormone replacement phytoestrogens include:

1. Klimadinon. The active ingredient is an extract of cymifugi-racimose. Reduces the intensity of hot flashes, eliminates the lack of estrogens. Therapy lasts at least three months.
2. Femicaps. Contains soy lecithin, vitamins, magnesium, passionflower, evening primrose. It normalizes the content of estrogens, corrects the psychological state of a woman, improves the mineral-vitamin balance.
3. Remens. Contains sepia, lachesis, cimicifuga extract. It has a tonic effect, eliminates the lack of estrogen. 2 courses of 3 months are assigned.

Complex hormonal preparations for HRT

Complex hormonal drugs include:

1. Klimonorm. Restores estrogen levels, and helps reduce autonomic and psycho-emotional menopausal symptoms. May be prescribed in case of removal of the ovaries, climacteric syndrome, atrophy of the mucous membranes and skin, sphincters Bladder. The course of therapy is 21 days.
2. Femoston. Normalizes estrogen deficiency in the body. Provides slow aging of the skin. Produces vaginal lubrication, slows down hair loss. It is useful to apply in case of urogenital atrophy, osteoporosis, cardiovascular diseases. The course of therapy is 28 days, 1 tablet per day.

Non-hormonal methods

An alternative to HRT are non-hormonal methods used when it is impossible to use hormonal drugs. The group includes only natural phytoestrogens.

herbal supplements

List of biologically active additives consists of many different drugs. The names of the most effective dietary supplements are presented in the table:

vitamins

With a competent approach to the selection of supplements for menopause, doctors recommend taking additional vitamins.

It is advisable to use them to remove certain symptoms:

1. Vitamins E, C, group B. Indicated for hot flashes with reddening of the skin and increased sweating.
2. Vitamin A. Reduces dryness and thinning of the vaginal mucosa.
3. Vitamin D. Necessary for the prevention of osteoporosis, changes mineral composition bones.
4. Vitamins K, B6, E. Prevent skin aging. Normalize night sleep and mood of a woman.

Dietary supplements and vitamins are not able to provide negative impact and harm the body. They do not contribute to the development of malignant tumors and blood clots in the vessels.

HRT after removal of the uterus and ovaries

Consequences in which HRT may be useful:

• the appearance of a depressive state;
• inability to sleep well and work fully;
• change in hormone levels.

The course of hormone treatment can be started 2-3 months after the operation.

It is harmful to use HRT in cases of:

• severe vascular pathologies;
• a long history of bad habits;
• after the treatment of malignant tumors;
• high risk of exacerbation of kidney and liver disease.

If dangerous factors are excluded, the woman is prescribed one of the drugs:

1. Klimonorm: brings the hormonal level closer to the natural background in the body of a woman. The course of treatment consists of 3 weeks with a break for 1 week.
2. Femoston: eliminates the symptoms of menopause, stops the development of osteoporosis. Can be taken daily for 4 weeks.
3. Klymen: prescribed for women experiencing symptoms of ongoing changes in the body: facial hair growth, change in voice timbre, change in figure to masculine forms. Helps with hair loss skin covering promotes weight loss. It is necessary to take the medication in cycles of 3 weeks with an interruption for 1 week.

Reviews

Nina, 51 years old, Pskov: “When menopause began, my health worsened. I began to fall asleep badly, mood swings intensified, nervousness appeared. had a lot chronic pathologies. Reported them to the doctor. They prescribed vitamin B9 and dietary supplements. The situation has improved markedly.”

Nadezhda, 45 years old, Malaya Vishera: “I have an early menopause. The state of health has worsened, at work I am embarrassed by hot flashes and heat. Has passed or has taken place inspection. The doctor prescribed hormone therapy with new generation pills. He said that once every 6 months it is necessary to come for an examination. I feel fine.”

Svetlana, 53 years old, Orsk: “I suffered from headaches and hot flashes for more than 2 years. I was afraid to take hormones, because I found out that weight could increase. In a pre-infarction condition, she was admitted to the hospital, where hormone therapy was prescribed. Thanks to the doctors for prescribing the latest generation of drugs. I advise all women to listen only to specialists, and not to self-medicate.

Opinions for and against use of HRT separated at the menopause. Many patients do not trust even the new generation of drugs. Experts are confident that timely treatment will only benefit

New generation drugs prescribed for HRT during the menopause can very smoothly remove the unpleasant symptoms of menopause and not harm the woman's health.

Grass red clover instead of estrogen-containing drugs

Making one of the red clover recipes at home will help replace pharmacy products with natural ones.

1. Tincture helps reduce hot flashes, eases mood and normalizes the functionality of the whole body. It will take 3 small spoons of crushed raw materials and 200 ml of boiled hot liquid, leave for 1 hour. Then filter and drink 100 ml four times a day before a snack for 30 minutes.
2. tea drink improves mood and normalizes normal sleep. You need to mix dried leaves of clover, linden, raspberries, strawberries 5 g each and add 0.7 liters of boiling water. Infuse for about 15 minutes and drink like regular tea.
3. douching normalizes the mucous surface of the vagina and eliminates dryness. It is necessary to pour 40-45 g of clover into 1.5 liters of boiled water, insist for 60-70 minutes. Then strain and use the product once a day for 1 week.

Classification and list of drugs

Hormone replacement therapy (HRT) can be systemic or local. Local therapy indicated for the treatment of urogenital disorders and does not affect the general condition of the body. Systemic therapy consists in taking hormonal pills.

There are several groups of hormonal drugs. A wide range creates certain difficulties in their choice. The choice depends on many factors - the age of the woman, the duration of menopause, concomitant diseases.

The table shows groups of hormonal drugs with a short description and a list of drugs.

Types of HRT, drugs used

Preparations containing hormones are divided according to the types of replacement therapy. Combined drugs include: Klimonorm, Femoston, Pauzogest, Cyclo-Progenova, etc.

Interesting video:

Klimonorm

The drug has two main components estrogenic and gestagenic. The first is aimed at eliminating negative psycho-emotional and vegetative symptoms. This is sleep disturbance, excessive sweating, dryness of the vaginal mucosa, emotional instability. The second is responsible for preventing the occurrence hyperplastic processes and endometrial cancer.

The medicine is available in boxes of 21 tablets on three plates. Nine tablets have yellow, as they contain estradiol valerate in a mass fraction of 2 mg. They are accepted first. The remaining twelve tablets are brown in color and, along with two milligrams of estradiol valerate, contain another 150 mg of levonorgestrelol. Take the drug in courses of one tablet per day with seven-day breaks. During this period, small discharges, similar to menstruation, should begin. In the case of a preserved menstrual cycle, take tablets from the fifth day of menstruation.

It has an affordable price and costs between 730-800 rubles, it is freely sold in pharmacy network. Its action is aimed at eliminating the symptoms of menopause, absolutely does not affect the increase in body weight, normalizes the psycho-emotional state. The disadvantages include the appearance of menstrual flow in the middle of the cycle, constant daily intake, the occurrence of pain in the mammary glands, acne.

Femoston

This drug is available with a different content of progestogen and estrogen components. There are types of Femoston 1/5, Femoston 2/5, Femoston 2/10. Let's take a look at the last option. This medicine is available in a package of 28 pieces, divided in half: 14 pink and yellow tablets each.

Roses contain 2 mg of estradiol hemihydrate. In yellow tablets, 10 mg of dydrogesterone was added to two milligrams of estradiol.

The course of treatment consists of four weeks of daily intake of one tablet. There is no break between courses.

Femiston 2/10 in pharmacies is dispensed by prescription and has a cost of 900-1000 rubles. Its action is aimed at relieving the symptoms of menopause, such as hot flashes, excessive sweating, etc. The negative aspects include the sudden onset of heavy menstruation, the appearance of headaches, and weight gain.

pausegest

Produced in a carton box of 28 tablets per blister. Each tablet contains 2 mg of estradiol and 1 mg of norethisterone acetate. The drug is taken daily on an ongoing basis, one tablet, starting from the fifth day from the start of the menstrual cycle.

Puzogest has a very high efficiency in the relief of menopausal symptoms, and also prevents endometrial hyperplasia and osteoporosis.

The disadvantages of the drug are its high price and frequent absence from pharmacy shelves. During treatment, swelling and disease state mammary glands and the appearance of sudden uterine bleeding.

Cyclo-Proginova

Produced in cardboard boxes of 21 tablets. For primary administration, 11 tablets are white and contain 2 mg of estradiol valerate. The remaining 10 tablets have a light brown coating and consist of estradiol with the addition of 0.15 mg of norgestrel. This drug is taken for three weeks, then there is a break for seven days. This break should start bleeding similar to menses.

Cyclo-Proginova refers to available drugs and costs 830-950 rubles. To positive qualities include the complete elimination of the symptoms of menopause, the restoration of sexual desire, the relief of headaches. The negative aspects include: the need for constant reception, tk. effectiveness is observed only during the course of treatment, pain in the mammary glands, flatulence, swelling.

Preparations based on the content of one hormone - estrogen. These include: Divigel, Menorest, Estrogel, etc.

Divigel

This tool is available in the form of a gel containing estradiol hemihydrate of 0.5 or 1 mg. The drug is used once a day by applying to clean areas of the skin. Area of ​​application: lower abdomen, lower back, shoulders, forearms, buttocks. The area covered by the gel should not exceed the size of 1-2 palms. It is recommended to change the rubbing area every day. It is forbidden to apply the gel on the skin of the face, chest, genitals.

menorest

Also available as a gel based on estradiol. It is packaged in tubes with a dispenser. The principle of operation is similar to the Divigel.

estrogel

Gel for external use is sold in tubes with a dispenser, with a total weight of 80 g. One dose of the gel contains 1.5 mg active substance. It is prescribed to eliminate estrogen deficiency, as it has proven itself in the field of relieving menopause symptoms and restoring the cycle. The difficulty lies in the dosage and possible appearance mastodonia.

Carrying out replacement therapy

The doctor prescribes the hormone treatment algorithm only after a thorough examination of the patient, since the appointment of certain drugs is purely individual.

Exist common factors influencing the doctor's decision:

• age and social and social activity;
• the state of the menstrual cycle, the presence of menstruation;
• the state of the reproductive system;
• the presence of fibroids and other cancers;
• contraindications.

The most common myths about replacement therapy in women

Many women refuse hormone replacement therapy because they are guided by myths that are widespread among the inhabitants. Here are the most common myths:

• Drugs are addictive. In fact, no addiction occurs, because the hormonal background fades on its own. It is only necessary to change the drug or dosage in time to maintain normal health.
• Hormones cause obesity. Indeed, imbalance of hormones leads to weight gain. The culprit is excess testosterone. But hormonal therapy, on the contrary, brings weight back to normal. Some weight gain will occur, but the IMS will meet health criteria.
• Oncology will develop. Cell division is a feature human body. Neoplasms occur both when taking hormonal drugs, and without them. Excess estrogen does cause various tumors, but with a well-chosen dosage, hormones will be a good prevention of cancer of the reproductive organs in menopause.

Basic drugs

Among the drugs for HRT, there are several main categories:

Estrogen-based products, names:

1. Ethinylestradiol, Diethylstilbestrol. They are oral contraceptives and contain synthetic hormones.
2. Klikogest, Femoston, Estrofen, Trisequens. They are based on the natural hormones estriol, estradiol and estrone. To improve their absorption in the gastrointestinal tract, hormones are presented in a conjugated or micronized version.
3. Klimen, Klimonorm, Divina, Proginova. The drugs include estriols and estrone, which are ether derivatives.
4. Hormoplex, Premarin. They contain only natural estrogens.
5. Gels Estragel, Divigel and Klimara patches are intended for external use.. They are used for serious liver pathologies, pancreatic diseases, hypertension and chronic migraine.

Means based on progestogens:

1. Duphaston, Femaston. They belong to dydrogesterones and do not give metabolic effects;
2. Norkolut. Based on norethisterone acetate. It has a pronounced androgenic effect and is useful in osteoporosis;
3. Livial, Tibolone. These drugs are effective in osteoporosis and are in many ways similar to the previous drug;
4. Klimen, Andokur, Diane-35. The active substance is cyproterone acetate. It has a pronounced antiandrogenic effect.

Universal preparations containing both hormones. The most common are Angelique, Ovestin, Klimonorm, Triaklim.

positive effects of hormones

Hormonal treatment can eliminate such manifestations and consequences of menopause as menopausal syndrome, expressed in the following conditions:

• hormonal changes (decrease or complete cessation of estrogen synthesis in the ovaries);
• metabolic disorders (as a result - weight gain or loss, the development of hyperhidrosis, as well as degenerative joint pathologies and osteoporosis);
• urinary disorders (exacerbations of chronic gynecological diseases, vaginal atrophy, dyspareunia, nocturia, cystitis, decreased libido);
• vegetative disorders (periodic chills, chest pains, pressure surges, hot flashes during menopause);
• psycho-emotional disorders ( emotional lability- abrupt mood swings depressive states, sleep disorders);
• development of psychosomatic diseases.

Accompanying troubles are such "little things" as the deterioration of the skin of hair and nails:

• thinning and fragility of the nail plates;
• increased hair loss;
• the appearance of age wrinkles on the face.

To eliminate these threats, hormone therapy is prescribed that increases estrogen levels.

Selective estrogen receptor modulators: Evista

Selective estrogen receptor modulators are drugs that act selectively as estrogens in some (non-reproductive) tissues, while as antiestrogen in other (reproductive) tissues.

First medicinal substance of this group, temoxifen was discovered. It acted as an estrogen in relation to bone tissue (preventing the development of osteoporosis) and as an antiestrogen in relation to the mammary gland (suppressing cell growth - proliferation and their degeneration into cancer). A side effect of tamoxifen was considered to be its estrogenic effect on the endometrium - stimulating growth. Tamoxifen is used only as an antitumor agent in the treatment of breast cancer.

The next generation of selective estrogen receptor modulators is raloxifene. As estrogen, it has a positive effect on bone tissue, lipid metabolism (prevention of atherosclerosis) and the blood coagulation system (the risk of thrombosis increases). How an antiestrogen affects the mammary gland without affecting the endometrium. Therefore, raloxifene is used for the prevention and treatment of osteoporosis in menopause.

Raloxifene is produced by the pharmaceutical companies Lilly S.A., Spain and Daiichi Sankyo, Germany in tablets of 60 mg under the trade name Evista. Take daily for a long time and under control laboratory research blood.

How to Maintain Good Health with HRT

In the age category of 50-60 years, the hormonal background of a woman changes. With severe symptoms of menopause, they consult a doctor for the appointment of hormone replacement therapy and examination.

In connection with the consensus of experts, HRT is an effective anticlimacteric therapy. In a woman, the course of menopause is facilitated, unpleasant symptoms are eliminated, and the skin is rejuvenated. With the help of hormones, the body is maintained both internally and externally.

Gynecologists advise:

• do gymnastics: this type of exercise strengthens the body and helps restore normal weight;
• control body weight: you need to stick to a diet, eat more vegetable and light foods;
• lead the right order of life, give up bad habits;
• be attentive to vaginal discharge, to prevent serious diseases.

In the absence of contraindications, hormone therapy can be used by all women during menopause. The main goal of a specialist is to prescribe drugs for a woman with correct dosage gestagens and estrogens. Hormone replacement therapy can be started before the age of 60 in order to subsequently ease the symptoms of menopause.

The benefits of female estrogen tablets

The use of hormones helps to improve the quality of life. This is manifested in getting rid of the symptoms of menopause, normalizing sexual desire, increasing efficiency, and improving appearance.

Proper use of estrogens has long-term beneficial effects. This is due to the fact that the lack of female hormones leads to the development of such diseases:

• violation of carbohydrate metabolism - prediabetes, type 2 diabetes;
• changes in the content of fats in the blood - the risk of progression of atherosclerosis with hypertension, angina pectoris, increased risk of stroke and heart attack;
• loss of bone density - osteoporosis, its consequences are fractures of the vertebrae, head of the pelvic bone, wrist joint with minor trauma;
• atrophy (thinning and dryness) of the mucous membranes of the vagina and urinary tract;
• depression, mental disorders;
• urinary incontinence;
• accelerated skin aging;
• inflammation, destruction of cartilage, and intervertebral discs hindering movement.

Timely appointment of hormones (up to 60 years) prevents the occurrence of these pathologies, and also reduces the likelihood of age-related dementia (dementia) and Alzheimer's disease. If you take drugs for more late age, the opposite effect is observed.

The protective effect of estrogens has also been noted for:

• obesity with a predominant deposition of fat in the abdomen;
• cancer of the cervix, endometrium (inner layer of the uterus);
• tumors of the intestine, stomach.

Places of fat deposition in women with menopause

Side effects of hormone replacement therapy

When using HRT for menopause, hormonal drugs can cause a number of side effects:

• migraine;
• exacerbation of gastrointestinal diseases (nausea, liver pathology, biliary dyskinesia, digestive disorders);
• increased appetite (result - weight gain);
• severe fatigue and weakness;
• the appearance of acne and seborrhea;
• spasms of the limbs;
• development of thrombosis or thromboembolism;
• fluid retention in the body (appearance of edema of the face and body);
• painful breast engorgement and the risk of cancer (tumors);
• degenerative change in the vaginal mucosa (dryness or increased secretion of mucus, bleeding from the vagina);
• the appearance of periodic bleeding from the uterus of a menstrual nature;
• development of hyperplasia.

Why does menopause have so many symptoms?

The work of the mammary glands, genitals, brain, cardiovascular system, the condition of the skin and hair, the work of the liver, large intestine and genitourinary system depends on estrogen - the female sex hormone. The lack of this hormone, which is observed during menopause, immediately affects all systems in the body.

There are more than 30 symptoms that a woman faces due to menopause after 40 years.

The most common mistake modern women is that they are accustomed to letting everything take its course, especially if the symptoms are not pronounced. Like, and so it will pass. But at this time, a woman just needs to undergo the first diagnosis in order to start helping her body in a timely manner.

What examination will be needed?

Before the doctor selects a hormonal drug for a lady, she needs to undergo a comprehensive examination, which includes:

• a blood test for the level of sex hormones and follicle-stimulating hormone produced by the pituitary gland;
• blood chemistry;
• gynecological examination, which includes a procedure for determining the thickness of the endometrium;
• mammography;
• measurement of blood pressure;
• study of bone density.

Also, the doctor will calculate the patient's body mass index. After all, excess weight is a contraindication for HRT.

Features of the treatment of surgical menopause

artificial or surgical menopause occurs after the removal of the ovaries, which leads to the cessation of the production of female hormones. In such circumstances, HRT can significantly reduce the risk of complications.

The therapy includes such schemes:

1. After removal of the ovaries, but the presence of the uterus (if the woman is under 50 years old), cyclic treatment is used in such options - estradiol and cipraterone; estradiol and levonorgestel, estradiol and dydrogesterone.
2. For women over 50 years old - monophasic estradiol therapy. It can be combined with norethisterone, medroxyprogesterone, or drosirenone. Tibolone is recommended.
3. In the surgical treatment of endometriosis. To eliminate the risk of recurrence, estraradiol therapy is carried out in combination with dienogest, dydrogesterone.

Treatment of menopause with non-hormonal drugs

Expert opinions on the advisability of hormone therapy today differ. 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 the treatment of menopause without hormones, which consists in the use of phytohormones, homeopathic medicines, dietary supplements, etc.

Homeopathic remedies for menopause

Homeopathy for menopause is very popular. The basis of the effect of homeopathic remedies is the activation natural mechanisms organism

Patients are prescribed small doses of substances that, in large doses, can lead to negative consequences.

Homeopathic remedies will help eliminate menopause symptoms such as:

• hyperhidrosis (excessive sweating);
• menopausal vertigo (dizziness);
• hot flashes during menopause;
• dryness of the mucous membranes of the vagina;
• mood swings;
• weight gain and others.

The benefits of homeopathy for menopause include the following:

• natural origin of the components;
• relatively low cost;
• there are practically no side effects, only an allergy to the components of the product;
• safety of use in the elderly.

Consider the most effective homeopathic remedies used for menopause.

• Remens - 580 rubles. The drug consists of soy 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 preparation contains phytoestrogens of soy and wild yam, as well as a complex of vitamins and microelements
  . Estrovel allows you to reduce the number and reduce the intensity of hot flashes and sweating.
• Feminal - 670 rubles. The composition of 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 to get rid of hot flashes, excessive sweating, emotional lability and dizziness during menopause, and women do not get better from this medicine.
• Climaxin - 120 rubles. This preparation consists of sepia, lachesis and cimicifuga
  . The action of Climaxin is mainly aimed at regulating vegetative-vascular disorders (insomnia, irritability, palpitations, excessive sweating, dizziness) during menopause.
• Klimakt-Hel - 400 rubles. This drug perfectly eliminates the symptoms caused by menopause.

Preparations for menopause of plant origin

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

Today, the most effective and popular drug for menopause symptoms is Inoklim, which is a biological supplement based on phytoestrogens.

Inoklim effectively fights such menopausal symptoms like a feeling of heat in the body, dryness of the vagina, increased sweating, and prevents the development of complications.

The drug has practically no contraindications and side effects. Inoklim is not prescribed only for those who are allergic to the substances that make up its composition.

Thus, we have analyzed what drugs to take with menopause in order to alleviate its symptoms. But drug therapy can and should be supplemented with a proper and balanced diet, drinking enough fluids, playing sports, taking vitamin and mineral complexes

Also, do not forget about the positive emotions that communication with loved ones, hobbies or needlework can give you.

Watch a video about drugs for menopause.

According to experts, new generation HRT drugs are the best method for treating menopausal syndrome. The composition of the funds includes a minimum amount of synthetic hormones, which makes the drugs practically harmless and suitable for long-term use.

Consider reviews of hormonal drugs for menopause of a new generation.

What hormones are missing?

The result of the development of menopause is a sharp decrease in the ability of the ovaries to produce progesterone, and subsequently estrogen due to the degenerative shutdown of the follicular mechanism and changes in the brain nerve tissues. Against this background, the sensitivity of the hypothalamus to these hormones decreases, which leads to a decrease in the production of gonadotropin (GnRg).

The response is an increase in the work of the pituitary gland in terms of the production of luteinizing (LH) and follicle-stimulating (FSH) hormones, which are designed to stimulate the production of lost hormones. Due to excessive activation of the pituitary gland, the hormonal balance is stabilized for a certain period of time. Then, the lack of estrogen affects, and the functions of the pituitary gland gradually slow down.

Decreased production of LH and FSH leads to a decrease in the amount of GnRh. The ovaries slow down the production of sex hormones (progestins, estrogens and androgens), up to the complete cessation of their production. It is a sharp decrease in these hormones that leads to menopausal changes in the female body..

Read about the norm of FSH and LH with menopause here.

If a woman becomes pregnant, can I drink OK?

Gynecologists assure that OK contains a very small amount of hormones, so if pregnancy occurs, they will not negatively affect the fetus, especially in the first 4 weeks.

However, if the first signs of future motherhood appear, it is still advisable to refuse to take OK and seek advice from a doctor.

The modern choice of hormonal pills gives an advantage to a woman to successfully cope with deviations in her health, to plan the birth of children. But in order not to harm the body, timely consultation with a specialist is needed. Independence in this matter is prohibited.

Article formatting: Mila Fridan

Early menopause (menopause)

Clinical features: climacteric signs, accompanied by the cessation of menstruation.

Diagnosis confirms elevated level FSH 3 months after amenorrhea in a woman under 40 years of age.

Premature menopause is caused by:

Primary and secondary ovarian insufficiency; radiation and / or chemotherapy for a malignant neoplasm of the pelvic organs or any other localization; cancer of the reproductive organs; inflammation/infection; condition after hysterectomy; hereditary predisposition; genetic syndromes with ovarian hypoplasia: removal of the ovaries; autoimmune diseases; endometriosis; polycystic ovary syndrome; genital tuberculosis; long-term GnRH therapy; ovulation induction in infertility for IVF; type 1 diabetes; Addison's disease; hypothalamic-pituitary causes.

In some women, the cause of early menopause cannot be determined.

Behavioral triggers include:

Chronic nicotine and alcohol intoxication; obesity/underweight.

Treatment

: hormone replacement therapy and correction of the underlying disease, if any.

Red brush tincture

The red brush is endowed with useful properties due to its chemical composition:

• silver;
• chromium;
• molybdenum;
• cobalt;
• manganese;
• nickel.

Together, they rejuvenate and strengthen the immune system. To prepare a recipe at home, you need to take the root, rinse it thoroughly, finely chop and dry. Then combine 300 ml of unboiled water and 1 tbsp. the resulting funds, boil it all and cook over low heat for 15 minutes.

Infuse for half an hour, filter and drink about 100 ml before meals 3 times. The addition of honey interrupts the bitter taste and enhances the effect. You can drink this tincture for at least a month. For prevention, the tincture is drunk about 3 times a year.

Despite the fact that menopause is a physiological process, many women need medication to make it easier to survive this period of life. A change in the hormonal background during menopause, which is based on a stop in the synthesis of estrogen, negatively affects the ability to work, appearance, physical health and psycho-emotional state of the lady. Then they can help special preparations with climax.

Specialists prescribe to many women menopausal age drug therapy, giving preference to homeopathic remedies, antidepressants, dietary supplements and other drugs that do not contain hormones. The limitation of 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 drugs for menopause from hot flashes, depression, fluctuations in blood pressure and other unpleasant symptoms that a woman may experience in this period of life. We will also analyze in what cases and what hormonal preparations a gynecologist can prescribe, as well as how to take them correctly in order to avoid undesirable consequences for good health.

Hormone replacement therapy for menopause (HRT): pros and cons

Hormone replacement therapy for the relief of menopausal symptoms is used by specialists in many European countries, since it has been proven to be highly effective and safe. But domestic gynecologists are afraid to relieve 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 physicians have established a number of conditions to minimize the risk of side effects, namely:

• timely appointment and cancellation of hormonal drugs for menopause;
• indications for hormone therapy;
• the use of microdoses of drugs from which undesirable effects will not appear;
• selection of drugs and its dosage, based on the results of a blood test for sex hormones;
• the appointment of drugs, which include exclusively natural hormones;
• strict adherence by the patient to the recommendations of the attending doctor.

But many patients still refuse hormonal drugs 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 get better
• afraid of addiction;
• afraid of the appearance of hair in unwanted places;
• think that hormonal agents damage the gastric mucosa;
• It is believed that taking drugs with sex hormones increases the risk of developing malignant neoplasms in the female body.

But these are all just prejudices, because, by observing the conditions that we spoke about earlier, one can avoid negative consequences for good health.

Thus, if the body lacks its own sex hormones, then it needs foreign hormones, since hormonal imbalance leads to disruption of the work of all organs and systems.

Indications for the use of hormonal drugs for menopause

Hormonal drugs are prescribed in the following situations:

• pathological menopause, which developed as a result of the removal of the uterus, the use of chemotherapeutic agents or radiation treatment;
• menopause in women under 40;
• too pronounced signs of menopause;
• the development of complications and diseases that appeared against the background of menopause (hypertension, atherosclerosis, polycystic ovaries, dryness of the vaginal mucosa, urinary incontinence, and others);
• the desire of the patient 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;
• the development of benign tumors in the uterus and appendages;
• uterine bleeding;
• increased risk.

Proper selection of the dose, strict adherence to the appointments of a specialist, the regularity of administration and the combination of estrogens with allows you to avoid the above side effects.

Absolute contraindications to hormonal drugs are the following conditions:

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

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 best reviews of gynecologists and patients about the latest generation of combined hormonal drugs that contain both estrogen and progesterone.

HRT for menopause includes new generation drugs:

• Angelica - 1300 rubles;
• Klimen - 1280 rubles;
• Femoston - 940 rubles;
• Kliminorm - 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 muscles of the sphincter of the bladder;
• 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 pills and tablets. One blister, where each tablet is numbered, is enough for 21 days of admission. After the woman takes the last pill, you need to take a break for seven days and only then proceed to a new blister. Each tablet has its own dose of hormones, which corresponds to the day of the cycle.

Femoston, Activel, Cliogest, as well as Angeliq are available in 28 tablets in a blister, seven of which are pacifiers, that is, they do not contain hormones.

Estrogens

Preparations that contain only estrogen in their composition are produced mainly in the form of gels, creams, patches or implants that are placed under the skin of a woman.

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

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

Among the estrogen patches, they showed themselves well, such as:

• 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, as they only need to be applied once a day to the skin of the shoulders, abdomen, or lower back.

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

The implants, which are sewn under the skin, last for 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 of hormonal agents, namely:

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

Progestins

To avoid the development of side effects, estrogens are prescribed in combination with progesterone. But if the uterus was extirpated, then the patient is shown estrogen monotherapy.

Progesterone preparations are mainly prescribed from the 14th to the 25th day of the menstrual cycle.

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

1. Tablets and dragees:

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

1. Gels and vaginal suppositories:

• Utrozhestan;
• Crinon - 2450 rubles;
• Progestogel - 900 rubles;
• Prajisan - 260 rubles;
• progesterone gel.

1. Intrauterine hormonal systems:

• Mirena - 12500 rubles.

Recently, 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 drugs

The choice of a hormone therapy regimen, the 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 the hormonal background of a woman, as well as taking into account the state of health in general. Self-treatment can lead to irreversible consequences!

Treatment of 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, since cancer can develop.

Rules for taking hormonal drugs:

• vaginal suppositories and tablets should be taken at the same time of day, as directed by your 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 pill at the appointed time;
• it is strictly forbidden to independently change the dose of the drug or the drug itself;
• you can not 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

Expert opinions on the advisability of hormone therapy today differ. 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 the treatment of menopause without hormones, which consists in the use of phytohormones, homeopathic medicines, dietary supplements, etc.

Homeopathic remedies for menopause

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

Homeopathic remedies will help eliminate menopause symptoms such as:

• hyperhidrosis (excessive sweating);
• menopausal vertigo (dizziness);
• hot flashes during menopause;
• dryness of the mucous membranes of the vagina;
• mood swings;
• other.

The benefits of homeopathy for menopause include the following:

• natural origin of the components;
• relatively low cost;
• there are practically no side effects, only an allergy to the components of the product;
• safety of use in the elderly.

Consider the most effective homeopathic remedies used for menopause.

• Remens - 580 rubles. The drug consists of soy 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 preparation contains phytoestrogens of soy and wild yam, as well as a complex of vitamins and microelements. Estrovel allows you to reduce the number and reduce the intensity of hot flashes and sweating.
• Feminal - 670 rubles. This preparation contains liquid extracts of nettle, oregano, celandine, hawthorn, shepherd's purse herb, centaury, St. John's wort, thyme, celandine and calendula. Feminal helps to get rid of hot flashes, excessive sweating, emotional lability and dizziness during menopause, and women do not get better from this medicine.
• Climaxin - 120 rubles. This remedy consists of sepia, lachesis and cimicifuga. The action of Climaxin is mainly aimed at regulating vegetative-vascular disorders (insomnia, irritability, palpitations, excessive sweating, dizziness) during menopause.
• Klimakt-Hel - 400 rubles. This drug perfectly eliminates the symptoms caused by menopause.

Preparations for menopause of plant origin

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

Today, the most effective and popular drug for menopause symptoms is Inoklim, which is a biological supplement based on phytoestrogens.

Inoklim effectively fights such menopausal symptoms as a feeling of heat in the body, dryness of the vagina, increased sweating, and also prevents the development of complications.

The drug has practically no contraindications and side effects. Inoklim is not prescribed only for those who are allergic to the substances that make up its composition.

Thus, we have analyzed what drugs to take with menopause in order to alleviate its symptoms. But drug therapy can and should be supplemented with proper and balanced nutrition, drinking enough fluids, playing sports, taking vitamin and mineral complexes. Also, do not forget about the positive emotions that communication with loved ones, hobbies or needlework can give you.

Watch a video about drugs for menopause.