RESUMEN
BACKGROUND: The onset of menopause leads to diminished estrogen exposure, resulting in a high morbidity burden related to menopausal symptoms. Menopausal hormonal therapy is an effective therapy that offers more advantages than disadvantages for women aged less than 60 years or who have had menopause for less than 10 years. OBJECTIVE: This study aimed to assess the prevalence of menopausal symptoms, identify factors associated with menopausal symptoms, and assess the use of menopausal hormone therapy among women aged 40-60 who visited the gynecological clinics of three hospitals in Addis Ababa, Ethiopia. METHODS: A facility-based cross-sectional study was conducted from January 2022 to June 2022 at Gandhi Memorial Hospital, Tikur Anbessa Hospital, and Zewditu Memorial Hospital on 296 middle-aged women. Data were collected using an interviewer-administered structured questionnaire and analyzed for sociodemographic factors, utilization of menopausal hormone therapy, and prevalence of menopausal symptoms using the menopause rating scale. Data were analyzed using SPSS version 25. Bivariate and multivariate logistic regression analyses were performed to identify independent predictors of each subscale of menopausal symptoms. The strength of the association was measured using odds ratios with 95% confidence intervals, and statistical significance was set at a value of P < 0.05. RESULT: The prevalence of menopausal symptoms was 89.9%. According to the menopausal rating scale, the frequency of reported symptoms was hot flushes (54.7%), muscle and joint pain (32.1%) on the somatic subscale; physical and mental exhaustion (55.1%), irritability (48.6%) on psychological subscale; and sexual problems (41.3%), bladder problems (39.2%) on urogenital subscale. This study also showed that the age of women [aOR: 0.317, 95%CI (0.102, 0.990)], and monthly family income [aOR = 0.182, 95% CI (0.041, 0.912)] were significantly associated with somatic menopausal symptoms. There was no utilization of menopausal hormonal therapy to treat menopausal symptoms and to prevent complications. CONCLUSION: The prevalence of menopausal symptoms is high; however, the utilization of individualized administration of menopausal hormone therapy according to symptoms is negligible. It appears essential for these institutions to work on service availability and delivery of menopausal hormone therapy for those in need of wider benefits for their clients.
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Sofocos , Menopausia , Humanos , Femenino , Estudios Transversales , Etiopía/epidemiología , Persona de Mediana Edad , Adulto , Sofocos/epidemiología , Encuestas y Cuestionarios , Prevalencia , Terapia de Reemplazo de Estrógeno/estadística & datos numéricosRESUMEN
Menopause, as a consequence of ovarian follicular decline, induces estrogen deficiency and metabolic changes that increase the cardiovascular risk in women. In particular, there is an increase in blood pressure during menopause. Menopausal hormonal therapy can be prescribed to women with symptoms of menopause to improve their quality of life. This article reviews the current literature on the pathophysiological mechanisms that explain blood pressure changes at menopause and describes the impact of menopausal hormone therapy on blood pressure.
La ménopause, conséquence d'une déplétion folliculaire ovarienne, induit une carence hormonale et des modifications métaboliques augmentant le risque cardiovasculaire chez la femme. Une hausse de la tension artérielle peut notamment être observée. Le traitement hormonal de la ménopause peut être prescrit aux femmes présentant des symptômes climactériques afin d'améliorer leur qualité de vie. Cet article revoit la littérature actuelle sur les mécanismes physiopathologiques expliquant les changements tensionnels à la ménopause et décrit l'impact des traitements hormonaux de la ménopause sur la tension artérielle.
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Terapia de Reemplazo de Estrógeno , Hipertensión , Menopausia , Humanos , Femenino , Menopausia/fisiología , Menopausia/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Terapia de Reemplazo de Estrógeno/métodos , Terapia de Reemplazo de Estrógeno/efectos adversos , Presión Sanguínea/fisiología , Presión Sanguínea/efectos de los fármacosRESUMEN
BACKGROUND Menopausal hormone therapy (MHT) has been receiving increasing attention in developed countries. The purpose of this study was to investigate understanding of menopause and acceptance of MHT in Qinhuangdao, China. MATERIAL AND METHODS We analyzed data from 186 perimenopausal patients on topics including menopausal symptoms and acceptance of and adherence to MHT treatment. We also surveyed 100 medical staff on menopausal-related knowledge. RESULTS Group A consisted of 41 patients treated with MHT for more than 1 cycle, group B consisted of 49 patients who had received MHT but had stopped it for more than 3 months, and group C consisted of 96 patients who never received MHT. There was a significant difference among them in modified Kupermann scores before treatment (P<0.05), but the difference disappeared after MHT (P>0.05). In group C, 32 patients (33%) were unaware of MHT, 60 (62.5%) were worried about the risk of breast/endometrial cancer, 24 (25%) were worried about high costs, and 67 (70%) had no obvious symptoms and did not want MHT. Similarly, in group B, most people stopped MHT for fear of breast or endometrial cancer. A survey targeting 100 medical staff in our hospital found 14 people (14%) knew about and were willing to accept MHT, 44 people (44%) knew about MHT but were afraid to use it, and 42 people (42%) did not know about MHT at all. CONCLUSIONS MHT has not yet been accepted by the majority of people, even medical staff, in Qinhuangdao, China, and much further progress is needed.
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Conocimientos, Actitudes y Práctica en Salud , Menopausia , Humanos , Femenino , China , Persona de Mediana Edad , Menopausia/psicología , Encuestas y Cuestionarios , Adulto , Terapia de Reemplazo de Hormonas/métodos , Terapia de Reemplazo de Estrógeno , Neoplasias de la Mama/tratamiento farmacológicoRESUMEN
Purpose: Hormonal therapy (HT) has been suggested to lower the risk of developing glaucoma. Our goal was to investigate the association between HT use and the onset of glaucoma diagnosis in postmenopausal women. Methods: This retrospective case-only study included female veterans with open-angle glaucoma from VA records between 2000 to 2019. Propensity score matching was used to match HT (n = 1926) users to untreated (n = 1026) women on multiple covariates (e.g., age of menopause, BMI, blood pressure, antihypertensive medications, and a co-morbidity index). A simple linear regression was used to evaluate the impact of HT duration on the age of glaucoma diagnosis, and multivariate linear regression analysis was used to determine which factors contributed to the age at diagnosis of glaucoma. Results: We found a linear relationship between the age at diagnosis of glaucoma and menopause in women with (r = 0.54) and without HT (r = 0.57) use. HT users tended to have a later diagnosis of glaucoma. Our multivariate analysis found that 0-2 years, 2-5 years, and >5 years of HT use were associated with a 2.20 [confidence interval (CI), 1.64, 2.76], 3.74 [CI, 3.02, 4.46], and 4.51 [CI, 3.84, 5.18] years later diagnosis of glaucoma. An interaction (-0.009 [-0.015, -0.003]) was observed between HT duration and age of menopause diagnosis, with the impact of HT decreasing for later menopause ages. Conclusions: Longer duration of HT use was associated with a later diagnosis of glaucoma in postmenopausal women in this case-only analysis. The impact of HT may be modulated by menopausal age, although further study is needed. The findings support a protective role of estrogen in glaucoma pathogenesis.
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Edad de Inicio , Terapia de Reemplazo de Estrógeno , Glaucoma de Ángulo Abierto , Presión Intraocular , Posmenopausia , Humanos , Femenino , Estudios Retrospectivos , Anciano , Persona de Mediana Edad , Glaucoma de Ángulo Abierto/epidemiología , Glaucoma de Ángulo Abierto/diagnóstico , Terapia de Reemplazo de Estrógeno/efectos adversos , Presión Intraocular/fisiología , Presión Intraocular/efectos de los fármacos , Factores de Riesgo , Anciano de 80 o más AñosRESUMEN
OBJECTIVE: Endogenous and exogenous hormonal factors have been associated with female breast, genital, and colorectal cancer risk. The aim of the present study is to conduct an evidence-based evaluation of the fraction of cancers attributable to and prevented by exogenous hormonal (i.e., combined oral contraceptives [COC] and combined estrogen-progestogen menopausal therapy [CEPMT]) and reproductive factors (i.e., parity and breastfeeding) in Italy. STUDY DESIGN: We calculated the population attributable and prevented fractions combining relative risks and prevalence of exposure in Italian women. Italian cancer incidence and mortality data were extracted from national sources and used to estimate the number of cancer cases and deaths attributable to reproductive factors and exogenous hormones in Italy in 2020. For long-term effects, a 20-year latency period was considered. RESULTS: COC were responsible for 4.4 % of breast and 10.9 % of cervical cancers in women aged 15-44, but also avoided 6.4 % of endometrial, 5.6 % of ovarian, and 2.9 % of colorectal cancers in women of all ages. Overall, COC use prevented 1174 cancer diagnoses and 577 cancer deaths. CEPMT caused 0.4 % of breast cancers at age 45-69. Low parity accounted for 8.1 %, 11.8 % and 15.5 % of breast, endometrial and ovarian cancers, respectively (6267 cases, 1796 deaths). Breastfeeding avoided 6.4 % of breast cancers (3775 cases, 897 deaths). CONCLUSIONS: Our analysis quantified the complex effects of hormonal and reproductive factors on cancer burden in Italian women.
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Neoplasias de la Mama , Humanos , Femenino , Italia/epidemiología , Adulto , Persona de Mediana Edad , Adolescente , Anciano , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/prevención & control , Adulto Joven , Anticonceptivos Orales Combinados , Paridad , Lactancia Materna/estadística & datos numéricos , Neoplasias Endometriales/epidemiología , Neoplasias Endometriales/prevención & control , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/prevención & control , Incidencia , Neoplasias/epidemiología , Neoplasias/prevención & control , Terapia de Reemplazo de Estrógeno/estadística & datos numéricos , Neoplasias Ováricas/epidemiología , Neoplasias Ováricas/prevención & control , Factores de Riesgo , Embarazo , Neoplasias de los Genitales Femeninos/epidemiología , Neoplasias de los Genitales Femeninos/prevención & controlRESUMEN
OBJECTIVE: To assess treatment satisfaction, unmet treatment needs, and new vasomotor symptom (VMS) treatment expectations among women with moderate to severe VMS and physicians treating women with VMS. METHODS: This noninterventional, nonrandomized survey included qualitative interviews and quantitative surveys of women and physicians in the US. Participating women had moderate to severe VMS in the past year and received ≥1 hormone therapy (HT), non-HT, or over-the-counter (OTC) treatment for VMS in the past 3 months. Participating physicians were obstetrician-gynecologists (OB-GYNs) and primary care physicians (PCPs) who treated ≥15 women with VMS in the past 3 months. Two online survey questionnaires were developed using insights from literature, qualitative interviews, and clinical experts. Menopause Symptoms Treatment Satisfaction Questionnaire (MS-TSQ) measured treatment satisfaction. Results were summarized descriptively. RESULTS: Questionnaires were completed by 401 women with VMS and 207 physicians treating VMS. Among women, mean total MS-TSQ score ranges were 62.8-67.3 for HT, 59.8-69.7 for non-HT, and 58.0-64.9 for OTC treatments. Among physicians, mean total MS-TSQ scores were considerably higher for HT than for non-HT and OTC treatments (HT: 73.4-75.6; non-HT: 55.6-62.1; OTC: 49.2-54.7). Women reported "lack of effectiveness" (41.2%), and physicians reported "long-term safety concerns" (56.5%) as main features that do not meet their current treatment expectations. The majority of women and physicians would consider trying a new non-HT treatment for VMS (75.8 and 75.9%, respectively). CONCLUSIONS: Treatment satisfaction and new treatment expectations were similar but with some differences between women and physicians; the need for additional treatments for VMS was identified.
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Sofocos , Menopausia , Satisfacción del Paciente , Humanos , Femenino , Persona de Mediana Edad , Menopausia/psicología , Menopausia/fisiología , Sofocos/tratamiento farmacológico , Encuestas y Cuestionarios , Adulto , Anciano , Actitud del Personal de Salud , Ginecología , Médicos de Atención Primaria , Terapia de Reemplazo de Estrógeno , Estados Unidos , Sistema Vasomotor/fisiopatología , Sistema Vasomotor/efectos de los fármacos , Médicos/psicologíaRESUMEN
Importance: Menopause is associated with biological aging, and hormone therapy (HT) is associated with health outcomes in postmenopausal women. Objective: To evaluate the association between HT use and discrepancies between chronological and biological age in postmenopausal women as well as the potential modifying role of socioeconomic status (SES). Design, Setting, and Participants: This population-based, retrospective cohort study included postmenopausal women registered in the UK Biobank. A baseline survey on HT use and biological aging biomarkers was conducted from March 2006 to October 2010. Data analyses were conducted in December 2023. Exposures: Information regarding HT use, the age at starting HT, and HT duration was collected via a touchscreen questionnaire. SES was evaluated by education, family income, occupation, and the Townsend Deprivation Index. Main Outcomes and Measures: Biological aging discrepancy was evaluated using validated phenotypic age, which was calculated using chronological age and 9 biomarkers measured at baseline. All-cause and cause-specific mortality were also assessed. Results: Among the 117â¯763 postmenopausal women (mean [SD] age, 60.2 [5.4] years), 47â¯461 (40.3%) ever used HT. The mean phenotypic age was 52.1 (7.9) years. Ever use of HT was associated with a smaller biological aging discrepancy than never use of HT (ß, -0.17 years; 95% CI, -0.23 to -0.10 years). This smaller aging discrepancy was more evident in those who started HT at age 55 years or older (ß, -0.32 years; 95% CI, -0.48 to -0.15 years) and in those who used HT for 4 to 8 years (ß, -0.25 years; 95% CI, -0.35 to -0.15 years). The association between HT and a smaller aging discrepancy was more evident in women with low SES, with a significant interaction observed for education (higher education: ß, -0.08 years [95% CI, -0.17 to 0.01]; other education: ß, -0.23 [95% CI, -0.32 to -0.14] years; P for interaction = .02). Phenotypic aging discrepancy mediated 12.7% (95% CI, 6.3% to 23.9%) of the association between HT and all-cause mortality and cause-specific mortality. Conclusions and Relevance: In this study, postmenopausal women with historical HT use were biologically younger than those not receiving HT, with a more evident association observed in those with low SES. The biological aging discrepancy mediated the association between HT and decreased mortality. Promoting HT in postmenopausal women could be important for healthy aging.
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Envejecimiento , Posmenopausia , Humanos , Femenino , Posmenopausia/fisiología , Persona de Mediana Edad , Envejecimiento/fisiología , Estudios Retrospectivos , Terapia de Reemplazo de Estrógeno/estadística & datos numéricos , Anciano , Reino Unido/epidemiología , Terapia de Reemplazo de Hormonas/estadística & datos numéricos , Terapia de Reemplazo de Hormonas/métodos , Biomarcadores/sangreAsunto(s)
Medicina General , Menopausia , Humanos , Femenino , Terapia de Reemplazo de Estrógeno , Persona de Mediana EdadAsunto(s)
Terapia de Reemplazo de Estrógeno , Menopausia , Intervención Psicosocial , Disfunciones Sexuales Fisiológicas , Disfunciones Sexuales Psicológicas , Femenino , Humanos , Persona de Mediana Edad , Estradiol/administración & dosificación , Terapia de Reemplazo de Estrógeno/métodos , Histerectomía/efectos adversos , Libido/efectos de los fármacos , Menopausia/efectos de los fármacos , Menopausia/psicología , Menorragia/cirugía , Neoplasias Ováricas/prevención & control , Prevalencia , Intervención Psicosocial/métodos , Salpingooforectomía/efectos adversos , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Fisiológicas/terapia , Disfunciones Sexuales Psicológicas/epidemiología , Disfunciones Sexuales Psicológicas/etiología , Disfunciones Sexuales Psicológicas/terapiaRESUMEN
Background: With the increasing use of hormone replacement therapy (HRT), there is a need to understand its impact on the occurrence of female malignant tumors. This systematic review and meta-analysis aimed to assess the risk of ovarian cancer associated with HRT and its related risk factors. Methods: PUBMED, OVID, Embase, Cochrane, and Web of Science were searched from 1980 to April 2022 to identify studies on the risk of ovarian cancer and hormone replacement therapy. The random-effects model was used to estimate the pooled risk of HRT in ovarian cancer, both in cohort studies and case-control studies. Additionally, the analysis examined the outcomes associated with different types of estrogen plus progesterone regimens. Meta-regression and sensitive analysis were performed to evaluate the heterogeneity. Results: 21 cohort studies (involving 15,313 cases and 4,564,785 participants) and 30 case-control studies (including 18,738 cases and 57,747 controls) were analyzed. The pooled risks of ovarian cancer for HRT users were 1.20 (95% confidence interval [CI] 1.01-1.44) from cohort studies and 1.13 (95%CI 1.04-1.22) from case-control studies. However, after restricting the study period to recent decades, the significant results indicating a higher risk disappeared in cohort studies conducted after 2010 and in case-control studies conducted after 2006. Furthermore, the continuous use of estrogen-progesterone replacement therapy (EPRT) was associated with a risk comparable to that of sequential use. Subgroup analysis showed that both estrogen replacement treatment (ERT) and EPRT had minor risks; The risk further increased with prolonged exposure time, particularly for durations exceeding 10 years. Additionally, serous ovarian cancer appeared to be more susceptible than other pathological types. Conclusion: The risk of ovarian cancer associated with HRT has been decreasing over time. However, ERT may increase this risk, particularly when used for an extended period. It is recommended that long-time users consider continuous EPRT as a safer alternative. Systematic review registration: www.crd.york.ac.uk/prospero/, identifier CRD42022321279.
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Terapia de Reemplazo de Hormonas , Neoplasias Ováricas , Humanos , Femenino , Neoplasias Ováricas/epidemiología , Terapia de Reemplazo de Hormonas/efectos adversos , Factores de Riesgo , Terapia de Reemplazo de Estrógeno/efectos adversos , Estudios de Casos y ControlesRESUMEN
Objective: To assess the safety and tolerability of ultra-low dose estradiol and dydrogesterone (E0.5 mg/D2.5 mg) among postmenopausal women. Methods: This pooled analysis of data from three clinical studies assessed the effects of continuous combined ultra-low-dose estradiol and dydrogesterone among postmenopausal women. Participants received E0.5 mg/D2.5 mg or placebo for 13 weeks (double-blind, randomized, European study), E0.5 mg/D2.5 mg or placebo for 12 weeks (double-blind, randomized, Chinese study), or E0.5 mg/D2.5 mg for 52 weeks (open-label, European study). Safety outcomes included treatment-emergent adverse events (TEAEs), treatment-emergent serious adverse events (TESAEs), treatment discontinuation due to a TEAE, and adverse events of special interest (AESIs). Results: Overall, 1027 women were included in the pooled analysis (E0.5 mg/D2.5 mg, n = 736; placebo, n = 291). Mean treatment exposure was 288.9 days in the E0.5 mg/D2.5 mg group and 86.6 days in the placebo group. The proportion of women experiencing ≥1 TEAE was similar in the E0.5 mg/D2.5 mg and placebo groups (50.1% vs 49.5%, respectively). TESAEs occurred in 12 (1.6%) women receiving E0.5 mg/D2.5 mg and 9 (3.1%) women receiving placebo. Discontinuation of study treatment was infrequent in both groups (E0.5 mg/D2.5 mg: 1.5%; placebo: 2.4%). The occurrence of breast pain was more common in the E0.5 mg/D2.5 mg group than in the placebo group (2.0% vs 0.3%) as was uterine hemorrhage (6.5% vs 2.4%). The incidence of acne, hypertrichoses and weight increased was similar between groups. Conclusions: Across three studies, ultra-low-dose estradiol plus dydrogesterone was well tolerated among postmenopausal women, with no increase in TEAEs or TESAEs compared with placebo.
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Didrogesterona , Estradiol , Posmenopausia , Humanos , Didrogesterona/administración & dosificación , Didrogesterona/efectos adversos , Femenino , Estradiol/administración & dosificación , Estradiol/efectos adversos , Persona de Mediana Edad , Método Doble Ciego , Anciano , Terapia de Reemplazo de Estrógeno/métodos , Terapia de Reemplazo de Estrógeno/efectos adversos , Progestinas/administración & dosificación , Progestinas/efectos adversos , Sofocos/tratamiento farmacológicoRESUMEN
OBJECTIVE: To compare patient satisfaction rate in postmenopausal women who chose dynamic quadripolar radiofrequency or topical estrogens as their preferred treatment for genitourinary syndrome of menopause. METHODS: Patients were divided into two groups according to their preference: one was treated with estrogen therapy (ET) and the other with dynamic quadripolar radiofrequency treatment (RF). All patients included fulfilled a series of validated questionnaires, at baseline and at the 6-mo follow-up, in order to evaluate the discomfort degree associated with the presence of vulvovaginal atrophy and the impact of the reported symptoms on QoL and sexuality. RESULTS: After propensity score matching, the proportion of women considering themselves satisfied with their genital health conditions was extremely small at study entry (5.2% of the RF group and 6.9% of the ET group), while at a 6-mo follow-up, it increased to 46.7% and 46.6%, respectively. No statistically significant between-group differences were found regarding mean numerical rating scale scores for dryness and dyspareunia at follow-up (5.6 ± 2.6 vs 5.3 ± 2.3, P = 0.5; and 2.9 ± 2.5 vs 3.0 ± 2.7, P = 0.46). At 6-mo follow-up, we observed no statistically significant differences between the two groups regarding the other items evaluated. RF treatment was overall well tolerated. CONCLUSION: The use of quadripolar radiofrequency devices seems effective, but it is not associated with better clinical outcomes compared with topical hormone treatment, which is a substantially cheaper and more convenient treatment for genitourinary syndrome of menopause. Therefore, we suggest limiting the use of dynamic quadripolar radiofrequency selectively when topical estrogens are not effective, not tolerated, or contraindicated.
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Atrofia , Estrógenos , Prioridad del Paciente , Posmenopausia , Vagina , Vulva , Humanos , Femenino , Persona de Mediana Edad , Vulva/patología , Vagina/patología , Estrógenos/administración & dosificación , Estrógenos/uso terapéutico , Dispareunia/tratamiento farmacológico , Dispareunia/terapia , Encuestas y Cuestionarios , Terapia de Reemplazo de Estrógeno/métodos , Satisfacción del Paciente , Calidad de Vida , Anciano , Terapia por Radiofrecuencia/métodos , Resultado del Tratamiento , Enfermedades Vaginales/tratamiento farmacológico , Enfermedades Vaginales/terapiaRESUMEN
OBJECTIVE: To identify clinics in Ohio, Michigan, and Pennsylvania that advertise menopause treatment on their website and evaluate whether clinics not affiliated with a Menopause Society Certified Practitioner (MSCP) are more likely to offer guideline-nonconcordant treatment compared to clinics affiliated with an MSCP. METHODS: We performed an Internet search to identify clinics advertising on their website menopause treatment in Ohio, Michigan, and Pennsylvania. We checked clinic personnel against The Menopause Society directory of practitioners to determine if the clinic was affiliated with an MSCP. RESULTS: We identified 174 clinics (41% in OH, 28% in PA, and 31% in MI). Thirteen percent of clinics were affiliated with an MSCP. Clinics with an MSCP are significantly less likely to advertise hormone testing (primary outcome; odds ratio [OR], 0.11; 95% confidence interval, 0.02-0.39), compounded hormone therapy (OR, 0.06; 95% confidence interval, 0.001-0.41), and bioidentical hormone therapy (OR, 0.07; 95% confidence interval, 0.001-0.26), compared to clinics without an MSCP-affiliated clinics that are also less likely to advertise that hormone therapy will help maintain youth or help with weight loss. CONCLUSIONS: Our pilot study has shown that in the states of Ohio, Michigan, and Pennsylvania, clinics with an MSCP were more likely to advertise on their website an adherence to The Menopause Society's guidelines and not advertise for compounded or bioidentical hormones, recommend hormone testing, or advertise hormones for a youthful appearance or weight loss.
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Menopausia , Sociedades Médicas , Humanos , Femenino , Ohio , Pennsylvania , Michigan , Guías de Práctica Clínica como Asunto , Terapia de Reemplazo de Estrógeno , Internet , Certificación , Instituciones de Atención AmbulatoriaRESUMEN
Many women seek treatment to improve menopausal vasomotor symptoms (VMS). The selection of women most likely to benefit from menopause hormone therapy (MHT) is crucial in clinical practice. There is general agreement that women younger than 60 years or who initiate MHT within the first 10 years of menopause, with no contraindications, have greater benefits considering symptomatic relief and additional advantages. This group may have the advantage of protection from osteoporosis and from other chronic diseases that affect postmenopausal women, namely cardiovascular disease (CVD). Cumulating evidence supports MHT for symptomatic women. However, inadequate use according to the needs of symptomatic women led to a burden of suffering worldwide. In recent years, the emergent use of non-regulated body-identical hormones (non-rBHT) can expose patients to potential harms. These hormone preparations are not regulated through the same tests of safety, efficacy or dosing consistency as regulated-BHT (r-BHT). The POESIT (Portugal + Spain + Italy) recommendations highlight the use of 17ß-estradiol (E2) and micronized progesterone (P4) as the real r-BHT. In addition, the group emphasizes as an example the data from the REPLENISH study with 1 mg E2/100 mg P4. The combination of the two hormones in one convenient pill showed a clear reduction or elimination of hot flashes and an improvement in sleep quality and, consequently, quality of life. At the same time, this combination has shown high rates of amenorrhea and no significant impact on lipid, glucose or coagulation parameters. Both the REPLENISH study and a real-life retrospective study pointed to the possibility of a lower risk of venous thromboembolism (VTE) with this formulation than with other combinations.
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Estradiol , Terapia de Reemplazo de Estrógeno , Sofocos , Menopausia , Progesterona , Humanos , Femenino , Sofocos/tratamiento farmacológico , Estradiol/administración & dosificación , Progesterona/administración & dosificación , Progesterona/uso terapéutico , Terapia de Reemplazo de Estrógeno/métodos , Persona de Mediana Edad , Calidad de Vida , España , ItaliaRESUMEN
OBJECTIVE: This study aimed to investigate the association of hormone replacement therapy (HRT) use, type, duration and age of commencement with myocardial infarction (MI) and stroke in postmenopausal Korean women. METHODS: This nested case-control study used data from the National Health Insurance Service database to analyze 2017 data from women aged ≥50 years and diagnosed with natural menopause between 2004 and 2007. Among 356,160 eligible women, 36,446 used HRT for ≥1 year and 319,714 did not (controls). These two groups were matched 1:1 for statistical analysis. Type and duration were categorized into three categories. RESULTS: Women who started estrogen-progestogen therapy (EPT) or estrogen therapy (ET) in their 50s, or EPT or tibolone in their ≥60s exhibited a lower stroke risk than controls. MI risk was lower among women who used tibolone - regardless of duration - or EPT or ET for 1-3 years than among controls. Stroke risk was lower with tibolone use for ≥5 years or with EPT or ET use for 1-3 years or ≥5 years than non-users. CONCLUSION: Our study may support the beneficial effect of HRT by showing that Korean postmenopausal women who used HRT at a relatively younger and healthier age had a relative benefit for MI and stroke.
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Terapia de Reemplazo de Estrógeno , Infarto del Miocardio , Norpregnenos , Posmenopausia , Accidente Cerebrovascular , Humanos , Femenino , Infarto del Miocardio/epidemiología , Persona de Mediana Edad , República de Corea/epidemiología , Estudios de Casos y Controles , Accidente Cerebrovascular/epidemiología , Norpregnenos/efectos adversos , Terapia de Reemplazo de Estrógeno/efectos adversos , Anciano , Factores de Edad , Bases de Datos Factuales , Factores de Riesgo , Terapia de Reemplazo de Hormonas/efectos adversosAsunto(s)
Menopausia , Salud de la Mujer , Humanos , Femenino , Terapia de Reemplazo de Estrógeno , Persona de Mediana EdadRESUMEN
Postmenopause is the 12-month absence of menstrual periods, characterized by decreased estrogen and progesterone levels, leading to physical and psychological alterations such as hot flashes, mood swings, sleep disruptions, and skin changes. Present postmenopausal treatments include hormone replacement therapy, non-hormonal drugs, lifestyle modifications, vaginal estrogen therapy, bone health treatments, and alternative therapies. Advanced drug delivery systems (ADDSs) are essential in managing postmenopausal effects (PMEs), offering targeted and controlled delivery to alleviate symptoms and improve overall health. This review emphasizes such ADDSs for addressing PMEs. Emerging trends such as artificial ovaries are also reviewed. Additionally, the prospects of technologies such as additive manufacturing (3D and 4D printing) and artificial intelligence in further tailoring therapeutic strategies against PMEs are provided.