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Menopause and hormone replacement treatments. When are they recommended?

Coinciding with the commemoration of International Women’s Day, we will address in today’s health blog entry hormone replacement treatments associated with an exclusively female condition, related to the stage of maturity of women: menopause.

In Spain, currently only 4% of women with menopausal symptoms and 2.35% of those in perimenopause resort to hormonal therapy. This figure contrasts significantly with the 20% of women who resorted to this type of treatment 20 years ago, according to data from the Spanish Association for the Study of Menopause (AEEM). This means, according to this same association, that one in five women over 50 has a worse quality of life today than two decades ago. How is it possible?

Doctor Amparo Santamaría, head of the Hematology Service of the Ribera health group, assures that women at this stage of life are “the great forgotten”. And that’s why he highlights the importance of the consensus document presented a year ago Eligibility criteria for use of menopausal hormone therapy (HMT) in women with medical conditions. It is a detailed analysis of 50 multidisciplinary specialists belonging to 21 Spanish and international scientific societies on the benefits and risks of these therapies. In other words, the aim is to establish with objective criteria when and why it is necessary to prescribe these hormone replacement treatments.

“We know that menopause is the cause, in some cases, of osteoporotic fractures, increased cardiovascular risk and stroke, cognitive impairment and other pathologies, and these problems could be prevented and treated with these treatments,” he points out.

What is hormone replacement therapy?

It is a treatment with estrogen or derivatives. It must always be guided by a healthcare professional. The administration can be orally, through transdermal patches, subcutaneous implants, ointments and even intranasally. The most common are the transdermal with patches or the oral route.

Some profiles for hormone replacement therapy

This document talks about:

  • women with early menopause
  • to reduce the impact of suffocation, night sweats etc
  • women genitourinary symptoms resulting from vaginal or vulvar atrophy, such as burning, stinging, itching or discomfort with sexual activity
  • women with symptoms linked to the vasomotor symptoms of menopause (waking at night, insomnia or poor quality of sleep), which in turn have an impact on lack of concentration, irritability, decreased self-esteem and mood swings.

Positive effects studied in specific cases

  • Some studies have shown the beneficial effect in reducing the risk of colon cancer. Users of menopausal hormone therapy at the onset of menopause were 36% less likely to develop this type of tumor in the following 10 years compared to those who had never used this therapy.
  • It has also been studied and shown to have a positive effect on the prevention of cognitive impairment

For Dr. Santamaría, it is very important “to publicize these problems and for women who suffer from these problems in menopause to stop being invisible and receive the treatment they need to have a good quality of life”. “There’s no need to be afraid of hormone replacement treatment if it’s prescribed by a specialist, because it can substantially improve our lives and reduce menopause problems,” he adds.

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