Menopause and hormone replacement therapy

Dr. Anne Kervasdoué, gynecologist and author, brings you simple answers to any questions you may have about menopause and hormone replacement therapy.
Menopause
You age and the feeling of unbearable heat makes you think that maybe menopause sets. What then are the manifestations of menopause? If menopause is final after a year without rules, the installation is done gradually over a period called perimenopause.

Menopause, what is it?
Menopause is the cessation of ovarian function, or the end of the sex hormones, estrogen and progesterone. The absence of these hormones will cause many disturbances in the longer term in women. Many women wonder how to overcome the hot flashes, the most common cause significant disruption. However, this period will also be accompanied by mood disorders and sleep disorders, anxiety and irritability. In the short term, menopause can have a negative impact on sexuality. It combines a low libido to a decrease in vaginal discharge and vulvar atrophy. Atrophy of the vulva is often the scene of vulvar lichen sclerosus, very common disease in postmenopausal women.

The consequences of menopause
While the average age of menopause is around 50 years, the life expectancy of a woman over 80 years. A woman is going to live another 30 years after the cessation of menstruation. In the long run, menopause important physiological effects on the health of the woman. The lack of hormones appears to promote heart disease and causes the acceleration of osteoporosis (bone loss). The post-menopausal osteoporosis significantly increases the risk of bone fracture. Hormone replacement therapy for menopause can be put in place to counteract the effects of this hormone decline.

The hormone replacement therapy (HRT)
The treatment is based on the use of estrogen with or without progestin. All women can benefit from this treatment. It can be recommended to women with early menopause (before age 40), those with hot flashes as well as women at risk for osteoporosis.

When should it start? Can we take this treatment for years after the menopause or should we start at the first signs?

Every woman is different, the choice of treatment is done in consultation with a doctor. Indeed, HRT is no consensus in the medical community. His prescription is going to be in office of the benefits and risks. Studies have shown a correlation between HRT and increased risk of breast cancer and arterial risk. Since then, the recommendations are to inform women. To them belongs the choice of this treatment or not.

The treatment is known to reduce the risk of bone loss and thus fracture. It also improves the quality of life and sexuality. However, due to the action of hormones, HRT is cons-indicated in women with cardiovascular risk and cancer (breast, ovary, endometrium).

Read:
The happiness of women: the truth about hormones,
Dr. Anne Kervasdoué
Editions Odile Jacob.

The recommendations of the AFSSAPS
HRT is indicated in postmenopausal women with functional disorders and menopause affect quality of life. It should be prescribed at the lowest effective dose for the shortest time possible, in accordance with the precautions and cons-indications. All women treated with HRT should receive regular re-evaluation of treatment, at least once a year.