Hormone replacement therapy: what it is and who needs it. Hormone replacement therapy for menopause - all the pros and cons Is it possible to do HRT for women 65 years old?

Thank you

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

general information

Hormones are active substances that are involved in all physiological processes. They are produced by glands internal secretion and coordinate various processes: growth, reproduction, metabolism, and so on.

Hormone therapy in children

This type of treatment requires special qualifications from doctors, since the use of even the “lightest” hormonal agent necessarily reduces the activity of the gland that secretes it. At the same time, you need to understand that ultimately endocrine glands develop only by the age of twenty-five. Therefore, inept use of hormones can disrupt the natural process of formation of the endocrine system.

Children are prescribed hormonal drugs only by special occasions and those that are quickly destroyed in the body ( prednisolone, hydrocortisone). It is better to give medicine containing hormones to your baby during ( or before) breakfast.
Children are very carefully prescribed insulin medications. The presence of glucose in the urine does not necessarily indicate diabetes. There are many diseases that are similar in their manifestations to diabetes, but not all of them are associated with a lack of insulin. Usually, when treating such diseases, hospitals do not use hormonal drugs.

After infectious diseases and if the functioning of the endocrine glands is disrupted, in some cases children are prescribed anabolic steroids, but they should absolutely not be used for illnesses of an infectious-allergic nature ( for example, collagenosis, glomerulonephritis).
Any hormonal drugs can be given to babies only after consulting an endocrinologist and in strict accordance with the prescribed dosage.
During the course of treatment, you need to carefully monitor the baby’s condition, his body weight, work digestive system.
If prednisolone is prescribed, you need to periodically check the amount of calcium and sugar in the blood, make sure that the child does not increase hairline on the body, the pressure did not rise, and signs of decreased adrenal function did not appear.

Replacement therapy for menopause

During menopause, a woman’s body produces not only less of the female sex hormone - estrogen, but also its weaker form - estrone. Thanks to the introduction of replacement therapy, the level of female sex hormone in the body is normalized, which has a beneficial effect on the condition of the body.

Pros:

• The work of the brain is activated,
• Sleep is normalized
• Blood pressure normalizes,
• Heart rate normalizes
• Collagen fibers are strengthened in blood vessels, cartilage, skin,
• Atherosclerosis is prevented ( the amount of lipoproteins increases high density– good cholesterol),
• The likelihood of a heart attack and heart attacks is reduced, the likelihood of death from coronary diseases is reduced by half,
• Reduces the risk of stroke by 50%,
• The likelihood of fractures due to osteoporosis is reduced by 50%,
• Symptoms of menopause such as vaginal dryness, vulvar itching, atrophy of the vaginal mucosa, difficulty urinating,
• Regulates the functioning of the thyroid gland,
• Body weight does not increase under the influence of testosterones.

Contraindications:

• Severe forms of diabetes mellitus,
• Liver dysfunction,
• Unexplained vaginal bleeding.

A large selection of drugs for replacement therapy, as well as modern diagnostic methods, make it possible to select an individual course of treatment for each representative of the fair sex. These drugs contain very few hormones, which reduces the likelihood of side effects.

Before prescribing medications, the doctor will order an examination to identify general diseases, the course of which may worsen when taking hormones. You will need to go to a gynecologist and have ultrasound examination pelvic organs, take an oncocytology test, examine the condition of the breast, check blood pressure, body weight, donate blood for cholesterol and a general analysis, for sugar, as well as a urine test.
During the course of replacement therapy, you need to undergo annual examinations with a doctor and ultrasound monitoring.

Replacement therapy in gynecology

Indications:

• Menopause,
• Previous ovarian failure
• Hypogonadotropic amenorrhea,
• Gonadal dysgenesis,
• Normalization of the endometrium after surgery or during chronic form endometritis,
• Medical menopause.

When treating women with infertility, hormone therapy is prescribed during stimulation of ovulation, during in vitro fertilization, and when using donor oocytes.

Steroid hormones are used in treatment because they affect many internal organs. Their lack negatively affects the condition of fatty tissue, liver, dermis, bones, digestive system, reproductive organs, blood vessels, and brain.

Hormonal drugs of the latest generations, almost one to one, imitate natural ones, their concentration in the blood. The treatment uses small dosages of sex hormones that do not disrupt ovulation and do not have a contraceptive effect.
The use of hormones in the treatment of infertility comes down to the fact that when there is a natural lack of hormones in the patient’s body, with the help of their artificial analogues, conditions are created that are as close to normal as possible. Thanks to this, fertilization and gestation of the fetus takes place. When prescribing drug dosages, one of the most important indicators is the condition of the endometrium.

For amenorrhea and early menopause, hormonal medications are taken in cycles. Treatment continues until the age of normal menopause. If a woman wants children, hormone intake is not interrupted, as it helps normalize the condition of the endometrium.

Tumors are divided into three groups:

• Hormone active,
• Hormone-dependent
• Hormone dependent.

Hormone-dependent are called neoplasms that appear as a result of disruption of the endocrine system. One such tumor is breast cancer, which develops when the function of the ovaries or thyroid gland is impaired.
The appearance of such a tumor does not in all cases indicate the advisability of hormonal treatment.

Hormone active - These are tumors that secrete hormones. Such neoplasms have a double destructive effect on the body. These include cancer of the adrenal gland or pituitary gland, pancreas, and thyroid gland. They may also appear on other organs, including healthy condition do not produce hormones ( for example, intestines or lungs).

Hormone dependent – these are neoplasms, the existence of which is impossible without the presence of certain hormones. A change in the hormonal background of the body, stopping the production of a hormone necessary for a tumor, leads to inhibition of tumor development. This category includes some tumors of the breast, testicles, ovaries, prostate, kidneys, thyroid gland, and uterus. Hormone therapy is needed to treat such tumors.

Hormone therapy is usually used for metastasis ( occurrence of secondary tumors). The effect depends on how sensitive the tumor is to hormones. Sometimes this method is prescribed for early stages in combination with other methods.
The most significant results have been achieved in the treatment of breast and prostate cancer with hormones.

Therapy for breast cancer

The female sex hormone estrogen in many cases activates the appearance of malignant breast tumors. Estrogens interact with proteins in upper layers neoplasms and accelerate the division of malignant cells.

The use of hormones for breast cancer leads to:

• Reducing the amount of estrogen produced by the ovaries,
• Inhibition of the activity of mammary gland receptors for progesterone and estrogen,
• Reducing the production of estrogen by the adrenal glands,
• Inhibiting the activity of the hormone itself by increasing the level of male sex hormones.

Hormonal treatment is often combined with chemotherapy. It is easier to tolerate and has less impact on the functioning of the body as a whole.
If the tumor is sensitive to this species therapy, it can eliminate itself completely along with metastases. Often, thanks to this type of treatment, patients live several decades longer.

Therapy after spay removal

After removal of the ovaries, young patients begin to experience sensations that are observed in menopausal women. Already after 15–20 days, symptoms of malaise appear, which begin to seriously annoy 8–12 weeks after surgery. This is due to the fact that the remaining estrogen is gradually removed from the body and early menopause develops.
The woman begins to experience fever, increased work of the sweat glands, tachycardia, her blood pressure and mood are unstable, she often has a headache, bad dream and no interest in the opposite sex.
After some time, these unpleasant signs will disappear, but other, more dangerous ones will take their place: dysfunction of blood vessels, urinary organs, and external genitalia.

Some hormones are produced by the adrenal glands. However, their work is not enough. Therefore, women are prescribed hormone replacement therapy. You can take hormonal medications for the rest of your life, which will prevent the development of early menopause and allow a woman to feel good for a long time.
If the ovaries were removed for a malignant tumor, hormonal treatment is usually prohibited. Then homeopathic remedies are prescribed instead.

For psoriatic arthritis

IN severe cases For joint lesions with psoriasis, the following drugs containing glucocorticoids are prescribed:

• Kenalog ,
• Flosteron ,
• Diprospan ,
• Hydrocortisone ,
• Metipred .

Positive effect of treatment:
The patient's condition improves quite quickly: pain in the affected joints is relieved, their mobility increases, fever and lethargy disappear.

Negative effect of treatment:

• The immune system is suppressed, which provokes ulcers on the body,
• The drugs are addictive
• Side effects: hypertension, obesity, diabetes, edema,
• The drugs must not be used continuously and for a long time,
• May contribute to the development of stomach ulcers,
• The drug should not be discontinued immediately, as the patient’s condition will sharply worsen.

Anti acne

Hormonal treatment can sometimes help those who suffer from acne on the face and body. The use of hormonal drugs reduces the production of sebum by the skin glands, so the skin actually clears up.
But many people notice that after stopping taking the drug, acne appears again. In order for the effect to last, hormones should be combined with skin treatment with special antibacterial agents. Products should be selected based on natural ingredients and do not contain antibiotics or chemicals.

Side effects observed when taking hormonal drugs to clear the skin of acne:

• Headache,
• Increase in body weight,
• Depressed mood
• Edema,
• Individual intolerance to the drug.

You should not experiment with medications on your own. It is better to get advice from doctors: a dermatologist and an endocrinologist.

Transsexuals and hormone therapy

To suppress testosterone production and give the body feminine traits estrogen preparations are used. In addition, progestogens are used, under the influence of which the mammary glands enlarge.
Antiandrogens suppress the production of male sex hormones. The use of these hormones makes it possible to reduce the dosage of estrogen drugs and reduce the sensitivity of internal organs to the action of testosterone.
Testosterone medications are taken to suppress the production of estrogen.

Hormonal therapy for gender reassignment is divided into two phases:
1. The first months of treatment ( six months) hormonal drugs are taken in large dosages, which allows you to achieve the desired result in a shorter time. Once the desired result is obtained or if the maximum dosage of hormonal drugs is taken, the doses should be slowly reduced. 20–30 days before surgery, hormonal medications should be completely discontinued to reduce the likelihood of developing blood clots. This phase of treatment suppresses the functioning of the sex glands and helps the appearance of signs of the desired sex. Treatment also helps prevent severe complication operations - post-castration syndrome, characterized by lethargy, weakness and craving for sleep.

2. The second phase begins after surgery. After removal of the testes, antiandrogens are stopped. After removal of the uterus and ovaries, the dosage of drugs to suppress the production of female sex hormones is reduced. However, in order to hormonal background corresponds to the chosen gender, therapy is carried out throughout life.

Taking hormonal therapy allows you to change the appearance of a transsexual to the desired gender type.
Most often, hormones are taken orally in tablet form. But there are drugs in the form of patches, gels, and liquid injections.
Since the use of hormonal therapy increases blood thickness, as side effect Thrombosis, stroke, or heart attack may develop. The likelihood of developing heart and vascular diseases and cancer increases mammary gland, osteoporosis and Alzheimer's disease.
To minimize the likelihood of developing side effects, you need to give up nicotine, balance your menu, lead a healthy lifestyle and carry out general diagnostics from time to time. Under no circumstances should you discontinue or prescribe hormonal medications on your own.

It should be understood that the effect of taking hormonal drugs occurs gradually and quite slowly. Only 24 months after the start of treatment can the maximum result be achieved.
The effect of drugs may be stronger or less depending on age and genetic characteristics. The strongest effect is observed in individuals aged 18 to 21 years. But if the patient is over 30 years old, the magic will not happen.

But there are indicators that even hormones cannot influence.
This:

• Facial hair growth. The hair will not be as coarse, but it will not disappear completely,
• The breasts may increase quite a bit,
• Shoulder width, height and size of legs and arms will not change,
• The voice will not change either.

Consequences of therapy in men

Hormone therapy with female sex hormones causes:

• Reduced attraction to the opposite sex,
• Flushing in the cheeks and upper body,
• Osteoporosis and bone fractures,
• Enlargement and tension of the mammary glands,
• Decrease in the level of red blood cells in the blood,
• Decreased memory function
• Decline muscle mass, increase in body weight due to fat,
• Lethargy and fatigue
• An increase in the amount of cholesterol in the blood,
• Depressed mood.

In men taking similar treatment, the risk of diabetes, hypertension, and heart disease increases.
Before use, you should consult a specialist.

Menopause is a rather serious test for a woman. Very simply, the problem can be described as follows: hormonal imbalance is accompanied by a variety of and rather unpleasant symptoms. Hormones have a direct effect on all organs and systems (the body works through neurohumoral regulation). A failure in their coordinated work leads to disturbances and responses in the form of hot flashes, insomnia, weakness, fatigue, etc. (you can read more about symptoms during menopause in the article “”).

A lack of the female sex hormone estrogen causes sudden mood swings and can lead to nervous breakdowns, stress and even severe depression. Additionally, the psycho-emotional state of women at this age is influenced by external signs natural aging processes, decreased sexual desire and attractiveness. It is in order to reduce the severity of symptoms and stabilize hormonal levels that HRT (hormone replacement therapy) is used. Its goal is to replenish the lack of hormones, the level of which gradually decreases during menopause. This solution allows us to successfully solve a number of problems that arise in women.

Unfortunately, many women have prejudices, and they are often afraid or even refuse to take hormones. Their fears are caused for various reasons(negative reviews, possible side effects, etc.). But medicine does not stand still; the new generation is excellent at helping to relieve negative manifestations. Moreover, they no longer have the negative consequences that are usually attributed to them. Accurate information about modern hormone-containing medications for menopause will help women make the right decision and reduce their critical attitude towards drugs of this type.

What hormones does a woman need?

To understand what hormones need to be taken during menopause, let's consider how it proceeds from the point of view of hormonal balance. This period is usually divided into several phases:

• (can last from 5 to 10 years);
• (counting starts one year after the last menstruation);
• (starts 5 years from the last menstruation and ends at 70 - 75 years).

The body reacts most acutely in the first two periods of menopause. Female hormones gradually cease to be produced by the body. Initially, the regressive process begins in the ovaries, this is facilitated by the depletion of the follicular apparatus. Naturally, the body begins to react to the lack of progesterone and estrogen, including compensatory reactions. At this moment, the pituitary gland begins to intensively produce LH and FSH (luteinizing and follicle-stimulating hormones). Against this background, the sensitivity of hormone-dependent receptors, which also play a role in normal operation female reproductive system.

For some time compensatory mechanisms allow the body to cope. But the synthesis of sex hormones continues to decline, strengthening the function of the pituitary gland no longer gives the desired results, and its sensitivity to their hormonal deficiency decreases. At this moment, more obvious and frequent manifestations of the menopause begin: they stop, and the main systems of the body begin to respond to hormonal changes. Symptoms are varied (there are about 30 manifestations of menopause), most often it affects:

• cardiovascular system (hypertension, increased heart rate, increased risk of heart attacks and strokes);
• nervous system: suffers especially severely, migraine pain, psycho-emotional instability, etc.;
• endocrine system: manifests itself as age-related weight gain, often leading to obesity, thyroid disease, diabetes, etc.;
• genitourinary system: in addition to ovarian dysfunction and reduction of the uterus in size, hypotonia of all muscles is observed, which leads to painful sensations during sexual intercourse (this is facilitated by a reduction in the volume of secretion in the vagina), accompanied by a frequent urge to urinate (later incontinence is possible), etc.

This is far from full list symptoms during menopause that cause discomfort to a woman.

The most typical complaints are vasomotor reactions (“hot flashes”, dizziness, etc.) and psycho-emotional reactions. The risk of developing a number of gynecological diseases, especially hormone-dependent ones. Disturbances in normal hormone synthesis increase the risk of cancer. Should we take adequate measures in such a situation? Naturally, the symptoms of menopause, unpleasant in themselves, carry a number of threats and contribute to the development of various pathological conditions. HRT in this situation may be the only way to relieve acute conditions caused by a lack of hormones.

Menopause itself is a natural process, but it occurs differently for each woman. Hormone replacement therapy is not indicated for everyone; it has a number of contraindications. HRT is not used unless necessary, and drugs are selected taking into account the characteristics of each patient after a comprehensive examination. But to refuse because of prejudice at a time when hormones are simply necessary for the female body means risking your own health in the future.

What is hormone replacement therapy and how does it work?

Preserving a woman’s health is the main goal of HRT. The balance of hormones is disrupted due to natural reasons, but the body's response to such changes can take pathological character. Partial compensation for the lack of hormones from the outside is HRT, which relieves the severity of symptoms.

Hormone replacement therapy for menopause can be aimed at restoring the level of hormones from the group of gestagens or estrogens; they can be prescribed in the form of mono- or complex drugs, contain androgens, etc. That is, the variety of modern medications allows you to choose the most effective tactics in each specific case.

The change in hormonal levels occurs gradually; a decrease in the production of one group of hormones during menopause consistently triggers the entire mechanism. As a result, almost the entire body is involved in the process, responding in one way or another to the changes taking place. Each woman’s reactions can proceed in her own way: some calmly experience all periods of menopause, without experiencing any special problems from periodically appearing symptoms. For others, age-related changes in the body occur rapidly and acutely. During menopause, a woman should especially closely monitor her health; this will help her understand in a timely manner when symptoms are becoming alarming and take timely measures.

Does hormone replacement therapy benefit the female body or is it harmful? There is no clear opinion on this matter. Many patients have a negative attitude towards taking hormones themselves, believing that it is easier to survive the unpleasant symptoms of menopause. There is also no clear agreement among doctors on this issue, but Lately HRT is being used increasingly.

The goal of hormone replacement therapy is to help the body cope with the lack of hormones with minimal losses. IN European countries HRT has become standard option medical care, it is currently actively used in domestic medicine. During menopause, HRT is the simplest and most effective way to get rid of the unpleasant symptoms of menopause and restore the balance of hormones at the time of restructuring of the body.

Hormone therapy - all the pros and cons

For women during menopause, hormone replacement therapy is not always prescribed. There are a number of contraindications for which hormones are strictly prohibited. Doctors' recommendations are based on:

• the general condition of the patient’s body;
• severity of symptoms;
• survey results.

This takes into account exactly what hormone the female body needs during a particular period of menopause.

The benefits of using hormonal drugs during menopause are as follows:

• it is possible to compensate for the deficiency of a specific group of hormones;
• the severity of symptoms is relieved, menopause is less painful;
• the body gets the opportunity to rebuild gradually, without sudden changes in hormone levels;
• aging processes slow down;
• taking HRT takes place under medical supervision, which allows you to adjust the course of treatment as necessary;
• drugs are selected individually, taking into account the health status of a particular patient.

Such treatment can cause harm if a woman begins to take hormonal drugs uncontrollably, based on reviews from friends or her own opinion. Prescribing such medications by a specialized specialist is a prerequisite for successful hormone replacement therapy without side effects and negative consequences.

Do I need to take hormones during menopause?

Drinking hormones during any of the menopause periods is a completely modern and effective way to relieve unpleasant symptoms and help the body cope with hormonal stress. But this should be done exclusively on the recommendations of doctors and after a comprehensive examination.

The selection of drugs is carried out only after passing tests that show the level of hormones. Symptoms of menopause can appear as a reaction to all hormonal changes, but it is important to determine which one needs replacement. Sometimes combined medicines.

Hormones during menopause will help correct their balance in the body, relieve acute manifestations, which arise as a response to natural age-related changes. The aging process slows down and is less painful. It should be remembered that one of the typical manifestations of menopause is sharp psycho-emotional reactions. HRT will help correct these symptoms. That is, women usually only benefit from its use, which allows us to talk about the benefits of such treatment.

Dosage regimen

How to take hormonal medications during menopause? Only an experienced specialist can solve this issue based on the results of the examination. At the moment, modern medicine offers two tactics:

• short-term use: for mild menopause, not complicated by acute reactions, therapy can last 1 – 2 years;
• long-term therapy: treatment can be carried out for 2 – 4 years.

It is important to understand that we are talking about a course of taking drugs; with HRT, one drug can be replaced by another. Correction occurs based on the results of tests for hormone levels. The patient needs medical supervision during treatment; this is how the greatest effectiveness can be achieved and any risks can be minimized.

Indications for HRT

Indications for the use of HRT are a number of symptoms that are especially threatening to the female body. These include:

• surgical menopause;
• risk of developing cardiovascular diseases;
• hereditary predisposition to osteoporosis, diabetes mellitus, obesity, hypertension and other pathological conditions.

Hormones should also be taken if menopause causes acute psycho-emotional reactions in order to eliminate the risk of developing neuroses and depressive states.

Contraindications

Menopausal hormone therapy for some pathologies is never prescribed to patients. There are a number of serious diseases that are not compatible with HRT. It is dangerous to prescribe hormones in such cases, so consultation with a specialized specialist and comprehensive examination– a prerequisite for starting HRT.

Contraindications:

• bleeding of unknown etiology;
• estrogen-dependent tumors (benign and malignant);
• oncological diseases;
• some pathologies of the heart and cardiovascular system;
• thrombosis, thromboembolism and bleeding disorders associated with increased thrombus formation;
• spicy and chronic diseases liver, liver and/or kidney failure;
• complicated diabetes mellitus;
• a number of autoimmune diseases;
• individual intolerance to drugs containing hormones.

The use of HRT will be useful and safe only if the medications are selected by a doctor.

Possible side effects

Hormone replacement therapy for menopause can cause a number of side effects, namely:

• fluid retention in the body (edema, pastiness);
• hypo- or hypersecretion of mucus in the vagina, menstrual-like bleeding;
• increased fatigue, weakness, headaches;
• various reactions from the gastrointestinal tract;
• soreness of the mammary glands;
• muscle spasms;
• seborrhea and acne.

These and other reactions can manifest themselves singly or in combination; their occurrence requires contacting a doctor to correct treatment tactics.

Main principles of HRT

Hormones for menopause are prescribed based on the results of the examination. Basic principles modern therapy are:

• the use of hormonal drugs similar to natural ones;
• low dosages;
• the use of combination medications to minimize the risks of endometrial hyperplasia;
• duration of the course that stabilizes hormonal levels.

Choosing HRT drugs: types and forms of drugs

Nowadays, choosing the right therapy is not particularly difficult. In addition to a varied combination of hormones, there is also the opportunity to choose the method of administration:

• tablets, dragees or capsules;
• local application: gels, suppositories, creams, patches;
• injections;
• subcutaneous implants.

Hormonal therapy for surgical menopause

HRT for menopause is prescribed for patients who have undergone surgery to remove the uterus. Method of using hormones for:

• women under 51 years of age with removal of the ovaries and preserved uterus;
• women over 51 years of age after amputation of the uterus and ovaries;
• after surgical removal endometriosis with a risk of relapse.

Dispelling myths about HRT

Menopausal hormone therapy is often a source of controversy and fear. Patients refuse HRT, believing that their use can lead to:

• addiction;
• obesity;
• complications from the gastrointestinal tract;
• risk of cancer;
• long-term negative results.

Many also believe that hormonal drugs are poorly researched and contain a large number of synthetic analogues of natural hormones. Modern HRT is a new generation of drugs that contain a minimal amount of hormones, natural and completely identical to female ones. They need and can be taken, since most symptoms are signs of natural processes during menopause. HRT does not enhance, but slows down their development. Medicines undergo preclinical and clinical trials. And the lack of data on long-term results in domestic medicine is compensated by studies abroad, where HRT has been actively used for several decades.

List of HRT drugs

The principles of hormone replacement therapy for menopause make it possible to select the most effective course of treatment for each patient. After 40 years, a woman should prepare for the upcoming restructuring of her body. In this moment regular examination becomes an important and mandatory condition for maintaining the normal functioning of the body. HRT helps restore hormone levels that will inevitably drop. Even with normal menstruation It is important to know the concentration of hormones, which will help in a timely manner to use medications effective for menopause.

As the synthesis function fades, the main symptoms of menopause increase. After consultation and examination, a drug is prescribed that will help correct hormonal imbalance at the moment. It can be:

• . As the name of this group implies, it contains natural analogues of estrogens. These include: Klimadinon, Femicaps, . Each of them is available in tablet form and is taken as a course;
• Bioidentical hormones. The combined medications Janine and Femoston in tablets also help relieve symptoms of menopause. as a derivative of progesterone, it is prescribed for its deficiency and to neutralize the effect of estrogen;
• Estrogen-containing. Any hormonal product of this type contains synthetic estrogen. The most commonly used are Klimonorm, Premarin, Ovestin;
• The androgenic effect for the prevention and treatment of osteoporosis is provided by Norkolut, Livial, Tibolon;
• Modern drugs with anti-androgenic effect are represented by Androcur, Klimen, Diane-35;
• The best combination products are Triaklim, .

List effective means is not limited to this list, there are also Klimara and Dermestil patches, hormonal gel Divigel, Ovestin suppositories, etc. An alternative form of release (gels, patches or suppositories) are used if topical application is necessary.

Non-hormonal agents

Non-hormonal drugs for menopause as an alternative to HRT, are prescribed in case of individual intolerance or inability to use hormonal drugs. According to modern classification, this group includes natural phytoestrogens. They are available in the form of homeopathic remedies and. In addition to the remedies listed above, to replace missing hormones during menopause, use:

• gels Bonisan, Klimakt Hel;
• tea or drops with red brush;
• tablets CI-klim, Estrovel;
• capsules, Menopace, etc.

How long to take hormones

Hormones should be taken under supervision and as prescribed by a doctor, even if we are talking about dietary supplements, herbal medicines or homeopathic remedies. There are several dosage regimens designed for several years:

• monotherapy;
• two- and three-phase course;
• combined.

Each medicine has its own timing of administration; some drugs can be replaced by others, which is necessary when the symptoms of menopause change.

Failure in the production of androgens leads to serious complications V male body, that is why hormone replacement therapy for men can be a salvation for them. But for many, this issue is considered controversial, because the artificial administration of hormones can be dangerous. To hormone therapy for men was not so frightening, you need to understand it in detail.

Hormone deficiency: causes and when treatment is necessary

Hormone therapy for men after 40 years is practically natural process, but sometimes younger people may need such treatment. Aging is not always the cause of a decrease in testosterone production by the endocrine glands. Any injury to the testis can lead to such deficiency. This is facilitated by oncological pathologies and/or a number of genetic diseases. No less dangerous is an excess of iron in the body, which will suppress testosterone. Improper functioning of the pituitary gland, a number of medications, chronic diseases, including alcoholism and smoking inhibit the production of vital androgens.

Important! If there are symptoms of androgen deficiency, men under 40 years of age should undergo appropriate testing, and after 40, do so regularly, even if clinical picture There is no lack of testosterone.

Hormone replacement therapy for men can be prescribed only after diagnosing the amount of hormones in their blood. This analysis is truthful and accurate. When will he confirm androgen deficiency and the absence of cancer in prostate gland, treatment will be prescribed to increase their level. It is necessary to exclude oncology because often androgen deficiency is the beginning of the development of carcinoma. And if testosterone therapy is carried out, the patient may become worse.

The following signs of testosterone deficiency in the body should be alarm bells for men:

• sexual desire is reduced or completely absent;
• frequent manifestations of loss of strength;
• depression;
• decreased growth;
• aggression and irritability that was not there before;
• erection problems;
• gaining excess weight;
• constant desire to sleep after lunch;
• enlargement of the mammary glands;
• osteoporosis and anemia;
• cholesterol plaques.

Any of the symptoms is dangerous, but if 3 or more are found, then a trip to the doctor should become a mandatory part of the man’s plan for tomorrow. Often, such therapy is resorted to when it is diagnosed:

1. Primary and secondary hypogonadal state.
2. Cryptorchidism.
3. Decreased erectile function and libido.
4. Androgen deficiency associated with age-related changes.
5. Gynecomastia.
6. Obesity that cannot be cured with traditional methods.

Testosterone therapy: a brief historical excursion

Testosterone therapy in men was carried out at the dawn of the last century. But its positive results were confirmed only 40 years later. Moreover, the side effects of such therapy were much worse than it positive effect. Synthetic testosterone of those times had only tablet form. After taking them, androgen metabolism occurred in the liver, where the main part of it was destroyed. This led to severe exposure of the liver to carcinogens and toxins. The organ was irreversibly destroyed, which became the reason for the ban on such treatment in many countries. But with the advent of analogues of the drug, but without such terrible side effects, this ban was lifted. Often these drugs are used by athletes, which is prohibited by a number of prestigious competitions, and this is what causes public scandals and showdowns.

Introduction of androgens into the male body: methods

Nowadays, there are the following forms of introducing androgens into the male body:

Oral

Where a tablet or capsule with the active substance is used. The tablet form is the very first form in the treatment of testosterone deficiency. Many people appreciate it for its ease of use and relatively low price when compared with other methods of androgen administration. It is the tablet form of testosterone that is most often counterfeited or produced in clandestine factories, which leads to serious problems with health. Frequently used licensed drugs:

• Andriol 150–200 mg every day;
• Striant 30 mg three times a day;
• Proviron or Vistimon 30–80 mg every day.

In injection

Doctors believe that thanks to it, testosterone enters the body naturally and smoothly. There are two types of testosterone most commonly used: enanthate and cypionate. Literally 100 mg of these drugs provide a week's supply of androgen in a man. This number varies from person to person, so some will need a higher dosage, while others will need a lower one. Anything above 200 mg of replacement therapy, becomes a bodybuilder's steroid cycle. Typically, the weekly dosage is divided into 2 equal parts and administered at equal intervals, which allows maintaining a stable level of the hormone in the blood. The injections are given subcutaneously, not intravenously. Commonly used injections:

• Delasteril 200–400 mg once a month, divided into equal doses;
• Nebido 1000 mg once every 90 days;
• Sustanol 250 mg once every 7–14 days.

Transdermal

Available in patches, gels and creams. Gels and creams make the flow of testosterone into the body smooth and gradual. However, doctors say that this form of administration is less effective. Difficulties may also arise with application, because the skin must be clean (preferably immediately after swimming), and it is forbidden to exercise or swim for some time after this, so as not to sweat. Others, especially children and women, should not touch the lubricated area of ​​skin, since androgen is dangerous for them. To be effective, the skin needs to be lubricated at least 2-3 times a day, which significantly complicates the usual routine of life. The cream and gel are applied without rubbing. The drug most often used in Russia is Androgel, because it is sold in pharmacies without a prescription and requires from 25 to 100 mg every day. Other transdermal agents:

• Androderm and Testoderm patches should be applied every day at a maximum dosage of 7.5 mg;
• Andromene cream is used daily at 15 mg;
• Andractim gel, its dosage is determined individually.

Subcutaneous

Where is an implant used for these purposes? Few people decide to have an implant, and doctors do not consider it advisable. But in some cases, especially with secondary hypogonadism, this cannot be avoided. More often hormone replacement therapy for men over 50 years of age, and the drugs to solve it are a testosterone implant at a dosage of 1200 mg, which is placed for six months.

Androgen administration: what to choose?

Tablets are recommended to be used if the level of deviation androgens insignificant from the norm. In case of serious pathologies, even a large dose of the drug will be ineffective. It is recommended to give preference to Andriol, since with it the main metabolism of testosterone takes place outside the liver, thereby not affecting it in any way. The drug penetrates the bloodstream as quickly as possible and raises androgens to the proper level. But because of this, it also leaves the body quickly, which makes it necessary to take it 3-4 times a day.

A man has been diagnosed with low testosterone. Replacement therapy should not only raise its level, but also not cause harm to the body. Therefore, many doctors prefer to use the injection method of administering the medicine. Testosterone ester, like Omnadren or Sustanol, when it enters the circulatory system will reach its maximum concentration on the second day. Over the course of a couple of weeks, its level will gradually decrease, reaching a minimum.

A man will feel an incredible increase in both his well-being and mood, as well as sexual desire. But the lower the concentration testosterone in the blood, the worse the condition, so by the end of the injection period there will be a decline. It is precisely because of such declines that patients do not want to use this form of androgen administration. However, their availability and low cost, with excellent effectiveness, often tip the scales of choosing a product in their favor.

With the release of the drug Nebido on the market, it was possible to avoid frequent surges, since it is an injection with a prolonged action. One dose of the product is enough for 3-4 months, which means the decrease will be gradual and without an acute change in sensations. It has been clinically proven that this medicine does not cause hepatotoxic and hepatocarcinogenic effects in the body.

More and more men are choosing to use testosterone patches or gels. With them, hormones in the blood quickly reach the required level, and the liver is not exposed to them harmful effects. There is no need to change them several times a day, and you can also adapt them yourself. Side effects are not pronounced, but the price is higher than average. It is impossible to place an implant in our country, because certification for none of them has not been completed.

When is replacement therapy prohibited?

Doctors share contraindications hormone therapy for men into absolute and relative.

The first include:

1. Oncological neoplasm in the prostate gland, because hello to its growth.
2. An oncological tumor in the mammary gland, which is rare in men, but hormonal treatment will also provoke tumor growth.

Relative contraindications:

• snore;
• gynecomastia;
• polycythemia;
• problems with removing fluid from the body;
• swelling;
• enlarged prostate size;
• failure in spermogenesis.

By relative contraindications the doctor will determine the degree of deterioration of the patient’s condition based on the effectiveness of hormone treatment. Usually these conditions can be moderated if they are treated comprehensively.

Complications

Not worth it hormone therapy treat it negligently, because if the dosage indicated for the patient is exceeded, side effects will not be long in coming. The physiological parameters of the whole organism will be disrupted, which will lead to:

• the body's inability to produce androgens on its own;
• swelling and delayed fluid excretion;
• covering the skin with acne and seborrhea;
• baldness and hair loss throughout the body;
• testicular atrophy;
• inhibition of sperm production.

Problems with excessive androgen level most often occur with young people who are passionate about sports and the physical ideality of the body. They are the ones who abuse testosterone-containing drugs, which negatively affects their health. This is not a joke, and the selection of such a remedy should only be carried out by a doctor and strictly for medical reasons.

New generation HRT drugs for menopause should be used only under medical supervision. All disorders at this time are caused by a lack of female sex hormones. HRT is the main mechanism for the appearance pain. During hormone therapy, it is necessary to strive for a minimum dose of medications that provide the amount of estrogen and make you feel better.

Features of treatment

Complex of HRT drugs latest generation during menopause, it helps relieve a woman from 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 diagnosis, the gynecologist evaluates the condition of the mammary glands, the structural features of the uterus and genital organs.

When menopause occurs, the dosage of medications is reduced. But their use continues under the supervision of a doctor. The gynecologist chooses which drugs can replace hormones for the patient’s condition on an individual basis. Today, pharmacies offer various hormonal drugs for the treatment of menopause. This makes it possible to make the optimal choice for any patient. If a woman’s uterus has not been removed, then the gynecologist prescribes a product of the latest generation, which contains a minimum amount of progestogens and estrogens.

During menopause, the patient may be prescribed several treatment options:

• 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 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 latest drugs Hormone replacement therapy for menopause helps reduce nervous excitement, hot flashes, restores mucous membranes, and relieves pain.

Medications

If a woman has had her uterus removed, cyclic or continuous estrogen monotherapy is prescribed. New generation hormonal HRT preparations for menopause include a patch and gel with estradiol (Estrogel, Divigel). The skin in the abdomen or buttocks area is treated with gel every day. If a patch is used, it must be applied to the skin once a week.

If a woman has uterine dysfunctional bleeding or uterine fibroids, then hormone replacement therapy for menopause with the help of gestagens is recommended. As a rule, the Mirena intrauterine system is used, which is presented in the form of a spiral.

A woman may be prescribed new hormonal drugs such as Provera, Utrozhistan, Duphaston. If the patient has a uterus and there are no diseases of this organ, then treatment is carried out with combined medications in a constant or cyclic mode (Divina, Fimoston, Klimonorm, Angelique).

All listed medications should be taken only as prescribed by a doctor. Moreover, the following side effects may occur:

• sudden change in mood;
• weight gain;
• pain in mammary glands and stomach;
• nausea;
• headache;
• diarrhea;
• vomit;
• weakened libido;
• swelling;
• breast enlargement;
• hives;
• skin rashes.

In rare cases, there is an increase in libido, speed dial weight, vaginal and mammary discharge, erythema. When these symptoms appear, you will need to consult a gynecologist. If there are certain indications, the specialist cancels the drug, changes the dose or regimen.

Since during menopause a woman’s body produces insufficient estrogen, but at the same time there is an excessive amount of progesterone, taking hormonal drugs helps normalize general state women. Using HRT, you can eliminate the following symptoms of menopause:

• enlarged arterial pressure- systematic disorder of the nervous system, during which mood swings are noted;
• dry mucous membranes - the total content of sex hormones in the blood decreases, this negatively affects reproduction and urination, the mucous membranes become thinner, which provokes a burning sensation in the vagina;
• hot flashes - an increase in temperature, which is accompanied by anxiety, rapid heartbeat, and increased sweating.

Hot flashes are a pronounced symptom of menopause, which is caused by a violation of the hypothalamus in a woman’s body’s thermoregulation. The doctor may prescribe one or a combination of medications to the patient. These drugs are manufactured under various brand names. Means for HRT are divided into groups that differ in the method of application:

• suppositories;
• injections;
• pills.

The method of drug administration is selected separately in each specific case. As a rule, tablets are used.

This drug belongs to the anti-menopausal group. This product contains two active ingredients - gestagen and estrogen, their effect is aimed at getting rid of menopausal symptoms and preventing the development of malignant tumors of hyperplasia and endometrium.

The unique composition of the drug and adherence to the regimen of use make it possible to normalize the monthly cycle in patients who have not undergone a hysterectomy procedure.

Located active substance estradiol replaces in female body lack of natural estrogen during menopause. This helps eliminate psychological and vegetative diseases that occur during menopause due to decreased sexual activity and a decrease in the amount of testosterone. With proper use of the medicine, you can reduce the appearance of deep wrinkles and increase the amount of collagen in the epidermal tissues. In addition, the product reduces the risk of developing gastrointestinal diseases and the amount of cholesterol in the blood.

During an unfinished menstrual cycle or rare periods bleeding Treatment should be carried out from the 5th day after the start of the critical days. During the onset of amenorrhea at the beginning of menopause, therapy can be performed at any time, provided that the woman is not pregnant.

One pack of medicine is designed for a three-week course of therapy. To achieve the desired effect, you need to take the drug taking into account the prescribed treatment. When using increased dosages of the drug, side effects may occur, which are manifested by bleeding not associated with menstruation, vomiting and disruption of the gastrointestinal tract. You can get rid of the unpleasant symptoms of an overdose with systematic therapy.

If the patient has no contraindications, then hormone replacement therapy during postmenopause involves the use of this combined two-phase drug. The two active ingredients that are part of this medicine - progesterone and estradiol - have the same effect on a woman’s body as natural hormones.

Together, the active elements help:

1. Prevention of osteoporosis, malignant neoplasms in the area of ​​hyperplasia and the uterus.
2. Getting rid of psycho-emotional disorders.
3. Relief of vegetative symptoms.

Femoston in tablet form should be taken daily at the same time interval. Treatment must be carried out taking into account the developed scheme. In the first 14 days, it is recommended to take hormones in white tablets. For the next 14 days of therapy, gray tablets must be used.

For patients with a predominant monthly cycle, therapy should occur from the first day of menstruation. For women who experience problems with monthly cycle, first a course of treatment is prescribed with Progestagen, after using Femoston, taking into account the required regimen. For patients with complete absence Menstrual medicine can be used at any time.

To achieve the desired effect, female hormones must be taken, strictly following the prescribed treatment, this is the only way to delay old age and improve overall well-being.

Herbal medicine Klimadinon

This product contains phytohormones. It is used to eliminate menopausal symptoms and treat vegetative-vascular diseases if there are obvious contraindications and the use of hormones during menopause is prohibited.

The duration of the course and treatment regimen are developed taking into account personal characteristics female body.

Angelique during menopause

Angelique, like the drug Klimonorm, are medications for menopause that can improve your well-being and get rid of unpleasant symptoms.

Angeliq is used for:

1. Getting rid of unpleasant symptoms of hot flashes and reducing the frequency of their occurrence.
2. Restoring general well-being.
3. Increasing the amount of testosterone and, accordingly, restoring sexual activity.
4. Prevention of the development of osteoporosis.

However, there are also contraindications. Do not use this drug if you have the following factors:

1. Vein thrombosis, high blood pressure, diabetes.
2. Malignant neoplasms in the mammary glands.
3. Bleeding from the vagina of unknown origin.

The product contains all the hormones required during menopause, which are an ideal solution for normalizing hormonal balance or improving well-being, especially for patients over 50 years of age.

This hormonal drug contains the active ingredient estradiol in a dosage of 3.8 mg. The patch is glued to a specific place skin, then the release of the active element and a general improvement in well-being begins. One patch should not be used for more than a week. It just needs to be replaced with a new one, making sure to change the fixation area.

Under the influence of this drug, the amount of testosterone in the body increases, which has a beneficial effect on improving libido and psycho-emotional state. There are no special contraindications for use, however, it is recommended to consult a doctor before using it.

HRT involves the use of tablets that consist of phytoestrogens. Hormones plant origin are required if the patient has contraindications to use hormonal drugs. Medicines in this group contain phytohormones that actively eliminate the symptoms of menopause. Moreover, no side effects are noted.

Natural remedies included in HRT include:

1. Remens.
2. Qi-Clim.
3. Estrovel.

The list of medications listed above are manufactured in the form of dietary supplements and homeopathic medicines. They are used for about 20 days. Therefore, treatment of HRT with non-hormonal agents lasts longer, in contrast to the use of hormones.

At the same time, it is advised to eat foods that are enriched with fiber. This is the only way it is observed positive result HRT. Phytoestrogens act slowly against the symptoms of menopause, but have a cumulative effect. Therefore, after completion of treatment, the woman is not subject to “withdrawal syndrome.” Moreover, the hormonal level is maintained at the required level. These drugs are used in the dosage prescribed by the gynecologist. Do not increase or change the dose. Otherwise, the general condition will worsen or side effects will appear.

Menopause is absolutely no reason to stop normal life. But you need to give up unhealthy habits as they increase the risk of developing heart disease and osteoporosis during menopause. Women are required to eat normally, move actively and rest. With HRT, in 90% of cases, clinical symptoms decrease or completely disappear.

Does not require treatment, because it is normal physiological process, not pathology. But menopause is a difficult “stage” in the life of every woman, affecting absolutely all areas of a woman’s life. The lack of sex hormones affects health, psycho-emotional state, appearance and self-confidence, sex life, relationships with loved ones and even labor activity, on the quality of life in general. Therefore, any woman during this period requires help both from professional doctors and reliable support and support from her closest relatives.

How to alleviate the condition during menopause?

What can a woman do to ease menopause?

• Do not withdraw into yourself, accept the fact that menopause is not a vice or a shame, this is the norm for all women;
• lead a healthy lifestyle ;
• have a good rest;
• review your diet in favor of plant-based and low-calorie foods;
• move more;
• don't give in negative emotions, receive positivity even from the smallest things;
• take care of your skin;
• follow all the rules intimate hygiene;
• consult a doctor promptly for preventive examination and if there are complaints;
• Follow your doctor’s orders and do not skip taking recommended medications.

What can doctors do?

• Monitor the condition of the body, identify and prevent the development of diseases associated with menopause;
• if necessary, prescribe treatment with sex hormones - hormone replacement therapy;
• Assess symptoms and recommend medications to relieve them.

What can family members do?

• Show patience with a woman’s emotional outbursts;
• do not leave alone with the problems that have piled up;
• the attention and care of loved ones works wonders;
• give positive emotions;
• support with words: “I understand”, “all this is temporary”, “you are so beautiful and attractive”, “we love you”, “we need you” and everything in that mood;
• lighten the household load;
• protect from stress and troubles;
• participate in trips to doctors and other manifestations of care and love.

Treatment of menopause - hormone replacement therapy (HRT)

Modern medicine believes that, despite physiology, menopause must be treated in many women. And the most effective and adequate treatment for hormonal disorders is hormone replacement therapy. That is, the lack of one’s own sex hormones is compensated for with hormonal medications.

Hormone replacement therapy has already been successfully used on a large scale throughout the world. Thus, in European countries, more than half of women entering menopause receive it. And in our country only 1 in 50 women receives such treatment. And all this is not because our medicine lags behind in some way, but because of many prejudices that force women to refuse what is offered hormonal treatment. But many studies have proven that such therapy for menopause is not only effective, but also absolutely safe.
Factors on which the effectiveness and safety of hormonal drugs for the treatment of menopause depend:

• Timely administration and withdrawal of hormones;
• usually use small doses of hormones;
• correctly selected drugs and their doses, under the control of laboratory tests;
• the use of drugs containing natural sex hormones identical to those produced by the ovaries, and not their analogues, only similar in their chemical structure;
• adequate assessment of indications and contraindications;
• taking medications regularly.

Hormone therapy for menopause: pros and cons

Most people are unjustifiably wary of treatment with any hormones; everyone has their own arguments and fears about this. But for many diseases, hormonal treatment is the only way out. The basic principle is that if the body lacks something, it must be replenished by ingestion. So, with a deficiency of vitamins, microelements and other useful substances a person consciously or even at the subconscious level tries to eat food with a high content of missing substances, or takes dosage forms vitamins and microelements. It’s the same with hormones: if the body does not produce its own hormones for any reason, they must be replenished with foreign hormones, because with any hormonal shift, more than one organ and process in the body suffers.

The most common prejudices regarding the treatment of menopause with female hormones:
1. "Menopause is normal, but its treatment is unnatural" , supposedly all our ancestors experienced it - and I will survive it. Until recently, the problems of menopause were a closed and “shameful” topic for women, almost like venereal diseases, so its treatment was out of the question. But women have always suffered during menopause. And we should not forget that women of those times were noticeably different from modern women. The previous generation aged much earlier, and most people took this fact for granted. Nowadays, all ladies strive to look as good and young as possible. Reception female hormones will not only ease the symptoms of menopause, but also prolong youth as appearance, so the internal state of the body.
2. "Hormonal drugs are unnatural." New trends against “synthetics”, for a healthy lifestyle and herbal preparations. So, hormonal drugs taken to treat menopause, although produced by synthesis, are natural, since their chemical structure is absolutely identical to estrogen and progesterone, which are produced by the ovaries of a young woman. At the same time, natural hormones that are extracted from plants and animal blood, although similar to human estrogen, are still poorly absorbed due to differences in structure.
3. “Hormonal treatment always means excess weight.” Menopause often occurs overweight, so that by correcting hormonal levels, weight gain can be avoided. To do this, it is important to take not only estrogens, but also progesterone in a balanced dose. In addition, many studies have proven that sex hormones do not increase the risk of obesity, but vice versa. While plant hormones (phytoestrogens) will not fight excess weight.
4. “After hormonal therapy, addiction develops.” Hormones are not drugs. Sooner or later, a decrease in sex hormones occurs in a woman’s body; she will still have to live without them. And hormonal therapy with sex hormones only slows down and facilitates the onset of menopause, but does not exclude it, that is, menopause will occur in any case.
5. “Hormones will cause hair to grow in unwanted places.” Facial hair grows in many women after menopause, and this is due to a lack of female sex hormones, so taking HRT will prevent and delay this process.
6. "Hormones kill the liver and stomach." Among the side effects of estrogen and progesterone drugs, there are indeed points regarding liver toxicity. But microdoses of hormones used for HRT usually do not affect liver function; problems can arise when taking drugs against the background of liver pathologies. You can bypass the toxic effect on the liver by replacing tablets with gels, ointments and other dosage forms applied to the skin. Irritating action HRT does not apply to the stomach.
7. “Hormonal replacement therapy with sex hormones increases the risk of cancer.” The deficiency of sex hormones itself increases the risk oncological diseases, as well as their excess. Properly selected doses of female sex hormones normalize hormonal levels, thereby reducing this risk. It is very important not to use estrogen-only therapy - progesterone neutralizes many of the negative effects of estrogen. It is also important to stop HRT in time; such therapy after 60 years is really dangerous for the uterus and mammary glands.
8. “If I tolerate menopause well, why do I need HRT?” A logical question, but the main goal of hormonal treatment of menopause is not so much the relief of hot flashes as the prevention of the development of diseases associated with menopause, such as osteoporosis, mental disorders, hypertension and atherosclerosis. It is these pathologies that are more undesirable and dangerous.

There are still some disadvantages to hormonal therapy for menopause. Incorrectly selected, namely high doses of estrogen drugs, can really do harm.

Possible side effects from taking high doses of estrogen:

• development of mastopathy and increased risk of breast cancer;
• painful menstruation and severe premenstrual syndrome, lack of ovulation;
• may contribute to the development of benign tumors of the uterus and appendages;
• fatigue and emotional instability;
• increased risk of developing cholelithiasis;
• uterine bleeding due to the development of uterine hyperplasia;
• increased risk of developing hemorrhagic strokes.

Other possible side effects of HRT not associated with high doses of estrogen:

• bloody vaginal discharge not associated with the menstrual cycle;
• increased gas formation in the intestines (flatulence);
• when using only estrogen preparations without progesterone, or vice versa, excess weight gain is possible.

But correctly prescribed HRT significantly reduces the risk of developing all side effects. Negative action estrogen is neutralized by combining it with progesterone. Therefore, in most cases, hormone replacement therapy is prescribed in the form of these two hormones. Single-drug monotherapy is usually indicated after hysterectomy.

In any case, replacement therapy should be carried out under the supervision of a physician. If an increased risk of developing a particular side effect is detected, the dose, schedule, route of administration of hormones and the advisability of further use of HRT are reviewed.

Indications for hormone replacement therapy (HRT) during menopause

• Any pathological menopause (after removal of the uterus, ovaries, radiation and chemotherapy);
• early menopause before the age of 40-45 years;
• severe menopause;
• the presence of complications and the development of diseases associated with menopause: hypertension, atherosclerosis, osteoporosis, polycystic ovary syndrome, urinary incontinence, severe vaginal dryness, etc.;
• desire to improve the quality of life during menopause.

Menopause medications for hormone replacement therapy (tablets, suppositories, creams, gels, ointments, patches)

Group of drugs	List of drugs	Application Features*
The best combined hormonal drugs of the new generation: Estrogen + Progesterone	Tablets and dragees: Klymen; Klimonorm; Angelique; Climodien; Divina; Pauzogest; Aktivel; Revmelid; Cliogest; Cyclo-Proginova; Ovidon and others.	These drugs are usually found in blisters of 21 tablets or dragees, each of them has its own serial number, according to which they must be taken one at a time. Each of these tablets has its own dose of drugs. Doses are adapted to the natural fluctuations of hormones depending on the phases of the menstrual cycle. After the 21st day, take a break for 7 days, then start a new package. Angelique, Femoston, Pauzogest, Actitvel, Revmelid and Kliogest are available in a package of 28 tablets, some of which are placebo, that is, they do not contain hormones (this is a break). These tablets are taken daily and continuously.
Preparations containing only estrogens	Pills: Estrofem; Estrimax; Premarin; Microfollin; Triaclim; Esterlan.	Menopause replacement therapy drugs containing only estrogens are usually used in cases of hysterectomy. If the uterus is preserved, it is required additional dose progestins, this may be an intrauterine system, cream or patch. Estrogens in tablet form are taken daily without interruption. If menopause has not occurred, then they begin on the 5th day of the menstrual cycle.
	Vaginal suppositories, creams and gels: Ovestin cream; Orniona cream; Ovipol Clio; Colpotrophin; Estriol; Estrocad; Estronorm and others.	Vaginal suppositories, creams and gels containing estrogens are used to treat vaginal atrophy and in the presence of problems with the urinary system associated with menopause. The drugs are administered once a day before bedtime. Start with maximum dose, then gradually decrease. The course of treatment with local estrogens is usually short, on average 1-3 months. When using them, it is necessary to stop taking estrogen in tablet form.
	Gels and ointments for application to the skin: Estrogel; Divigel; Dermestril; Menorest; Octodiol; Plasters: Klimara; Estraderm; Menostar; Estramone; Alora. Subdermal implants with estrogen	Gel Apply daily once a day to the skin of the abdomen, shoulders and lumbar region (where the fat layer is most pronounced) using a special applicator. If the gel is applied correctly, it is completely absorbed into the skin after 2-3 minutes. 1. Intimate hygiene products for menopause are very important not only for eliminating dryness, but also for daily prevention various inflammatory processes vagina. There are also quite a lot of them on the shelves of stores and pharmacies. These are gels, panty liners, wipes. A woman in menopause should wash herself at least twice a day, as well as after sexual intercourse. Basic requirements for intimate hygiene products: the product must contain lactic acid, which is normally found in vaginal mucus and determines the acid-base balance; should not contain alkalis and soap solutions; must include antibacterial and anti-inflammatory components; the gel for washing should not contain preservatives, dyes, or aggressive fragrances; the gel should not cause irritation or itching in a woman; Panty liners should not be colored or scented, should not consist of synthetic materials and should not injure the delicate intimate area. 2. Correct selection of underwear: it should be comfortable, not narrow; consist of natural fabrics; should not shed or stain the skin; must always be clean; It should be washed with laundry soap or fragrance-free powder, after which the laundry should be rinsed well. 3. Prevention sexually transmitted diseases : monogamy, use of condoms and chemical methods of contraception (Pharmatex, etc.). Vitamins for menopause During menopause, changes occur in many systems, organs and processes in a woman’s body. A lack of sex hormones always leads to a slowdown in metabolism. Vitamins and microelements are catalysts for many biochemical processes in the body of every person. That is, they accelerate metabolic processes, also participate in the synthesis of their own sex hormones and increase defenses, alleviate the symptoms of menopause, hot flashes and improve the tolerance of hormonal therapy. Therefore, a woman after 30, and especially after 50 years, simply needs to replenish her reserves with useful substances. Yes, many vitamins and microelements come to us with food, they are the most useful and are better absorbed. But in the menopause this is not enough, so it is necessary to obtain vitamins in other ways - these are medications and biologically active additives(dietary supplements). In most cases, a woman is prescribed