Practical Strategies for Diagnosing and Treating Depression in Women
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Fibromyalgia is a common musculoskeletal pain condition associated with chronic widespread pain, tenderness at various points on the body, fatigue, and sleep abnormalities. Individuals with fibromyalgia often have comorbid anxiety, depression, and/or other pain syndromes. Research into pharmacologic remedies for fibromyalgia has demonstrated efficacy for a variety of agents, but pharmacology is only one piece of the puzzle when it comes to successful management of fibromyalgia. Sensitive and appropriate methods of diagnosis and an integrated treatment plan including proper patient education, aerobic exercise, and cognitive-behavioral therapy have been shown to be effective in alleviating fibromyalgic symptoms.Keywords:
Depression
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Five years after the menopause, we can see the increase in cardiovascular risk due to prolonged deficiency of ovarian hormones. These risks are the same or even more severe than those in men within the same age group. The basic influence of normalizes those disturbances. In 2002. published data from a WHI study show an increase in cardiovascular risk during the first year of hormone replacement therapy with no protective effect. The most recent published data from WHI study show positive effects of hormone replacement therapy, within postmenopausal women younger than 65 years. Those women had significantly reduced calcifications on coronary vessels The American Association of Clinical Endocrinologists and the estrogens can be genomic and non genomic. Estrogens influence endothelia and smooth muscle wall of arterial blood vessels, metabolism of lipoproteins and induce the metabolic syndrome. Hormone replacement therapy partially or completely International Menopause Society proclaim that the hormone replacement therapy can prevent cardiovascular diseases and slow down the progress of atherosclerosis. The aim of ongoing KEEPS is to investigate the preventive effect of the hormone replacement therapy on blood vessels, in early postmenopausal period (women younger than 60 year). This study should be valid enough to define new clinical knowledge about the hormone replacement therapy and cardiovascular risk.
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The author reports on the up to date view of the hormone replacement therapy of women with postmenopausal complaints. The benefits of the hormone replacement therapy in the treatment of vasomotor symptoms and bleeding disorders and in the prevention of cardiovascular disease and postmenopausal osteoporosis are discussed. The connection between hormone replacement therapy, thromboembolism and cancer are reported. In the authors opinion, the hormone replacement therapy must be available for all the most women suffering from climacteric complaints. A strong cooperation between the menopausal care units and GP-s is advisable.
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Hormone replacement therapy can successfully treat menopausal symptoms. A postal questionnaire was used to investigate the knowledge of and attitudes to hormone replacement therapy of an age-stratified, computer-generated, representative sample of 1500 women living in the Grampian region of Scotland. A response rate of 78% was achieved. Comparisons were made between women of differing age, educational background and their current or past experience of hormone replacement therapy. The questionnaire also assessed their knowledge of osteoporosis, including the possible beneficial role of hormone replacement therapy. The results showed that women had a poor knowledge of the potential risks and benefits of oestrogen, lack of knowledge being greatest in the less educated and older women. The majority of women agreed with the view that because the menopause is brought on by diminished hormone levels, it should be viewed as a medical condition and treated as such, and also that a woman who experiences distressing menopausal symptoms should take hormone replacement therapy. Despite this, relatively few postmenopausal women were currently taking hormone replacement therapy (9%) or had taken the treatment in the past (7%), although many had experienced menopausal symptoms for over six months. The most common reason for postmenopausal women never having taken hormone replacement therapy was that they had never considered the treatment (70%) and had not discussed it with a doctor (79%).(ABSTRACT TRUNCATED AT 250 WORDS)
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Many menopausal women use hormone therapy, including regulated body-identical hormone therapy (rBHT), to relieve vasomotor symptoms and prevent cardiovascular disease. Despite growing interest in rBHT, there is uncertainty regarding potential benefits and risks. With this narrative review, we aimed to synthesize the literature regarding the efficacy of these therapies for managing vasomotor symptoms and preventing cardiovascular disease. Thirteen articles were identified, with authors of several studies showing rBHT and combination therapy (rBHT with synthetic hormone therapy) to be efficacious in managing vasomotor symptoms when compared to placebo. Conflicting evidence exists regarding the efficacy of rBHT in the prevention of cardiovascular disease, with some studies demonstrating improved cardiovascular biomarkers, particularly among women who are at the beginning of the menopausal journey and experiencing symptoms. In summary, rBHT may have a role in the care of women trying to manage vasomotor symptoms and in protecting against cardiovascular disease among menopausal women; however, larger, more rigorously designed randomized controlled trials are required.
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Menopausal symptoms can disrupt a woman's personal and social life. Vasomotor symptoms (hot flushes and night sweats) are the most common symptoms and can be treated very effectively with oestrogen-based hormone therapy. The decision to use oestrogen (often simply termed hormone therapy or hormone replacement therapy or HT) therapy involves balancing the potential benefits against the potential risks. Most agree that short-term oestrogen therapy, using the lowest effective dose, is a reasonable option for recently menopausal women with moderate-to-severe symptoms who are in good cardiovascular health (Martin and Manson. 2008. J. Clin. Endocrinol. Metab. 93, 4567-75). Whilst effective and safe in most instances, HT is not suitable for all women or for all menopause-related symptoms when alternatives are available. The role of HRT in chronic disease prevention is also discussed.
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