Menopausia y Terapia Hormonal de la Menopausia Las recomendaciones 2018 de la Unidad de Endocrinología Ginecológica de Clínica Alemana de Santiago -Sociedad Italiana de la Menopausia y la Sociedad Chilena de Endocrinología Ginecológica
M. ParraN. LagosMarco LevanciniM. VillarroelE. PizarroPaula Sofía VanhauwaertSoledad VelascoM FernadezMarco GambaccianiNicoletta BigliaAngelo CagnacciSalvatore CarusoEttore CicinelliVincenzo De LeoCostantino Di CarloManuela FarrisAlessandro GamberaSecondo GuaschinoAntonio LanzonePaoletti AmNovella RussoFranco VicariottoPaola VillaAnnibale VolpePablo LavínM. LopezClaudia CampusanoPatricio BarrigaSergio Brantes G.
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In the last decade, the risk benefits ratio of MHT has been evaluated mainly in terms of cardiovascular risk. Present Consensus Statement is largely inspired by the Global Consensus on Menopausal Hormone Therapy in 2013 and 2016 by leading global menopause societies (The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society).Abstract Background: Menopause is a natural phase of life, but it can bring about physical problems for women. It seems that hormone replacement therapy (HRT) can be helpful in preventing problems at this stage of life. Patient and physician attitudes regarding menopause and HRT may affect decisions about the use of HRT. This study was conducted to determine attitudes about the importance of sex in menopausal women and examine the relationship between HRT and sex life after menopause. Methods: This is a comparative study that was done in the year 2000. The questionnaire used had two main parts. One hundred and fifty‐four women receiving HRT were chosen from private gynecology clinics north of Tehran city and 130 women who were not receiving HRT were chosen from the neighborhood of the HRT group. The sex lives and attitudes towards sex of the women before and after menopause were then compared, and the results were tabulated in 55 tables. Descriptive and inferential statistical methods were used. Results: The average age in the HRT group was 53 years and that in the non‐HRT group was 56 years. There was a significant difference in the average age between the two groups ( P < 0.001). The average number of years post‐menopause was 3.9 in the HRT group and 5.9 in the non‐HRT group. In the HRT group, 91.9% of the women used the hormone as prescribed by their physician. In this group, 85.7% of the women were of the opinion that sex was important, but this proportion in the non‐HRT group was 25.4%. There was a significant difference between the HRT and non‐HRT groups ( P < 0.001). Compared to the attitudes before menopause, the attitudes about the importance of sex in 56.5% of the HRT group and 19.2% of the non‐HRT group did not change after menopause. Women receiving HRT fared better in all aspects of their sex life, including libido, sexual activity, sexual satisfaction, sexual pleasure, frequency of orgasms and sexual importance at the time of the study. There were significant differences between the HRT and non‐HRT groups ( P < 0.001). With respect to sexual pleasure, 6.5% of the HRT group and 4.6% of the non‐HRT group experienced greater pleasure; 68.5% of the HRT group and 11.5% of the non‐HRT group experienced no change; and 83.8% of the non‐HRT group experienced less pleasure. There was a significant difference between the two groups with respect to the change in sexual pleasure ( P < 0.001). Conclusion: Although the importance of sex decreased for elderly women in both the HRT group and non‐HRT group, HRT affected their attitudes about the importance of sex. There was a significant difference between the HRT group and non‐HRT group in this area ( P < 0.001). The importance of sex in the HRT group did not change much after menopause, compared to the non‐HRT group. There was a significant difference between the two groups ( P < 0.001). There were fewer changes in all aspects of sex life after menopause for those in the HRT group compared to those in the non‐HRT group. In the month before the interview, 30.5% of the HRT group and 10.8% of the non‐HRT group had experienced complete sexual satisfaction. The difference was significant between the two groups ( P < 0.001). On the basis of the importance of sex during post‐menopausal life, counseling on the benefits of HRT might be recommended.
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Although women frequently associate skin issues with menopause and hormone replacement therapy (HRT), little work has been done to investigate a possible relationship. A questionnaire was given to women attending a specialist menopause clinic; 87 women responded. Skin problems generally were common, with over 64% of respondents reporting past problems. Around half felt that the menopause had resulted in skin changes; dry skin was the predominant complaint at this stage. However, use of HRT in the short term did not result in any conclusive trends in skin condition in the majority of users.
Hormone Therapy
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As a student I asked a consultant gynaecologist “What's HRT?”. He replied, “Its Hormone Replacement Therapy, we use it for women who go mad at the menopause.” During the 1970s in the UK, HRT was viewed with suspicion. Our undergraduate textbook only briefly mentioned hot flushes and (over)emphasised the benefits of the menopause: “for many women the menopause is a blessed relief from the burden of childbearing”.
Estrogen replacement therapy
Surgical Menopause
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The efficacy and safety of hormone replacement therapy for postmenopausal women are no longer issues of heated debate. The same cannot be said of hormone replacement therapy for women approaching menopause who, though still menstruating, have the emotional and physical symptoms of clinical menopause. In this article, Dr Wells presents a solid case advocating such treatment during the premenopausal stage of the climacteric.
Climacteric
Hormone Therapy
Surgical Menopause
Hormone replacement
Estrogen replacement therapy
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Estrogen deficiency is one significant cause of accelerated bone loss in women during and after menopause. Postmenopausal osteoporosis is a major health problem, primarily because of the severe morbidity and mortality associated with osteoporotic fractures. The Women's Health Initiative Study (WHI) reported that hormone replacement therapy (HRT) prevented osteoporotic fractures. The risks and benefits of HRT are complex and require the individual assessment of each woman considering taking HRT. Use of HRT can be considered as a treatment option for osteoporosis but the risks and benefits should be discussed with each individual woman before starting treatment.
Estrogen replacement therapy
Hormone replacement
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Background: Women all over the world now have to spend almost 1/3rd of their lives in menopausal years. Therefore, menopause now is a concerning matter to maintain and improve women’s health. Hormone replacement therapy (HRT) is an effective treatment for menopausal symptoms. This study was conducted to determine knowledge, attitude and practice toward menopause HRT among women. Objective of the study was to determine the level of knowledge, attitude, and practice related to menopause and HRT among women.Methods: This cross-sectional study was carried out in May 2020 to July 2020 in a rural area of Ernakulam district of Kerala, India. 150 women were interviewed using a predesigned, pretested questionnaire.Results: In the present study, 42.6% of menopausal women had knowledge of menopausal symptoms. 31.3%, 38% and 26% knew that menopause increases risk of cardiovascular, osteoporosis and breast cancer respectively. 16.6% think menopausal women should consult a physician, only 42% of menopausal women are aware of HRT. 60.6% think menopausal symptoms affect quality of life. 50.6% think that menopause means end of sexual life. 42.6% think that absence of menstruation is a relief. 48.6% think physical changes of menopause are inevitable, hence acceptable. 35.3% had consulted a physician at the onset of menopause. 80% preferred natural approaches when compared to HRT. 76% and 86% think that HRT has many complications and side effects hence should be avoided respectively.Conclusions: The study concluded that the knowledge and attitude of the participants towards menopause and HRT was poor in the study population.
Menstruation
Surgical Menopause
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The female population comprises 48.66% of our total population, of which 10.30% are above the age of 49, many of whom are post-menopausal. Menopause is associated with bone-loss and its consequences. Hormone replacement therapy (HRT), particularly replacement of estrogen, prevents bone-loss. We undertook this prospective case-controlled study to find out whether or not HRT is beneficial to our women. A total of 106 patients were studied, amongst them 60 were cases and 46 were controls. The women in the first group were given either conjugated equine estrogen alone (surgical menopause group) or conjugated equine estrogen plus cyclical progesterone (natural menopause group). Results showed that there was 4.29% increase in bone mineral density in women who received hormone replacement therapy (HRT). This increase was 5.23% in early and 3.56% in late menopause group. Women with natural menopause gained more bone mass (4.22%) than women with surgical menopause (3.9%). Our results also showed that women who denied HRT (controls) lost bone mass (5.26%), the loss was more in those with surgical menopause (6.24%) than those with natural menopause (4.87%). Therefore it can be concluded that post-menopausal hormone replacement therapy prevents bone-loss. However, to evaluate the beneficial effect of long-term HRT, further studies with larger samples are recommended.
Surgical Menopause
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Hormone Therapy
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Background There is considerable inconsistency in the results of studies of the psychological and sexual sequelae of the menopause and their treatment. Method A search of the literature on Medline was made of studies of psychological symptoms in women who were either naturally or surgically menopausal or who were receiving hormone replacement therapy for menopausal symptoms. Results There is evidence of a small increase in psychological morbidity (not usually amounting to psychiatric disorder) preceding the natural menopause and following the surgical menopause. Psychosocial as well as hormonal factors are relevant. While the response of psychosocial symptoms to hormone replacement therapy with oestrogens is variable and most marked in the surgical menopause, in some studies the effect is little greater than that for placebo. Where sexual symptoms are present, there is more consistent evidence that hormone replacement therapy is effective. Conclusions In the light of the available evidence, the current use of hormone replacement therapy to treat psychological symptoms detected at the time of (but not necessarily therefore due to) the natural menopause must be questioned. It does appear that oestrogen therapy ameliorates psychological symptoms after surgical menopause.
Psychological therapy
Sex therapy
Hormone Therapy
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The objective of this study is to assess the actual experiences of menopause in menopaused women without hormone replacement therapy. A cross-sectional study was conducted among 342 women who had natural menopause. The target population was recruited from subjects attending the Departement of Gynécologie-Obstétrique du CHU TOKOIN from November 1996 to October 1997. All women investigated presented clinical signs related to menopause. 51.5% found its symptoms embarrassing. 53.8% of the women enjoyed their menopause. The difference between the two groups of women having accepted their menopausal status or not, where the menstrual period were embarrassing or not (p = 0.0001) and were the climateric symptoms were embarrassing or not (p = 0.0001) were significant. Agreement to undertake a hormone replacement therapy were given by 29.8% of women. In spite of the climateric symptoms, menopaused women hardly accept their status and few were available for a hormone replacement therapy.
Surgical Menopause
Hormone Therapy
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