madman
Super Moderator
Abstract
Menopause hormone therapy (MHT) is the most efficient treatment for symptoms of the acute climacteric syndrome and for efficient prevention of long-term estrogen deficiency. Vaginal administration of low doses of estrogen is a therapy of choice for the treatment and prevention of urogenital atrophy and its consequences. Systemic treatment may include estrogen, but an equally efficient alternative is tibolone. Nonhormonal therapy relies on phytoestrogens, black cohosh extract, and serotonin reuptake inhibitors.
Conclusion
Menopause hormone therapy still remains a dominant therapeutic modality in climacteric medicine. The core medical skill is the ability to choose the optimal MHT preparation for the given patient. Such choice is based on an understanding of various clinical and metabolic effects of MHT depending on the composition, dosage, and method of application (Box 3). The general trends are individualization, dose minimization, and early start of therapy. When those rules are observed, the benefits of therapy will prevail over its risks. There are nonhormonal and nonpharmacological alternatives for the treatment of acute climacteric syndrome – while they may have a better safety profile, they are less effective. Pharmacotherapy should be regarded as only one of the pillars of comprehensive care for aging menopausal women.
Menopause hormone therapy (MHT) is the most efficient treatment for symptoms of the acute climacteric syndrome and for efficient prevention of long-term estrogen deficiency. Vaginal administration of low doses of estrogen is a therapy of choice for the treatment and prevention of urogenital atrophy and its consequences. Systemic treatment may include estrogen, but an equally efficient alternative is tibolone. Nonhormonal therapy relies on phytoestrogens, black cohosh extract, and serotonin reuptake inhibitors.
Conclusion
Menopause hormone therapy still remains a dominant therapeutic modality in climacteric medicine. The core medical skill is the ability to choose the optimal MHT preparation for the given patient. Such choice is based on an understanding of various clinical and metabolic effects of MHT depending on the composition, dosage, and method of application (Box 3). The general trends are individualization, dose minimization, and early start of therapy. When those rules are observed, the benefits of therapy will prevail over its risks. There are nonhormonal and nonpharmacological alternatives for the treatment of acute climacteric syndrome – while they may have a better safety profile, they are less effective. Pharmacotherapy should be regarded as only one of the pillars of comprehensive care for aging menopausal women.
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