Until the results of the Women's Health Initiative (WHI) study were announced, hormone therapy in menopause was widely recommended and found to be safe. The WHI results became controversial in Turkey, as in the rest of the world. The most striking one was the headline "Hormone therapy causes breast cancer" and many women quit hormone therapy upon the news. What was not explained in these headlines was that approximately 10 new cases of breast cancer occur in every 10 thousand women who have gone through natural menopause and use the estrogen-progesterone combination.
In our opinion, the most important result of the study is that it shows that the treatment does not reduce the risk of heart disease after menopause. The finding that it reduces the risk of death due to heart disease by 50 percent, which is perhaps the most important reason why hormone therapy is supported and recommended in postmenopausal women, was not supported by this study and was even reported to cause a very slight increase in risk. For this reason, estrogen-progesterone therapy during natural menopause is recommended only for short periods in women who complain of serious hot flashes and night sweats. For women in surgical menopause, estrogen therapy alone is sufficient. With estrogen therapy alone, the risk of breast cancer decreases and the risk of cardiovascular disease does not change. Currently, the most effective treatment for complaints such as hot flashes and night sweats in all menopausal women is hormone therapy. Treatment should be planned by your doctor at the lowest dose and short term that suits you.
Selective estrogen receptor modulators (SERMs)
These drugs block the action of estrogen on the cardiovascular system. These drugs can be summarized as drugs that do not have negative effects on the system, breast and uterus, but have positive effects on the bone. However, they do not eliminate hot flashes, which are the most important menopausal complaints, and they cause an increase in the frequency and severity of these complaints. Those with a history of vascular occlusion should not use it.
Vaginal estrogen
It is recommended to preserve the existing elasticity of the vagina before menopause and to prevent increased vaginal, urinary infections and urinary incontinence complaints after menopause. . It is available in vaginal tablet, cream and suppository forms. Long-term, controlled-release vaginal product abroad There is also an inner ring form.
Treatments used for osteoporosis
Bisphosphonates, strontium, SERMs, calcitonin, Calcium and vitamin D are drugs used in the treatment of osteoporosis. Significant bone loss occurs in the first years after menopause. During this period, you can protect your bone mass by reducing smoking and alcohol consumption, regular exercise, a diet low in saturated fats and a calcium supplement recommended by your doctor.
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