Women are approaching or entering perimenopause after the age of 45, and some women have even gone through menopause. Menopause is an inevitable physiological process for women, but after perimenopause, the body will experience a series of uncomfortable symptoms, including sweating, hot flashes, emotional instability, sleep disorders, low libido, and sexual intercourse disorders that affect the quality of work and life. In addition, there is atrophy of the genitourinary organs, susceptibility to inflammatory diseases such as vaginitis and urethritis, frequent urination, urinary incontinence, uterine prolapse and other organic diseases, and after menopause people enter an old age.
Why does a woman experience a distinct menopausal phase? It has to do with our ovaries. The ovary is an important reproductive organ of women, and it is also an endocrine organ, like our thyroid, pituitary and adrenal glands, responsible for the secretion of female hormones. However, it is different from other endocrine glands: the function of other endocrine glands ends with the end of life (with the exception of certain endocrine diseases), and once these organs become abnormal, they must be treated, otherwise they will seriously affect the health of a person’s life, but the ovaries cease to function after menopause, no matter how long the whole life is, it no longer works, and this is normal for everyone and is not considered This is normal for everyone and is not considered a pathology and can be treated without treatment. When the ovaries begin to stop working, the process of declining estrogen levels results in a series of self-conscious symptoms. When estrogen drops to postmenopausal levels and remains low, the symptoms disappear.
Due to the improvement in the standard of living and medical care, people are living much longer than ever before. 70 years old is not very old anymore, and living to 80 or 90 years old is not uncommon. We not only want to live longer, but also to live better and to stay young forever. Therefore, hormone replacement therapy began to appear in the 1950s and 1960s, and estrogen supplementation therapy began during the perimenopause and after menopause.
After half a century, hormone therapy has been sought after, has experienced much strife, and has caused panic. Its terminology has changed several times: estrogen replacement therapy, hormone replacement therapy, and hormone therapy. In the beginning, it was thought that all the symptoms of menopause were caused by the loss of estrogen, so it was simply estrogen supplementation, hence the name estrogen replacement therapy. Later, it was found that the application of estrogen alone had many complications: it could cause endometrial diseases, and estrogen plus progestin was started to be given, hence the name hormone replacement therapy. Then later, hormone application was not only applied in the postmenopausal period. When perimenopause is reached and self-conscious symptoms appear, treatment can be administered. Hormone therapy is not only applied to supplement or replace hormones after they are reduced to very low levels, but when symptoms appear before menopause or when menstrual disorders appear, hormone therapy is collectively called hormone therapy.
So what are the advantages and disadvantages of hormone therapy?
Advantages.
1. Relief of menopausal symptoms such as hot flashes, sweating, irritability, depression, fatigue, sleep disorders, palpitations and headaches caused by estrogen deficiency.
2. Treatment of senile genitourinary tract atrophy.
3, prevention and treatment of postmenopausal osteoporosis; within 1 year after the occurrence of osteoporotic fracture, 20% of people die from various complications. About 20% of fracture patients can die within 1 year due to complications of pulmonary embolism and pneumonia.
4.Reducing the incidence of coronary heart disease.
5.Prevent Alzheimer’s disease.
6.Reducing the occurrence of colon cancer.
7.Improve ataxia in elderly women.
Disadvantages.
1, endometrial problems
Estrogen can promote the mitosis of endometrial cells and the proliferation of endometrium. Progestin can play a role in inhibiting endometrial proliferation. However, endometrial cancer due to estrogen therapy has low malignancy, good tissue differentiation and is easily detected at an early stage, so it does not increase the morbidity and mortality rate of endometrial cancer. When applying hormone therapy, endometrial thickness should be monitored regularly. For patients with irregular uterine bleeding or ultrasound showing endometrial thickness of 5mm or more, endometrial biopsy should be performed.
2. Breast problems
Some women have breast swelling and pain related to both estrogen and progesterone when using HRT. The relationship between the application of hormone therapy and breast cancer is still controversial. It is generally believed that the use of hormone replacement for more than 5 years may increase the risk of breast cancer. Therefore, regular breast examination is crucial, and early detection and early treatment can reduce the mortality rate of breast cancer.
3.Oral estrogen reduces bile acid secretion
In addition, it will increase the cholesterol saturation in bile, thus increasing the incidence of cholelithiasis. Patients with cholelithiasis should use oral estrogen with caution or switch to transdermal estrogen.
4. Causes thrombophlebitis
Estrogen, especially synthetic estrogen, can increase coagulation function and cause thrombophlebitis, so patients with thrombophlebitis should not use estrogen. The advantages and disadvantages of perimenopausal hormone replacement therapy are both objective, but experts from the International Menopause Group believe that the advantages outweigh the disadvantages. Doctors will inform patients about the need for replacement therapy depending on the patient’s condition, whether there are indications and whether there are contraindications.
Women entering perimenopause should not blindly follow hormone replacement therapy and should not be afraid of hormone therapy. Under the guidance of a doctor and with regular medical checkups, the necessary hormone therapy will significantly improve the quality of life.