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Prescription rules of hormone replacement therapy and its alternative


Authors: Tomáš Fait 1,2
Authors place of work: Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha 1;  Katedra zdravotnických studií, Vysoká škola polytechnická Jihlava 2
Published in the journal: Čas. Lék. čes. 2022; 161: 309-313
Category: Review Article

Summary

Hormone replacement therapy is still the most effective treatment for acute climacteric syndrome and prevention of osteoporosis. When starting treatment within 10 years of menopause, i.e., before the onset of irreversible changes in the vessel wall and nervous tissues, it is a window of opportunity to prevent atherosclerosis and dementia. At a later start, on the contrary, it worsens these processes.

To increase the safety of the treatment, especially in affecting the breast tissue, we choose the lowest effective dose of estrogen and give preference to gestagens structurally close to progesterone.

For women who, for objective or subjective reasons, prefer non-hormonal treatment, they can choose from an extensive range of complementary and alternative medicines. Unfortunately, it does not always reliable documentation of efficacy and safety from well-performed studies. However, the data for fermented soybean extract DT56a, pollen extract PI82/GC Fem, and some traditional Chinese medicine procedures offer an interesting opportunity.

Physical activity cannot be forgotten in a comprehensive approach.

Keywords:

Atherosclerosis – osteoporosis – hormone replacement therapy – acute climacteric syndrome – complementary medicine


Zdroje
  1. The 2022 Hormone Therapy Position Statement of The North American Menopause Society Advisory Panel. The 2022 Hormone Therapy Position Statement. Menopause 2022; 29: 767–794.
  2. Salpeter SR, Cheng J, Thabane L et al. Bayesian metaanalysis of hormone therapy and mortality in younger postmenopausal women. Am J Med 2009; 122: 1016.e1–1022.e1.
  3. Fait T. Hormone replacement therapy: latest developments and clinical practice. Drugs Context 2019; 8: 212551.
  4. Santoro N, Epperson CN, Mathews SB. Menopausal symptoms and their management. Endocrinol Metab Clin North Am 2015; 44: 497–515.
  5. Avis NE, Crawford SL, Greendale G et al. Study of Women’s Health Across the Nation. JAMA Intern Med 2015; 175: 531–539.
  6. Biglia N, Cagnacci A, Gambacciani M et al. Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases? Climacteric 2017; 20: 306–312.
  7. Thurston R, Chang Y, Barinas-Mitchel E et al. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause 2017; 24: 886–893.
  8. Herber-Gast B, Brown WJ, Mishra GD. Hot flushes and night sweats are associated with coronary heart disease risk in midlife: a longitudinal study. BJOG 2015; 122: 1560–1567.
  9. Thurston RC, Aizenstein HJ, Derby CA et al. Menopausal hot flashes and white matter hyperintensities. Menopause 2016; 23: 27–32.
  10. Notelovitz M, Lenihan JP, McDermont M et al. Initial 17estradiol dose for treating vaomotor symptoms. Obstet Gynecol 2000; 95: 726–731.
  11. Panay N, Ylikorkala O, Archer DF et al. Ultra-low-dose estradiol and norethisteron acetate: effective menopausal symptom relief. Climacteric 2007; 10: 120–131.
  12. Stevenson JC, Durand G, Kahler E, Pertynski T. Oral ultra-low dose continuous combined hormone replacement therapy with 0,5 mg 17estradiol and 2,5 mg dydrogesterone for the treatment of vasomotor symptoms. Maturitas 2010; 67: 227–232.
  13. Gambacciani M, Cappagli B, Ciaponi M et al. Ultra low-dose hormone replacement therapy and bone protection in postmenopausal women. Maturitas 2008; 59: 2–6.
  14. Lundström F, Bydgeson M, Svane G et al. Neutral effect of ultra-low-dose continuous combined estradiol and norethisterone acetate on mammographic breast density. Climacteric 2007; 10: 249–256.
  15. Sturdee DW, Archer DF, Rakov V, Lang E. Ultra-low-dose continuous combined estradiol and norethisterone acetate: improved bleeding profile in postmenopausal women. Climacteric 2008; 11: 63–73.
  16. Bergeron C, Nogales FF, Rechberger T et al. Ultra low dose continuous combined hormone replacement therapy with 0.5mg 17beta-estradiol and 2.5mg dydrogesterone: protection of the endometrium and amenorrhoea rate. Maturitas 2010; 66: 201–205.
  17. Koire A, Joffe H, Buckley R. Replacement in the prevention and treatment of cognitive decline, dementia, and cognitive dysfunction of depression. Harv Rev Psychiatry 2022; 30: 215–222.
  18. Kim J, Chang JH, Jeong MJ et al. A systematic review and metaanalysis of effects of menopause hormone therapy on cardiovascular diseases. Sci Rep 2020; 10: 20631.
  19. Fait T, Vrablík M. Coronary heart disease and hormone replacement therapy – from primary and secondary prevention to the window of opportunity. Neuro Endocrinol Lett 2012; 33 (Suppl. 2): 17–21.
  20. Tan DA, Dayu ARB. Menopausal hormone therapy: why we should no longer be afraid of the breast cancer risk. Climacteric 2022; 25: 362–368.
  21. Ruan X, Mueck AO. Primary choice of estrogen and progesteron as components of HRT. Climacteric 2022; 25: 443–452.
  22. Fournier A, Berino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat 2008; 107: 103–111.
  23. Cauley JA, Robbins J, Chen Z et al. Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women’s Health Initiative randomized trial. JAMA 2003; 290: 1729–1738.
  24. Robbins JA, Argaki A, Crandall CJ et al. WHI trials: interaction of calcium and vitamin D with hormone therapy. Menopause 2014; 21: 116–123.
  25. Torgerson DJ, Bell-Syer SEM. Hormone replacement therapy and prevention of nonvertebral fracture: a meta-analysis of randomized trials. JAMA 2001; 285: 2891–2897.
  26. Zhu L, Jiang X, Sun Y et al. Effect of hormone therapy on the risk of bone fractures: a systematic review and meta-analysis of randomized controlled trials. Menopause 2016; 23: 461–470.
  27. NAMS. Management of symptomatic vulvovaginal atrophy, position statement of the North American Menopause Society. Menopause 2013; 20: 888–902.
  28. Simon J, Nachtigall L, Gut R et al. Effective treatment of vaginal atrophy with an ultra-low-dose estradiol vaginal tablet. Obstet Gynecol 2008; 112: 1053–1060.
  29. Ulrich LSG, Naessen T, Elia D et al. Endometrial safety of ultra-low-dose Vagifem 10 μg in postmenopausal women with vaginal atrophy. Climacteric 2010; 1: 228–237.
  30. Sirotkin AV, Harrath AH. Phytoestrogens and their effects. Eur J Pharmacol 2014; 741: 230–236.
  31. Parkin DM. Cancers of the breast, endometrium and ovary: geographic correlations. Eur J Cancer Clin Oncol 1989; 25: 1917–1925.
  32. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility (7th ed.). Lippincott Williams & Wilkins, Philadelphia, 2005.
  33. Duncan AM, Phipps WR, Kurzer MS. Phyto-estrogens. Best Practice Research Clin Endocrin Metab 2003; 17: 253–271.
  34. Ye YB, Tang XY, Verbruggen M, Su YX. Soy isoflavones attenuate bone loss in early postmenopausal Chinese women. Eur J Nutr 2006; 45: 327–334.
  35. Yuan JP, Wang JH, Liu X. Metabolism of dietary soy isoflavones to equol by human intestinal microflora. Mol Nutr Food Res 2007; 51: 765–781.
  36. Atkinson C, Newton KM, Bowless EJ et al. Demographic, anthropometric, and lifestyle factors and dietary intakes in relation to daidzein-metabolizing phenotypes among premenopausal women in USA. Am J Clin Nutr 2008; 87: 679–687.
  37. Raimondi S, Roncaglia L, De Lucia M et al. Bioconversion of soy isoflavones daidzin and daidzein by Bifidobacterium strains. Appl Microbiol Biotechnol 2009; 81: 943–950.
  38. Somjen D, Yoles I. DT56a creatine kinase activity in vascular tissues of rats. J Endocrinol Invest 2003; 26: 966–971.
  39. Sánchez-Borrego R, Navarro MC, Llaneza P et al. Efficacy and safety of a phyto-SERM as an alternative to hormone therapy. Climacteric 2015; 18: 350–357.
  40. Labos G, Trakakis E, Pliatsika P et al. Efficacy and safety of DT56a (Femarelle) compared to hormone therapy in Greek postmenopausal women. J Endocrinol Invest 2013; 36: 521–526.
  41. Sánchez-Borrego R, Mendoza N, Llaneza P. A prospective study of DT56a (Femarelle®) for the treatment of menopause symptoms. Climacteric 2015; 18: 813–816.
  42. Fait T, Borovský M. DT56a in treatment of climacteric syndrome in a Central European population sample. Bratislavské lekárske listy 2021; 122: 301–304.
  43. Orleans RJ, Li L, Kim MJ et al. FDA approval of paroxetine for menopausal hot flushes. N Engl J Med 2014; 370: 1777–1779.
  44. Nembutsu H, Sasa M, Kiyotani K et al. Should CYP2D6 inhibitors be administered in conjunction with tamoxifen? Expert Rev Anticancer Ther 2011; 11: 185–193.
  45. Hellström AC, Muntzing J. The pollen extract Femal – a nonestrogenic alternative to hormone therapy in women with menopausal symptoms. Menopause 2012; 19: 825–829.
  46. Fait T, Sailer M, Regidor PA. Prospective observational study to evaluate the efficacy and safety of the pollen extract Sérélys® in the management of women with menopausal symptoms. Gynecol Endocrinol 2019; 35: 360–363.
  47. Llaneza P, Garcia-Portilla P, Llaneza-Suarez D, Armont B. Depressive disorders and the menopause transition. Maturitas 2012; 71: 120–130.
  48. Toffol E, Keikinheimo O, Patronen T. Hormone therapy and mood in perimenopausal and postmenopausal women: a narrative review. Menopause 2015; 22: 564–578.
  49. Sun A-J, Wang Y-P, Gu B et al. A multi-center, randomized, controlled and open clinical trial of Heyan Kuntai capsule and hormone therapy in perimenopausal women. Chin J Integr Med 2018; 24: 487–493.
  50. Kim KH, Kang KW, Kim DI et al. Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women. Menopause 2010; 17: 269–280.
  51. Lee MS, Shin BC, Ernst E. Acupuncture for treating menopausal hot flushes: a systematic review. Climacteric 2009; 12: 16–25.
  52. Taylor-Swanson L, Thomas A, Ismail R et al. Effects of traditional Chinese medicine on symptom clusters during the menopausal transition. Climacteric 2015; 18: 142–156.
  53. Liu T, Chen S, Mielke GI et al. Effects of exercise on vasomotor symptoms in menopausal women: a systematic review and meta-analysis. Climacteric 2022; 25: 552–561.
  54. Moreira LDF, de Oliveira M L, Lirani-Galvão AP et al. Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women Arq Bras Endocrinol Metabol 2014; 58: 514–522.
Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist

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