Sizzling flashes, evening sweats and sleep disturbances are widespread signs of menopause that may have an effect on well being, high quality of life and work productiveness. A brand new evaluate printed in CMAJ (Canadian Medical Affiliation Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.221438 recommends menopausal hormone remedy, traditionally often known as hormone substitute remedy (HRT), as first-line therapy in folks with out threat components.
Menopausal signs might happen as much as 10 years earlier than the final menstrual interval and may final greater than 10 years, with unfavorable results for many individuals.
“Menopause and perimenopause might be related to distressing signs and decreased high quality of life,” writes Dr. Iliana Lega, Ladies’s School Hospital and the College of Toronto, Toronto, Ontario, with coauthors. “Menopausal hormone remedy is the first-line therapy for vasomotor signs within the absence of contraindications.”
The evaluate summarizes the most recent proof for diagnosing and treating menopausal signs in addition to the dangers and advantages of therapies to assist clinicians and sufferers handle the situation.
“Though many remedies exist for menopausal signs, fears across the dangers of menopausal hormone remedy and lack of expertise concerning therapy choices typically impede sufferers from receiving therapy,” write the authors.
Advantages of menopausal hormone remedy embrace
decreased sizzling flashes in as many as 90% of sufferers with average to extreme signs;
improved blood lipid ranges and a potential decreased threat of diabetes; and
fewer fragility fractures of the hip, backbone and different bones.
What in regards to the dangers?
Though earlier proof has proven an elevated threat of breast most cancers, the danger is far decrease in folks aged 50–59 years and in those that begin menopausal hormone remedy within the first 10 years of menopause.
Some research present an elevated threat of ischemic stroke in girls older than 60 years who begin remedy 10 years after the beginning of menopause, however the threat is low for these youthful than 60.
For folks with threat components or those that don’t wish to take menopausal hormone remedy, nonhormonal therapies, comparable to some selective serotonin reuptake inhibitors (SSRIs) and different drugs, may also help alleviate signs.
“Regardless of early issues of an elevated threat of cardiovascular occasions with menopausal hormone remedy after the Ladies’s Well being Initiative trial, growing proof reveals a potential discount in coronary artery illness with menopausal hormone remedy amongst youthful menopausal sufferers, particularly those that begin menopausal hormone remedy earlier than age 60 years or inside 10 years of menopause,” write the authors.
They emphasize that it is essential for clinicians to ask about signs earlier than and through menopause and to debate remedies with sufferers based mostly on their private preferences and potential threat components.
Supply:
Canadian Medical Affiliation Journal
Journal reference:
Lega, I. C., et al. (2023) A realistic strategy to the administration of menopause. CMAJ. doi.org/10.1503/cmaj.221438.