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20October2017

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Don’t wait for menopause to sneak up on you

Speak to your doctor and get your hormones to play ball Do you need a bit of help to make your menopause more bearable? Here is why you should consider transdermal oestrogen as a hormone therapy . . .

You feel awful and definitely do not have the energy to endure what you have to. You dreaded this period of your life and now it is finally here. Apparently Hubby cannot handle you anymore and you just want to curl into a ball and cry.

Remember that going through menopause is a normal part of a woman’s life and it does not always need to be treated.1 Yet, women who suffer from bothersome symptoms during menopause, such as hot flushes, night sweats, mood changes, sleep problems and vaginal dryness can be reassured that effective treatments are available.1

What happens during menopause?
Between the ages of 45 and 55 a woman’s ovaries stop producing eggs and her menstrual periods come to an end. This is when the big M-word washes over many women like a bucket of cold water. Some women struggle with minimum symptoms while others experience symptoms that interfere with everyday life.1

During the transition to menopause, the ovaries’ production of oestrogen decreases by 90% and it is this reduction that causes the typical symptoms of menopause; the hot flushes, night sweats and a dry vagina.2

So what can you do?
Hormone therapy (HT) is the most effective treatment for women with moderate to severe symptoms3 due to an oestrogen deficiency and is most beneficial for women before the age of 60 or within 10 years of the start of menopause.3

When hormone therapy is mentioned, two hormones play a part: oestrogen and progestogen.2 Oestrogen is the hormone that relieves the symptoms while progesterone protects a woman’s uterus (if she has not yet had a hysterectomy).2 If a woman has thus already had a hysterectomy she does not need progesterone.2

The different types of hormone therapy
Hormone therapy for menopause includes a wide variety of products and treatment options.3 It is available as oral tablets, a skin patch, a topical gel and several vaginal preparations (ring, tablet and cream). Some products contain only oestrogen and some products contain oestrogen and progesterone.

Why should you consider hormone therapy?
Besides hormone therapy being the most effective treatment for moderate to severe menopause symptoms3, it also offers important benefits in younger recently menopausal women, particularly in terms of reducing the risk of osteoporosis-related fractures and heart disease.3,4

Choose the hormone therapy that is right for you
A healthcare professional is in the best position to advise you on the benefits and risks of hormone therapy, based on your personal medical history. Together with your healthcare professional you may decide on whether to start hormone therapy, which products to use and for how long treatment should be continued.

While hormone therapy may be continued for at least 5 years in healthy women starting treatment before age 60, it is important that women taking hormone therapy have at least an annual check-up with their healthcare professional.3

Why you should consider transdermal oestrogen
The transdermal (via the skin) route of giving hormone therapy in the form of a patch or gel appears to be associated with a lower risk of stroke and fewer blood clots in the legs than oral oestrogen.2,3,5 The major benefits of transdermal oestrogen are because it bypasses the liver and so avoids the liver effects that occur with the use of oral oestrogen.3

Transdermal oestrogen
• Does not appear to be associated with an increased risk for stroke.3
• Has little or no increased risk for blood clots in the legs.3
• Lowers total and LDL cholesterol (like oral oestrogen), but unlike oral oestrogen, it also lowers triglycerides.4,6

When considering the many advantages, transdermal hormone therapy should be considered as a first-choice option for all women considering hormone therapy and particularly for women with a high risk of heart disease (like obese women, smokers, women with high blood pressure and women with a history of blood clots).4,5 The transdermal route is also suitable for women with high triglyceride levels, liver disease, migraines and glucose intolerance.5

Talk to you doctor or hormone therapist and your menopause can pass without a hitch.

For more information on Adock Ingram's specialised range visit: www.healthywomen.co.za

References: 1. UpToDate. Patient education: Menopause (Beyond the Basics). [online] Jun 2017 [cited: 4 July 2017]. Available from: http://www.uptodate.com/contents/menopause-beyond-the-basics. 2. UpToDate. Patient education: Menopausal hormone therapy (Beyond the Basics). [online] Jun 2017 [cited: 4 July 2017]. Available from: http://www.uptodate.com/contents/menopausal-hormone-therapy-beyond-the-basics. 3. De Villiers TJ, Pines A, Panay N, et al. Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Climacteric 2013;16:316-337. 4. Davey M. Transdermal estrogen – a first-choice option in hormone therapy. SAMS Menopause Focus 2014;2(3):12-14. 5. Guidozzi F, Alperstein A, Bagratree JS, et al. South African Menopause Society revised consensus position statement on menopausal hormone therapy, 2014. SAMJ 2014;104(8):537-543. 6. Crook D, Cust MP, Gangar KF, et al. Comparison of transdermal and oral estrogenprogestin replacement therapy: effects on serum lipids and lipoproteins. Am J Obstet Gynecol 1992;166(3):950-955.
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