We present a new guest articlethat was written by the team at Fifty & Me Magazine. Today they tell us about the hormone treatments women may take during menopause.
Although it is a normal phenomenon that will - sooner or later - be part of every woman's life, menopause raises many questions. Indeed, this period marks a change, more or less brutal, both on the physiological level (with often painful manifestations such as sleep disorders, the famous "vapors", mood swings, a drop in libido, etc.) and on the psychological level (with often painful manifestations such as sleep disorders, the famous "vapors", mood swings, a drop in libido, etc.). on an emotional level. Is hormone replacement therapy right for all of us? What are its benefits but also its risks? Is it necessary to start it at the first signs of perimenopause? What are the alternatives? Dr. Aghayan, a gynecologist at the Brussels Menopause Clinic, gives us some answers...
Guest article written by Fifty & Me Magazine.
How does HRT help to make this often difficult period in a woman's life more manageable?
Menopause is experienced harmoniously by some women, but for others, it is a really painful stage. HRT contributes to the well-being of these women by relieving them of their complaints.
Does the decision to start hormone replacement therapy apply to all women?
The vast majority of patients have had the procedure done, but the decision should be made after discussion between the patient and her physician, taking into account her personal and family medical history. On the other hand, the patient's wishes must always be taken into account: some prefer to turn to so-called natural methods, at least initially.
Should we start at the first signs or later?
Treatment should be initiated in the first few years of menopause. The definition of menopause is the cessation of menstruation, so we speak of menopause after one year of amenorrhea (absence of menstruation). It is important to know that HRT allows for the prevention of cardiovascular disease as well as certain forms of senile dementia only if it is instituted during the first years of menopause, i.e., those following the year of amenorrhea. If started too late, not only does HRT no longer have these beneficial cardiovascular and neurological effects but, conversely, it can have deleterious effects!
What are the contraindications?
It is obviously difficult to give a complete list, but the main ones are personal history of breast cancer and some other gynecological cancers (not all of them), a poorly balanced metabolic syndrome, thrombosis, patients at risk of thrombophlebitis ... The evaluation of contraindications must be done by the physician after a complete history. Treatments are highly personalized and re-evaluated annually.
What are the benefits of HRT?
Relieve menopausal complaints such as hot flashes, insomnia, mood disorders, vaginal and skin dryness, decreased libido, arthralgia, memory and concentration problems ... but there are also other beneficial effects on the cardiovascular and neurological levels and against osteoporosis.
And its risks?
If the patient is well targeted after the history, there is no risk. Otherwise, it is especially at risk of thromboembolic events.
How has HRT evolved in recent years?
Towards the lowest effective dosage...
As a woman, as well as a doctor, are you in favor of hormone replacement therapy?
Well prescribed, it can only bring well-being to the woman who remains very active nowadays during the 30 years that she will spend on average in menopause!
What are the alternatives to HRT?
Dietary supplements are valid alternatives but none of them offer all the benefits of HRT...
Living well with menopause
"Menopause concerns 2,250,000 women in Belgium. Hormone replacement therapy has been a great leap forward in the medical management of women and a sign of a change in mentality. Finally, medicine no longer took for granted the disorders that women complained about: it was no longer a simple matter of comfort. Today, 25% to 30% of menopausal women use hormone replacement therapy," says Dr. Crabbéfounding president of the European Association of Holistic Gynecology. At present, we can only confirm - with recent studies to support it - that the combination of estrogens and progesterone which constitutes the classic therapy is "safe" in the sense that these hormones are not considered to be disruptive in the long term. The European Menopause and Andropause Society (EMAS) also recommends an annual evaluation and a reduction of the dosage by age group because hormone requirements decrease with age.
On the other hand, and to increase the general and daily comfort, the so-called soft or holistic medicines also bring very good results in supplementary treatment. To answer our daily worries "I sweat, I feel bad, I lack energy, I am less patient, etcetera", we have two options: to turn to supplements which are hormonal precursors and which help to regulate the symptoms; or to turn to plants which will silence the symptoms. The great classics are the yam or soybeans. We are talking about phytohormones whose estrogenic or progestational activity is similar to that of estrogen and progesterone: these plants mimic the action of human sex hormones. Soy isoflavones are an interesting alternative when HRT is undesirable. On the other hand, Yam extracts mimic the effects of DHEA.
To reduce most of the symptoms, laboratories combine these different plants in food supplements. Mr. Rousseau, an experienced naturopath, explains
We almost always find the same plants, it's chaste tree, black cohosh and Yam. Sometimes a little bit of passionflower and lemon balm to have a calming effect that will help you sleep better. These plants are active on the symptoms and act as nervous system regulators. Apart from that, there is a product that gives very good results which is Maca, considered as the Peruvian Ginseng. It is said to be an adaptogen that will allow the adrenal glands to adapt to stress. The interest of Maca is that we have at the same time a hormonal regulation for people who have the first symptoms of menopause. Giving Maca will improve comfort and general condition. Very often, the person will feel more fit.
Finally, each laboratory tries to be creative in proposing solutions by focusing more closely on the different phases of menopause with more targeted solutions for premenopause or postmenopause. Broad-spectrum herbal formulas for menopausal disorders and related risk factors are increasingly available. They can be used as a support in case of menopausal symptoms, mood disorders, hot flashes, irascibility during menopause, or vaginal dryness. Good to know: Beware, hormone precursors can compete with HRT. Finally, we can also turn to gemmotherapy by favoring extracts of apple tree buds, hawthorn, sage and especially cranberry. The bilberry is recognized as an interesting concentrate for all the problems related to menopause. Only a few drops are able to neutralize all symptoms such as hot flashes, urinary problems, etc.
Menopause is not a disease
Finally, each profile has its own formula for finding the right balance. Both hormonal and psychological! Sometimes neglected, this aspect is essential to live well during menopause. Let's not forget that body and mind are inseparable. While the therapy acts only on the metabolism, it is essential to "heal" the mind to welcome this passage serenely. Because at 50, family life changes, the children leave the nest, we sometimes feel that it is too late to start something or too early to stop. It is important to give yourself time to find a new well-being, whether through physical exercise or cultural leisure.
And why not consider joining a yoga group? To attend workshops on aromatherapy? To start Nordic walking? There is no shortage of opportunities to do yourself good and create a new social fabric around you. Menopause must also serve this purpose... it is in a way a quest to give meaning to one's life.
"Often, at this time, women feel much less fit than men of the same age. "Because they experience this period as a rupture", says Mr. Rousseau. In addition to this, it is sometimes difficult to accept society's view of the aging physique. Hair graying, wrinkles, body changes,... the external appearance undermines them.
"Yet to each age its characteristics (and joys!), it is up to us to live them positively or negatively," Fabienne, 54.
Even today's models are taking on white hair. And if we were looking less to get younger than to feel good about our age and our skin... Solutions exist. The proof.