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HORMONAL REPLACEMENT THERAPY: DOES AGING LIMIT THERAPEUTIC BENEFITS?

HORMONAL REPLACEMENT THERAPY: DOES AGING LIMIT THERAPEUTIC BENEFITS?. CECI MENDES CARVALHO LOPES CLÍNICA GINECOLÓGICA DO HCFMUSP. menopause?. treatment?. HELP!!!. what to do?. Therapy?. Estrogens?. Therapy?. Estrogens?. Progestogens?. Therapy?. HRT. Better quality of life

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HORMONAL REPLACEMENT THERAPY: DOES AGING LIMIT THERAPEUTIC BENEFITS?

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  1. HORMONAL REPLACEMENT THERAPY: DOES AGING LIMIT THERAPEUTIC BENEFITS? CECI MENDES CARVALHO LOPES CLÍNICA GINECOLÓGICA DO HCFMUSP

  2. menopause? treatment? HELP!!! what to do?

  3. Therapy? Estrogens?

  4. Therapy? Estrogens? Progestogens?

  5. Therapy?

  6. HRT • Better quality of life • Acting positively on • Symptoms • Lipids • Bone mass • Skin

  7. HRT • Better quality of life • Acting positively on • Symptoms • Lipids • Bone mass • Skin • But there are risks and adverse effects! • Thromboembolism • Cancer

  8. HERS II (Cardiac events/ 10000) NS

  9. What to conclude? • It seems there is cardioprotection • if HRT isiniciated in early menopause • Indeed it is the best choice for symptoms • It is beneficial to genitourinary problems • Prevents genitourinary atrophy • Preserves bone mass • Maintains skin appearance

  10. Until when? • It is a permanent question • Good until it is beneficial • The minimum dose, the minimum time

  11. Until when? • It is a permanent question • Good until it is beneficial • The minimum dose, the minimum time ... ??? ...

  12. Which hormones? • Estrogens • Conjugated equine estrogens? • Progestins • Medroxyprogesterone?

  13. Which hormones? • Estrogens • Conjugated equine estrogens? • 17β-estradiol? • Progestins • Medroxyprogesterone? • Dydrogesterone? • Drospirenone? • Trimegestone?

  14. Which hormones? • Estrogens • Conjugated equine estrogens? • 17β-estradiol? • Progestins • Medroxyprogesterone? • Dydrogesterone? • Drospirenone? • Trimegestone? Oral? Non oral?

  15. Which hormones? • Estrogens • Conjugated equine estrogens? • 17β-estradiol? • Progestins • Medroxyprogesterone? • Dydrogesterone? • Drospirenone? • Trimegestone? long-term studies? Oral? Non oral?

  16. Treatment without hormones? • One medicine to each problem • Results maybe not so good • Less risk?

  17. Treatment without hormones? • One medicine to each problem • Results maybe not so good • Less risk? Each patient is unique!

  18. So, the question remains...

  19. ceci.lopes@hcnet.usp.br

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