Aftercare Education Articles

Recognize menopause and hormone supplement therapy 認識更年期及荷爾蒙補充療法

2016-11-09
What is menopause?
  • Menopause (Menopause): 
The aging of ovarian follicular function causes permanent menopause which happens to Taiwanese woman between ages 48 to 52. Doctors can often give affirmative diagnosis if the patients have no menstrual period for a year, counting from her last one.
  • Menopause (Climacteric): 

When women transit from having fertility ability to infertility, it is often referred to as climacteric menopause. 

Early menopause symptoms
  • The most common symptoms: 
Symptoms include hot flashes, night sweats, insomnia, irritability, palpitations (rapid heartbeat), depression, anxiety, arthralgia, muscle pain, and memory decline; all are direct reactions of reduced estrogen in vivo. 
  • Urogenital system: 

After menopause, epithelial and connective tissue of urogenital system atrophy and cause urinary tract infections. When the infection kicks in, it often incurs frequent micturition and incontinence. As a result, epidermal tissues of vagina turn thinner and triggers dryness leading to vagina inflammation and painful intercourse.

Late menopause issues 
  1. Cardiovascular system: 
    Pre-menopausal women rarely have myocardial infarction; because they lack of protection from estrogen, they are more vulnerable of getting coronary heart diseases such as myocardial infarction and stroke risk
  2. Osteoporosis: 
    Bone loss rate varies from person to person and bone density reaches its peak when women hit 35. After that, bone density loses as one ages; a woman’s osteoporosis condition becomes worse after menopause and that puts her at risk of spine, carpal, and hip fractures. 
Hormone Replacement Therapy 

Hormone replacement therapy can be divided into three categories: 

  1. Contains only estrogen: 
    appropriate for women after hysterectomy. 
  2. Periodical hormone (antagonist type) replacement therapy: 
    Patients would be given estrogen for 21-25 days per month with 12-14 days progesterone periodically, and they may still have stable menstrual period with such a treatment. 
  3. Continuous combined hormone replacement therapy: 
    This kind of therapy prevents patients from monthly bleeding because taking combined estrogen and progesterone on a daily basis forces continuous progesterone to fight estrogen in order to prevent endometrial hyperplasia. 
The use of hormone replacement therapy may incur
  • breast tenderness 
  • irregular bleeding 
  • stomach flatulence 
  • and weight gain side effects 

Note: If patients are treated with proper doses of hormone formulations, their conditions should be improved  

Contraindication of the use of hormone replacement therapy
  1. genital tract bleeding without a definite diagnosis
  2. Known or suspected breast cancer
  3. Acute thrombosis or phlebitis or thrombo-embolism.
  4. Serious liver-type activities 
Conclusion

Taiwanese women’s average life span has reached 83.3 years old, and one third of their life is menopause; most of them are terrified of the idea, yet all women are capable of living elegantly with high-quality healthy life if they work out regularly, consume a balanced diet, check in for Pap smear once a year, examine they own breast once a month, and exercise hormone replacement therapy correctly.

中國醫藥大學附設醫院

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