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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 - PowerPoint PPT Presentation
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HORMONAL REPLACEMENT THERAPY: DOES AGING
LIMIT THERAPEUTIC BENEFITS?
CECI MENDES CARVALHO LOPES
CLÍNICA GINECOLÓGICA DO HCFMUSP
Therapy?
Estrogens?
Therapy?
Estrogens?
Progestogens?
Therapy?
HRT• Better quality of life
– Acting positively on
• Symptoms• Lipids• Bone mass• Skin
HRT• Better quality of life
– Acting positively on• Symptoms• Lipids• Bone mass• Skin
– But there are risks and adverse effects!• Thromboembolism• Cancer
HERS II (Cardiac events/ 10000)
NS
What to conclude?
• It seems there is cardioprotection – if HRT is iniciated 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
Until when?
• It is a permanent question
– Good until it is beneficial
– The minimum dose, the minimum time
Until when?
• It is a permanent question
– Good until it is beneficial
– The minimum dose, the minimum time
... ??? ...
Which hormones?
• Estrogens– Conjugated equine estrogens?
• Progestins– Medroxyprogesterone?
Which hormones?
• Estrogens– Conjugated equine estrogens?– 17β-estradiol?
• Progestins– Medroxyprogesterone?– Dydrogesterone?– Drospirenone?– Trimegestone?
Which hormones?
• Estrogens– Conjugated equine estrogens?– 17β-estradiol?
• Progestins– Medroxyprogesterone?– Dydrogesterone?– Drospirenone?– Trimegestone?
Which hormones?
• Estrogens– Conjugated equine estrogens?– 17β-estradiol?
• Progestins– Medroxyprogesterone?– Dydrogesterone?– Drospirenone?– Trimegestone?
Treatment without hormones?
• One medicine to each problem
• Results maybe not so good
• Less risk?
Treatment without hormones?
• One medicine to each problem
• Results maybe not so good
• Less risk?