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HORMONAL REPLACEMENT THERAPY: DOES AGING LIMIT THERAPEUTIC BENEFITS?. CECI MENDES CARVALHO LOPES CLÃNICA 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? CECI MENDES CARVALHO LOPES CLÍNICA GINECOLÓGICA DO HCFMUSP
menopause? treatment? HELP!!! what to do?
Therapy? Estrogens?
Therapy? Estrogens? Progestogens?
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
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
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? Oral? Non oral?
Which hormones? • Estrogens • Conjugated equine estrogens? • 17β-estradiol? • Progestins • Medroxyprogesterone? • Dydrogesterone? • Drospirenone? • Trimegestone? long-term studies? Oral? Non oral?
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? Each patient is unique!