Hormonal contraceptives during menopause. The use of hormonal drugs during menopause: a review of remedies. Selective estrogen receptor modulators: Evista

Menopause in women is a period of decline of the reproductive system. This stage is characterized by a gradual cessation of hormone production. Due to hormonal changes, the menstrual cycle changes.

At the beginning of menopause (premenopause occurs approximately 4 years before menopause), cycle fluctuations appear - menstruation becomes irregular, light and short-lived, and rarely disappears suddenly.

However, eggs still continue to be produced. Therefore it exists. Gradually, the discharge decreases until menstruation stops completely, and menopause occurs (no discharge for more than 12 months) - the end of the reproductive period.

The longer premenopause lasts, the lower the likelihood of fertilization, but still the possibility of becoming pregnant remains. This is why it is recommended to use contraceptives.

Do I need to use protection if I haven’t had my period for more than 3 months? The symptoms of menopause and pregnancy have similar signs, so a woman may misinterpret a delay in menstruation, and pregnancy tests may not respond during this period. If a gynecologist confirms premenopause, then it is imperative to use protection.

How to protect yourself during menopause?

The most suitable contraceptives for menopause are hormonal contraceptives, which not only protect against pregnancy, but also produce healing effect, due to the normalization of hormonal balance. As a result, the woman’s condition improves, and the unpleasant symptoms of menopause appear less pronounced.

Intrauterine hormonal devices, which contain the active substance gestagen, also have a therapeutic effect. The spiral is installed for several years and is a wonderful preventive measure for uterine bleeding and endometrial hyperplasia.

Sometimes hormonal drugs are contraindicated, in which case other contraceptives may be used as methods of contraception. The latter do not produce a therapeutic effect on the body, but effectively protect against pregnancy:

• Condoms;
• Candles;
• Surgical sterilization.

To understand how to protect yourself during menopause and which specific method of contraception to choose, you should consult a gynecologist.

Birth control pills and menopause

At making the right choice hormonal contraceptive, the likelihood of developing the following complications of menopause is reduced:

• Atherosclerosis;
• Ischemic disease.

Contraceptive hormonal medications suppress ovarian function and prepare the body for natural aging. The drugs have a substitution effect and compensate for the lack of own hormones with artificial analogues.

As a result, work is normalized nervous system, the hormonal balance is corrected and the manifestation of such unpleasant symptoms of menopause as hot flashes, insomnia, high blood pressure, etc. is reduced.

In what cases can you take contraceptives?

Oral contraceptives should be prescribed after a complete examination of the patient and a series of tests. After the results are obtained, the doctor must assess the woman’s health status and, based on this, prescribe the necessary drug and regimen.

The doctor should also consider the following factors:

• Blood viscosity;
• Patient's weight;
• Having bad habits;
• Diseases of the liver, kidneys;
• Presence of diabetes mellitus;
• Having had a stroke or heart attack.

If a woman has at least one of the above factors, then the use of hormonal contraceptives is questionable.

If a woman does not have any restrictions on use, then the use of such contraceptives will be beneficial in the pathological course of menopause: disorders of the endocrine, nervous, cardiac systems and other changes in the body.

List of contraceptive drugs

Currently, the pharmaceutical market is overflowing with various hormonal contraceptives. Medicines have different mechanisms of action, so a drug that is suitable for one woman may be contraindicated for another, depending on the prevailing symptoms of menopause and the general health of the patient.

The most popular, effective and safe medications in this group are:

Lendinet 30.

These hormonal birth control pills and menopause are perfectly compatible. The drug has a low hormone content, so it is not a source of side effects.

Janine.

Taking the medication helps normalize the menstrual cycle, reduce the amount of discharge and, as a result, reduce the likelihood of iron deficiency anemia.

Yarina.

The drug is well tolerated. In addition to the contraceptive effect, the drug prevents weight gain and fluid retention in the body.

Regulon.

Used as a contraceptive and also for the treatment of menstrual irregularities. The medicine has a beneficial effect on lipid metabolism and reduces the volume of menstrual flow.

With the onset of premenopause, a woman’s body begins to experience menopausal symptoms associated with a deficient level of estrogen.

Particular discomfort is caused by manifestations such as increased sweating, rapid gain of extra pounds, disturbances in the rhythm of the heartbeat, a feeling of dryness on the vaginal mucosa, and urinary incontinence. Hormonal medications for menopause will help eliminate all unpleasant menopausal symptoms.

All hormonal drugs are divided into 2 main groups:

1. Estrogen-containing medications, prescribed mainly after hysterectomy (surgical removal of the uterus).
2. Combined products containing progesterone, which protects the endometrium, as well as estrogen.

Hormonal pills for menopause are in an efficient way relief from severe climacteric consequences. The basis of treatment with hormone replacement therapy is the systematic intake of hormones, observation by a specialist and periodic examination of the whole body to identify pathologies accompanying the menopause.

It is also necessary before taking HRT drugs to make sure that it is suitable for the body and there are no contraindications. Hormone replacement therapy for menopause should only be prescribed by a qualified specialist.

Let's take a closer look at why hormone therapy is prescribed and its positive aspects.

The positive side of hormone therapy

With the onset of menopause in women, involutional changes begin in the body, characterized by the extinction of hormonal levels, the functionality of the ovaries, changes in the structure of tissues in the brain, leading to a decrease in the production of progesterones, and then estrogens, and the appearance of corresponding symptoms, manifested in the form of:

• Menopausal syndrome. In premenopause, it occurs in 35% of the female population, in 39-42% in women with the onset of menopause, in 19-22% after 12 months from the onset of menopause and in 3-5% after 4-5 years after the menopause.

The manifestation of menopausal syndrome is associated with the formation of hot flashes and a sudden sensation of heat, increased sweating followed by chills, psycho-emotional instability, increased blood pressure and its spasmodic nature. Also, an increase in the rhythm of the heartbeat, the appearance of a feeling of numbness at the tips of the fingers, pain in the heart area, sleep disturbance and the appearance of insomnia, depression and other associated symptoms.

• Disorders of the female genitourinary system, manifested in the form of decreased libido against the background of decreased testosterone levels, dryness on the mucous surfaces in the vaginal area, urinary incontinence, especially during sudden sneezing, coughing or fright. You may also experience pain during urination.
• Dystrophic changes in the skin and their appendages, accompanied by the formation of diffuse alopecia, dry skin, increased fragility of the nail plates, and the appearance of deeper wrinkles.
• Disorders of metabolic processes in the body: this type of pathological changes is accompanied by a decrease in appetite and a simultaneous increase in the mass of the subcutaneous fat layer. Also, fluid from the body begins to be excreted at a slow pace, which leads to the formation of pastiness in the face and swelling of the legs.
• The development of late manifestations related to the formation of osteoporosis, which occurs against the background of a decrease in the level of calcium in the skeletal system of the body, as well as hypertension, ischemia, Alzheimer's disease and other equally serious pathologies.

Consequently, all menopausal changes occurring in a woman’s body can occur with the development of certain symptoms with varying degrees expressiveness.

Hormone replacement therapy for menopause is an effective method that helps prevent, eliminate or significantly reduce dysfunction of all organ systems and reduce the risk of serious pathological processes occurring against the background of hormonal deficiency.

The main principles of hormone replacement therapy are:

1. Prescription of drugs, the main composition of which is similar to female sex hormones.
2. Taking small doses corresponding to the level of endogenous estradiols, especially in the proliferative stage.
3. Treatment with various combinations of estrogen and progesterone to help prevent the occurrence of endometrial hyperplasia.
4. After a hysterectomy (surgical removal of the uterus), it is possible to take medications containing only estrogens.
5. Prophylactic use of hormonal drugs, aimed at eliminating the occurrence of pathologies such as osteoporosis and cardiac ischemia, should be at least 5 years.

The main active component of hormonal drugs is estrogens. By adding gestagens, a kind of prevention of the hyperplastic process on the mucous membranes of the uterus and control of its condition are carried out. Let's look at the list of the most effective hormonal drugs.

HRT drugs

Taking HRT during menopause and new generation drugs should only be prescribed by a qualified specialist.

Klimonorm

This medicine belongs to the group of antimenopausal drugs. This drug contains two active components - estrogen and gestagen, the main action of which is aimed at eliminating menopausal symptoms and preventing the occurrence of endometrial cancer and hyperplasia.

The unique composition of the drug and adherence to a special dosage regimen in combination provide a chance of restoring the menstrual cycle in women who have not undergone a hysterectomy.

The active component estradiol contained in Klimonorm completely replaces the lack of natural estrogen in a woman’s body during menopause. This helps eliminate vegetative and psychological problems that arise during menopause due to a decrease in testosterone and sexual activity. When taken correctly, the drug can reduce the rate of formation of deep wrinkles and increase the collagen content in the skin. Moreover, the drug reduces blood cholesterol levels and the risk of gastrointestinal pathologies.

If the menstrual cycle is unfinished and even rare menstrual discharge occurs, treatment should begin on the fifth day after the start of menstruation. If amenorrhea develops at the beginning of the menopausal period, treatment can be started at any time, provided there is no pregnancy.

One package of the drug is designed for a 3-week course of treatment. To achieve the desired result, you must take hormones according to the prescribed treatment regimen. When taking increased doses of the drug, adverse reactions of the body may occur, manifested by stomach upset, vomiting and bleeding not associated with the menstrual cycle. You can get rid of the symptoms of an overdose with the help of systematic treatment prescribed by your doctor.

Femoston

Hormone replacement therapy during the postmenopausal period involves taking this two-phase combination drug if the woman has no contraindications. The two active components that make up this drug, estradiol and progesterone, have a similar effect on the body as natural female sex hormones.

Together, estradiol and progesterone contribute to:

• Elimination of vegetative symptoms;
• Elimination of psycho-emotional disorders;
• Prevention of the development of osteoporosis, cancer of the uterus and hyperplasia.

The tableted drug Femoston must be taken at the same time period once a day. Treatment should be carried out according to the prescribed regimen. In the first two weeks, it is recommended to take hormones in white tablets. For the next two weeks of course treatment, you need to take gray tablets.

For women with a predominant menstrual cycle, treatment is prescribed from the first day of menstruation. For those who have irregularities in the menstrual cycle, a course of treatment with the drug “Progestagen” is initially prescribed, then Femoston is taken, according to a special treatment regimen. Women who have no menstrual cycle at all can start taking the drug at any time.

To obtain the desired result, female hormones in tablets must be taken, strictly following the treatment regimen, this is the only way to improve overall well-being and delay the onset of old age.

Klimadinon

This drug belongs to the group of herbal medicines containing phytohormones. Prescribed for the treatment of menopausal symptoms and elimination of vegetative-vascular disorders, when there are obvious contraindications and hormones cannot be taken during menopause.

The treatment regimen and duration of treatment are prescribed depending on the individual characteristics of the woman’s body.

Angelique

Angelique, like Klimonorm, are medications for menopause in women that help get rid of unpleasant symptoms and improve overall well-being.

Angeliq is used for:

• Normalization of general well-being;
• Eliminating unpleasant symptoms of hot flashes and reducing the frequency of their occurrence;
• Prevention of osteoporosis;
• Increasing testosterone levels, and, consequently, normalizing sexual activity.

Do not accept this medicine in the presence of the following factors:

• The presence of bleeding from the vagina of unknown etiology;
• Development of a cancerous tumor in the mammary glands;
• For diabetes, hypertension and venous thrombosis.

Angelique contains the necessary hormones during menopause, which are an excellent solution for improving well-being and restoring hormonal imbalances, especially for women over 45-46 years old.

Klimara

This is a hormonal drug, produced in the form of a patch, which contains estradiol in a dose of 3.8 mg. The patch is glued to a certain area of ​​the skin, after which the active component begins to be released and the woman’s general well-being improves. It is recommended to wear one patch for no more than a week. On the last day of the week, it is necessary to replace the used patch with a new one, making sure to change the place for its fixation.

Under the influence of the patch, the level of testosterone in the body increases, which has a positive effect on the psycho-emotional state and increased libido. There are no special contraindications to the use of the patch, but before using it you should consult a specialist.

During menopause, female hormones decrease under the influence of age-related changes and the transition period, worsening the woman’s condition. Therefore, it is necessary to use HRT drugs that can, in a short period of time, relieve a woman of disorders of the autonomic system, decreased testosterone levels and the ensuing consequences: changes in the psycho-emotional state. Among other things, hormonal drugs are generally well absorbed and have no adverse reactions.

In order to find out what to drink during menopause, you need to undergo a complete diagnosis of the body’s condition and consult with a specialist.

Spontaneous intake of hormonal drugs can be not only useless for the body, but also dangerous, entailing irreversible consequences. Therefore, you should take hormonal medications only as prescribed by your doctor.

Interesting and educational video

Some women prefer to use hormonal drugs during menopause. At this time, the ovaries begin to work less and less. The production of essential hormones (estrogen and progesterone) is much slower. Changes occur in the body, accompanied by hot flashes and unpleasant symptoms such as dryness of the uterus.

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How do hormonal drugs work?

Taking hormonal medications allows you to replenish the reserves of necessary hormones in the body; this is a very effective method of treating hot flashes in women. There are possible complications when taking it, including a predisposition to stroke and cancer, the formation of blood clots, and problems with the gallbladder. This depends on the woman's age and whether she has had a hysterectomy (surgery to remove the uterus).

Hormones should not be used during menopause in the following cases:

• breast or uterine cancer;
• suffered a stroke, heart attack;
• problems with blood clotting or recent vaginal bleeding;
• liver diseases;
• pregnancy or the possibility of its occurrence;
• allergic reactions to hormonal drugs.

Before treatment, you should consult with your doctor to determine whether menopause hormones are an appropriate treatment for you. He will definitely advise the best drugs during menopause.

Do I need to take hormonal medications during hot flashes?

Hormones should be used at the lowest dose for a short period of time. In this case they are effective. Hormones can be very effective for hot flashes, reducing their number and severity. They also help with vaginal dryness and bone loss.

What medications should I take during menopause? Products for women during this period may take the form of tablets, patches, rings, implants, gels and creams. There are many types and may include estradiol, conjugated estrogens, selective estrogen receptor modulators, and complex or synthetic hormones.

There is a common misconception that synthetic (“bioidentical”) hormones are safer and less risky than other types. They pose the same risks as any other drug.

There are relatively minor side effects when using hormonal therapy. These include breast tenderness, spotting or return of periods, colic or bloating. Your doctor can help control these effects by prescribing other medications or reducing the dose. Over time, these side effects may disappear on their own.

Complications with hormone therapy

Russian scientists in 2007 conducted a study aimed at studying the effect of these drugs on the body. Its results showed that women using hormonal pills during menopause and menopause had a significantly higher risk of stroke, gallbladder disease, urinary incontinence and breast cancer.

This caused concern among the female population; they became wary of using hormones. However, studies have reported that younger ladies are less at risk of negative consequences. They were mainly found in women 60 years of age and older.

What is best to drink during menopause and whether to use treatment at all, everyone decides for themselves. New drug prescriptions developed since 2007 significantly reduce the risks associated with the use of hormones.

There is an opinion about the treatment of hot flashes with such means as black cohosh (plant), soy isoflavones (phytoextragens). These folk recipes turned out to be not very effective when studied by scientists, the effect on the course of menopause was observed to be rather weak. The existence of other beneficial and safe herbs or natural products for menopause has not been sufficiently studied.

Types of drugs

Hormone therapy for menopause is used all over the world. These are effective drugs that, when taken, artificially supplement the deficiency of estrogen and gestagen.

New generation combined hormonal drugs

Combined drugs are new drugs for menopause. They are usually dispensed in 21 tablets and increase the amount of two hormones: estrogen and progestogen. All of them are marked with a special number so that the patient can use them in a certain sequence according to these numbers. Dosages may be different for each product. They are indicated in the instructions.

New generation hormonal drugs for menopause

The period for taking each product is 21 days. After this, you need to take a short break (a week). Some medications are taken daily. They have a portion of the pills without hormones that should be taken as a break. These include: Cliogest, Angelique, Pauzagest, Femostol and Actitvel.

Klimonorm is an effective drug for menopause of a new generation

Doctors also recommend hormonal contraceptives such as Janine during this period. This tool Prevents iron deficiency anemia, contains dienogest and ethinyl estradiol. Contraindications for taking it: diseases of veins and blood vessels, migraine, smoking, diabetes, liver dysfunction. Side effects may include nausea and vomiting.

Preparations with estrogens

All drugs contain the substance estradiol, which increases the amount of estrogen in a woman’s body. There are different forms of release of funds. Estrogen gel and cream for menopause are sold with an applicator for applying them. If it is not included in the package, you should buy it separately. Apply these medicines during menopause it is necessary once a day on the stomach and lumbar region. Next, you should wait a few minutes for them to absorb.

List of gels with estrogen

The patches are used once every 7 days. You need to glue them on the buttocks or along the spine, changing the place each time. They are not afraid of water, but can peel off if overheated.

List of plasters

You can also use subcutaneous implants, which are sewn under the skin for half a year. Their main advantage is a one-time installation, after which you can forget about them. The implants release the required amount of hormone daily to maintain normal condition.

All products with estrogens must be taken in combination with gestagens. This will prevent possible side effects. The course of treatment is selected individually.

Preparations with gestagen (progesterone)

Preparations with gestagen are prescribed together with estrogens. The duration of treatment may vary and is determined only by the doctor.

WARNING. Women with an absent uterus should not take gestagens.

They are produced in tablets, gels, and suppositories. There are also hormonal IUDs.

Female hormones in tablets

Products with gestagens are taken in cycles of 10 days. Most often tablets are prescribed, but in some cases gels or suppositories are used.

Candles and gels to eliminate menopause symptoms

It is possible to install a hormonal device into the uterus; it lasts about 8 years, after which it should be replaced. Your personal doctor will be able to select the best medications for a specific case.

Plant hormones

Herbal hormones with fewer side effects are a good alternative. They are often prescribed when there are contraindications to non-herbal drugs to alleviate well-being during menopause.

Remens is a herbal product

All of these products are dietary supplements and can achieve a noticeable effect only with long-term use. On average, when taken systematically for 21 days, the body of a premenopausal woman is saturated with the required amount of hormones.

It is useful to take Femiwell during menopause. This is a vitamin complex designed specifically for women during this period.

Video

Gynecologist-endocrinologist Irina Vsevolodovna talks about hormonal medications for menopause.

For women, the most difficult physiological period in life is menopause, which is a transitional state of the body associated with natural aging. This important and long period consists of several stages (premenopause and postmenopause), begins at 45 years of age and lasts until 69-75 years of age, after which old age sets in. Are any pills prescribed for menopause, and which ones are the best?

It is impossible to give an unambiguous answer to these questions, since the individual characteristics of each organism, the accumulated consequences of somatic diseases and neuropsychic disorders are reflected in the nature of the course of the same disease or disorder. Therefore, treatment planning should be individualized, taking these features into account.

How to delay the onset of menopause and reduce its manifestations

The aging process is the cause of the decline of the hormonal function of the ovaries, mainly in which the synthesis of sex hormones occurs. When their level in the blood decreases, the body reacts with corresponding changes in the functioning of all organs and systems, which is necessary to maintain a constant internal environment.

If this process is physiological and inevitable, then how does it manifest itself? Is it possible to slow it down and what medications to take during menopause to correct negative manifestations?

Manifestations of menopause

It is accompanied by various disorders, often worsening a woman’s health and reducing her quality of life. A decrease in the level of sex hormones, mainly estrogens, is manifested by certain, more or less pronounced, symptoms of disorders, depending on which drugs are prescribed to treat menopause. Early symptoms include:

1. Psycho-emotional disorders - increased fatigue and decreased activity, vulnerability, mood instability and depressive disorders in the form of a feeling of tension, internal anxiety for one’s health, unmotivated touchiness and increased irritability, tearfulness, conflict, feelings of hostility, suspicion and distrust towards others, fear before approaching old age, etc.
2. Dissomnia disorders - impaired sleep quality, difficulty falling asleep, frequent awakenings, snoring and nighttime breathing stops (“sleep apnea”), restless legs syndrome.
3. Vegetative-vascular disorders, which, as a rule, are combined with psycho-emotional and dyssomnic ones. These include a feeling of palpitations, lack of air and suffocation, headache and dizziness, aching and stabbing pain in the heart area, instability (high and low) blood pressure, chills and hot flashes to the upper half of the body, accompanied by redness of the face and skin of the anterior surface of the chest cells, attacks of severe profuse sweating, numbness of the fingers, etc.

The listed three groups of symptoms and syndromes belong to early manifestations climacteric period and are united by one term - “menopausal syndrome”. It begins in the premenopausal period, menopause and the first 1-3 years of postmenopause and can last about 2-5 years.

Subsequently, the following group of symptoms develops, called medium-term and lasting about 5-10 years after menopause:

1. Urogenital disorders - urinary incontinence, symptoms of urethritis and cystitis, dryness of the vaginal mucosa and associated discomfort when walking, pain during sexual intercourse, burning and itching in the genitals.
2. Pathological changes in the skin and its appendages - dryness and itching of the skin, the appearance of folds and deepening of wrinkles, increased fragility and hair loss, brittle nails.

5-10 years after menopause, late manifestations of estrogen deficiency gradually develop, which are, in fact, complications of menopause:

1. Metabolic disorders of fats and carbohydrates and associated weight gain, diabetes mellitus, atherosclerotic changes in blood vessels, mainly in the heart and brain.
2. Hypertension and coronary heart disease.
3. A decrease in bone mass and its mineral density (osteopenia), which is the initial stage of osteoprosis of bones.
4. Memory loss, difficulty thinking.
5. Dementia called Alzheimer's disease.

General principles of treatment during menopause

Is it worth taking hormonal medications during menopause, given the deficiency of sex hormones? This question reflects doubt not only among women outside the medical profession. It has been the subject of discussion among practitioners and scientists for many years.

Non-hormonal drugs

In the first period, taking non-hormonal drugs during menopause, which occurs with a small number of manifestations of the menopausal syndrome and a low degree of their intensity, is quite sufficient to correct the woman’s condition. There are many means of different groups.

For example, Clonazepam, which has an antiparoxysmal effect. It helps reduce the number of hot flashes, especially at night, helps with sweating and helps normalize night sleep.

By taking drugs from the group of dopamine receptor agonists, you can significantly reduce the severity of restless legs syndrome, which develops most often at night, or get rid of it altogether. This, in turn, helps to normalize or improve the quality of night sleep and significantly improve overall well-being.

Taking Magne B 6 Forte, which replenishes the deficiency of magnesium, which accumulates in the bones and often decreases during menopause, also helps to reduce the intensity of the manifestations of this syndrome (“restless legs”). “Magne B 6 forte” promotes normal cellular functioning, participates in the processes of regulating the transmission of impulses from nerve endings to muscles, helps normalize blood pressure and has a mild sedative effect.

Sedative (sedative) and hypnotic drugs of various groups, synthetic or herbal, effectively help in eliminating or reducing the severity of dissomnia, psycho-emotional and vegetative disorders. They relieve sudden changes in blood pressure, insomnia, sweating, etc.

Selective serotonin reuptake inhibitors, which include the latest generation antidepressants such as Sertraline, Fluoxetine, Citalopram and many others, are highly active and safe. They are indicated in cases of significant severity of emotional and affective disorders, especially when a woman refuses to use hormone replacement therapy or if there are contraindications to its use.

Pharmaceutical individual calcium preparations are produced for the prevention of osteopenia and osteoporosis, mineral-vitamin complexes, as well as homeopathic preparations for menopause, containing proteins and nucleotides, non-hormonal estrogen-like substances with a mild effect, vitamins and microelements, plant extracts with sedative and blood pressure-normalizing effects.

Here short list homeopathic medicines:

1. Qi-Clim.
2. Beta-alanine.
3. Klimakt-hel.
4. Menopace.
5. Metro-adnex-inject.
6. Felipax.
7. Ovarium compositum.
8. EDAS.
9. Klimalanin.
10. Epifamin.
11. Red brush.
12. Lady’s formula “Menopause”, etc.

Often, menopausal syndrome is severe, which leads to disability and difficulties in relationships even with loved ones. It may be accompanied by growth and menstrual irregularities in the form of heavy and frequent bleeding. Treatment regimens without hormones and the prescription of only symptomatic therapy in these cases are ineffective.

Hormone therapy

At the same time, hormone replacement therapy and modern hormonal drugs used for menopause are a pathogenetically based method of treatment. These are the most effective drugs (in the absence of contraindications), which can relieve not only the severe course of menopausal syndrome (hot flashes and chills, excessive sweating and restless legs syndrome, palpitations, etc.), but also can prevent the development of medium-term and late complications.

What hormonal medications should I take?

Thus, the best methods for relieving the manifestations of menopausal syndrome and preventing cardiovascular pathology, osteoporosis, and Alzheimer's disease are schemes (long-term and short-term, monophasic, biphasic and triphasic) of hormone replacement therapy, which includes drugs containing estrogens and estrogens with progestins.

In addition, sometimes they resort to prescribing drugs that are similar in their mechanism of action to the male sex hormone testosterone or that stimulate the synthesis of the latter in the body.

Basic drugs with estrogens for menopause

This list includes estrogens and drugs with estrogen-progestin action, monophasic and biphasic:

• Ethinyl estradiol and diethylstilbestrol (also included as components in).
• Estrofen.
• Cliogest.
• Proginova and Cycloproginova.
• Premarin and Hormoplex.
• Estriol and Ovestin.
• Regulon (Marvelon).
• Diana is 35.
• Logest.
• Novinet (Mersilon).
• Femoden.
• Rigevidon.
• Miniziston.
• Klymen.
• Divina.
• Klimonorm.
• Femoston and Duphaston.
• Livial (Tibolon) - considered the most effective drug for osteoporosis (for treatment and prevention).
• Androcur (cyproterone acetate) - although it is not an estrogen, but, by displacing androgens competitively in target organs, it is their antagonist and thereby enhances the effect of estrogens (prevents hirsutism, androgenic alopecia, excessive secretion of sebum by the sebaceous glands, etc.).

New generation combination drugs - three-phase:

• Trisiston.
• Tri-regol.
• Triquilar.
• Triaclim.
• Trisequence.
• Divisek.

Non-hormonal medications for menopause

It is highly effective and characterized by a rapid therapeutic and prophylactic effect. Unfortunately, due to medical contraindications, its use is limited. In addition, among many women there is a prejudice against hormonal treatment.

In such cases, alternative means may be used. Certain herbal preparations for menopause (phytohormones) have estrogen or androgen-like effects. Offers its own remedies and courses of treatment and homeopathy.

Although the effect of various herbal medicinal forms, including phytohormones, is much less pronounced than that of synthetic hormones, nevertheless, in some cases their effectiveness can be sufficient not only to reduce the severity of menopausal syndrome, but also to prevent complications of menopause (osteoporosis , obesity, etc.).

The most effective medications for menopause of plant origin are extracts of the rhizome of angelica chinensis, or female ginseng, sanguinaria sinensis, native dry extract of the rhizome of black cohosh, and soybeans. They are also included in homeopathic preparations. These plants, especially black cohosh, while not being hormones, have a pronounced hormonal, estrogen-like effect. Its components (isoflavones, saponins, essential oils, cohosh, etc.) act on estrogen receptors and the anterior pituitary gland and, as a result, help stimulate the synthesis of estrogen by the body itself.

Considering disorders of fat metabolism and weight gain, herbal and homeopathic remedies are recommended, along with proper nutrition And physical exercise, as drugs for weight loss during menopause.

Homeopathic preparations containing cohosh extract or soy extracts containing biologically active substances with an estrogenic effect (short list):

1. Climandion and Climandion-uno.
2. Klimaktoplan.
3. Estrovel.
4. Remens.
5. Lefem.
6. Inoclim.
7. Femiwell.
8. Feminal (red clover extract), etc.

However, the ovaries produce not only female sex hormones, but also a small amount of testosterone (male sex hormone), the concentration of which also decreases as their function fades. The male sex hormone in a woman’s body is involved in:

• maintaining libido;
• metabolic processes - lipid, mineral, carbohydrate and other types;
• maintaining a balance in the ratio of muscle and adipose tissue - reduce the content of adipose tissue mass in relation to muscle mass;
• regulation of cellular regeneration processes, including hair follicle cells;
• formation of young collagen and elastin fibers;
• regulation, together with estrogens, of the function of the sebaceous glands, since testosterone is able to transform into progesterone.

Testosterone deficiency leads to:

• development of atherosclerotic processes;
• decreased activity;
• the appearance of drowsiness;
• decreased muscle tone and physical strength;
• the appearance of lethargy;
• decreased ability to assimilate new information;
• decreased bone mineral density;
• deposition of adipose tissue on the anterior abdominal wall and lateral surfaces of the abdomen according to the male type, etc.

However, testosterone and its derivatives are not prescribed specifically to eliminate these negative processes, including osteoporosis and to reduce body weight. Their use is possible only for men, and use by women is potentially dangerous due to the possibility of developing metabolic syndrome.

If necessary (under the control of blood tests), the drug “DHEA” can be used, which is a dietary supplement in the form of tablets containing dihydroepiandrosterone. The latter is an anabolic ketosteroid produced in the human body by the adrenal cortex. In cells, it is able to transform into both testosterone and androstenedione, and into estrogens, which is regulated by the body itself. Thus, the transformations of this steroid, depending on the lack of certain sex hormones in the blood, are carried out without negative consequences through self-regulation.

Also, during menopause, such herbal preparations as Tribestan tablets, which is a dry extract of a herb called Tribulus terrestris, and Tribulustan+, the main components of which are dry extracts of fenugreek and dioskerea, can be used.

The active biologically active substances of these drugs are dioscin and protodioscin. The structure of these three medicinal plants is not entirely understood, but it is believed that in the body they are released or converted into dihydroepiandrosterone, the meaning and mechanism of action of which is described above. Their use, in addition to the testosterone-like effect, is quite effective against osteoporosis and for reducing body weight.

Thus, at present, there is a huge arsenal of means that allow them to be used in complex therapy and quite effectively stop the most diverse manifestations of menopause, restore a woman’s quality of life and prevent the development of its complications.

At the same time, their independent, uncontrolled and often unjustified use can not only complicate the course of the menopausal period and complicate its subsequent treatment by specialists, but also lead to cancer. It is only possible, and only for a short period of time, to self-correct neurovegetative and psychosomatic disorders with infusions of plants and homeopathic medicines, taking into account the small dosages of the active components contained in them.

This is the cessation of menstruation, which sooner or later occurs in the life of every woman. Menopause does not come suddenly: already 12-24 months before the cessation of menstruation, a woman begins to notice signals indicating the approach of menopause.

At what age does menopause occur?

For most women, menopause occurs between the ages of 45 and 55. The first signs of menopause may appear in women under 45 years of age.

What happens while taking birth control pills?

During menopause, the level of female sex hormones in the blood decreases, which causes sweating, mood swings and other symptoms of menopause. Birth control pills contain female sex hormones, which compensate for the deficiency of their own hormones during menopause. Thus, the body “does not notice” that there are fewer hormones and continues to work in the old mode.

So, for example, during the 7-day break between packages, “menstruation” still occurs. The word “menstruation” is deliberately placed in quotation marks, since, in fact, it withdrawal bleeding caused by discontinuation of hormones. Women often confuse this withdrawal bleeding with real menstruation and are not even aware that they have already entered menopause.

What symptoms indicate the approach of menopause?

The main sign of approaching menopause (menstrual irregularities and cessation of menstruation) is absent in women taking birth control pills. If you take birth control pills, you can recognize the approach of menopause by the following symptoms:

• Hot flashes
• Increased sweating at night
• Insomnia
• Mood swings

The signs described above may appear only occasionally, during a 7-day break between packs, when the body temporarily does not receive hormones from the outside. These signs may be very weak or completely absent while taking oral contraceptives.

How safe is it to take birth control pills after 35-40 years of age?

Oral contraceptives are prescribed with caution to women over 35 years of age. First of all, this is due to the fact that birth control pills thicken the blood, increasing the risk of blood clots forming in the blood vessels. Such blood clots, when entering the vessels of the heart, cause a heart attack, and into the vessels of the brain - a stroke. These are dangerous conditions that can cause death.

However, if you have been taking oral contraceptives for a long time and are satisfied with them, then if the following conditions are met, you can continue taking birth control pills after 35 years:

• If you don't smoke
• If you have normal blood pressure (no hypertension)
• If you are not overweight
• If you: your diet contains large number plant products and small amounts of animal fats
• If you do not suffer from varicose veins of the legs
• If you are taking birth control pills that contain small doses of hormones
• If you regularly (at least once a year) visit a gynecologist

How to protect yourself from complications?

In order to protect yourself from complications such as the formation of blood clots in the vessels, take a blood test for coagulation (coagulogram). Contact your gynecologist with the test results.

How do you know that menopause has already arrived?

How can you find out about the onset of menopause if birth control pills mask almost all of its symptoms?

Only with the help of a blood test for the sex hormone - follicle-stimulating hormone (FSH). A high level of FSH indicates that menopause has not yet occurred, and a low FSH level in the blood indicates menopause.

FSH and menopause

A low level of FSH in the blood does not provide a 100% guarantee that menopause has already occurred. It sometimes happens that when FSH levels are low, a woman stops taking birth control pills and her menstrual cycle resumes. This indicates that menopause has not yet occurred and the woman can still become pregnant. Cases of pregnancy at 45-50 years old, although rare, do occur.

When should you take a blood test for FSH?

Taking birth control pills distorts the results of a blood test for FSH. You need to donate blood for analysis on those days when hormones are practically eaten out of the body.

• If your package of birth control pills contains 28 pills, then you need to donate blood for analysis on the days you take the last pills from the package (27 and 28 tablets).
• If there are 21 pills in a package of your birth control pills, then you need to take a blood test on the 6-7th day of the week-long break between packages.

What to do if menopause has already arrived?

During menopause, the likelihood of pregnancy is significantly reduced. Pregnancy becomes impossible a year after menopause.

Thus, after the onset of menopause, you no longer need to take birth control pills.

Should I stop taking birth control pills during menopause?

As already mentioned, birth control pills reduce the symptoms of menopause, making its onset more invisible to a woman. So why give up oral contraceptives if they help mask the onset of menopause?

The answer is simple. Even low-dose birth control pills contain doses of hormones that suppress ovarian function. After the arrival of menopause, the need for such doses of hormones disappears, since the work of the ovaries no longer needs to be suppressed (they no longer function anyway).

There is no point in taking doses of estrogen that are 5-7 times higher than the dose you need during menopause. Moreover, excess estrogen can lead to the development.

Do I need estrogens during menopause?

Additional doses of estrogen help reduce hot flashes, eliminate insomnia, smooth out mood swings, and increase sexual desire. But even the smallest doses of hormones have side effects. That is why it is recommended to take estrogens only when necessary and only for the time when it is necessary.

• If, after stopping taking birth control pills, symptoms of menopause, although they appear, do not cause great discomfort, then you do not need additional estrogens.
• Hormone replacement therapy with estrogen is needed only for those women who have severe symptoms of menopause that interfere with everyday life.