Definicija i epidemiologija. Menopauza, poznata i kao klimakterij i klimaks, vreme je u životnom dobu žena kada menstruacijski period prestaje trajno i žene više ne mogu rađati. Menopauza je suprotnost menarhe, doba kada devojčici počinju menstruacije. Obično se javlja u dobu između i. Iz Wikipedije, slobodne enciklopedije Menopauza označava posljednje menstrualno krvarenje iz maternice i prestanak reproduktivno plodnog životnog vijeka žene. To je prirodna faza u životu žene.
Termin se izvorno se koristi za opisivanje reproduktivnih promjene kod žena, gdje trajno zaustavljanje menstruacije pokazuje kraj plodnosti. Bu səhifə sonuncu dəfə 29 dekabr tarixində redaktə edilib. Mətn Creative Commons Attribution-ShareAlike lisenziyası altındadır, bəzi hallarda əlavə şərtlər tətbiq oluna bilər. Ətraflı məlumat üçün istifadə şərtlərinə baxın.; Gizlilik siyasəti; Vikipediya haqqında. From Wikipedia, the free encyclopedia. (Redirected from Menopausal hormone therapy) Jump to navigation Jump to search. This article is about hormone replacement therapy in menopause. For other forms, see Hormone therapy. Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of.
Kategoritë: Për përmirësim Articles lacking sources All articles lacking sources Faqe pa burim informacioni. Estrogens and antiestrogens. Ndërsa ky ndryshim fillon të thellohet, aq më shumë simptoma para-menopauzale fillojnë të shfaqen. Në fazat fillestare të menopauzës njihen edhe cikle që zgjasin nga dy javë. Faza e peri-menopauzës, menopauzës dhe post-menopauzës është një ndryshim natyror dhe nuk duhet shikuar si sëmundje edhe pse tek disa femra ka vështirësi shumë më të mëdha se Menopauză wikipedia disa të tjera. Wikimedia Commons.
HRT is associated with an increased risk of ovarian Menomin Forte În Româniawith women using HRT having about one additional case of ovarian Menomin Forte În România per 1, users. The results were almost universally reported as risks and problems associated with HRT in general, rather than with Prempro, the specific proprietary combination of CEEs and MPA studied. Oral estrogens. Ndryshimet e papritura të humorit, pagjumësi, lodhje, probleme me kujtesën dhe një sërë simptomash Menopauză wikipedia tjera Menopauză wikipedia nuk kanë Menopauză wikipedia me çrregullimin hormonal të kësaj faze, megjithatë ende nuk mund të themi se cilat janë burimet e sakta Menopauză wikipedia i shkaktojnë këto simptoma. Menopauză wikipedia implant. Edhe niveli i hormonit mashkullor, testosteronit fillon të bjerë. For prevention, the WHI suggested that HRT may increase risk of dementia if initiated after 65 years of age, but have a neutral outcome or be neuroprotective for those between 50—55 years.
Lidhjet këtu Ndryshime të ndërvarura Ngarkoni materiale multimediale Faqet e veçanta Lidhja e përhershme Informacioni i faqes Cito artikullin Objekt Wikidata.
Articolul Menopauză este un subiect de care se ocupă Proiectul Medicină, o inițiativă ambițioasă de a dezvolta articole despre medicină, adăugând informații cât mai cuprinzătoare, detaliate și citate cu surse de încredere Dacă doriți să participați la acest proiect, vă rugăm să vă înscrieți aici. 6/29/ · Wikipedia: Instance of: biological process: Subclass of: menstrual cycle phase, climacteric: Part of: multicellular organism aging, development of the human body.
Category:Menopause – Wikimedia Commons
Menopauza predstavlja završetak reproduktivne sposobnosti kod osoba ženskog pola. Coronary heart disease. August Conjugated estrogens. New York Times. Në këtë Menopauză wikipedia përfshihet edhe ajo para-menopauzale që sjell një sërë ndryshimesh drejt menopauzës. Journal of Clinical Pathology. Annals of Internal Menopauză wikipedia.
Multiple studies suggest that the possibility of HRT related stroke is absent if therapy is started within five years of menopause,  and that the association is absent or even preventive when given by non-oral routes.
In postmenopausal women, continuous combined estrogen plus progestin decreases endometrial Menomin Forte În România incidence. Endometrial Menomin Forte În România has been grouped into two forms in the context of hormone replacement. Type 1 is the most common, can be associated with estrogen therapy, and is usually low grade.
Type 2 is not related to estrogen stimulation and usually higher grade and poorer in prognosis. Paradoxically, progestogens do promote the growth of uterine fibroids , and a pelvic ultrasound can be performed before beginning HRT to make sure there are no underlying uterine or endometrial lesions. Androgens do not stimulate endometrial proliferation in post menopausal women, and appear to inhibit the proliferation induced by estrogen to a certain extent. Studies regarding the association of breast Menomin Forte În România with hormone replacement are inconsistent and vary with type of replacement and time since menopause. While some evaluations suggest an increased risk, in others it is decreased. There is a non-statistically significant increased rate of breast Menomin Forte În România for hormone replacement therapy with synthetic progesterone.
There have been no randomized controlled trials to date.
The most recent follow up of the Women’s Health Inititiative participants demonstrated a lower incidence of breast Menomin Forte În România in post-hysterectomy participants taking equine estrogen alone, though the relative risk was increased if estrogen was taken with medroxy-progesterone. HRT has been more strongly associated with risk of breast Menomin Forte În România in women with lower body mass indices BMIs. No breast Menomin Forte În România association has been found with BMIs of over Evaluating the response of breast tissue density to HRT using mammography appears to help assessing the degree of breast Menomin Forte În România risk associated with therapy; women with dense or mixed-dense breast tissue have a higher risk of developing breast Menomin Forte În România than those with low density tissue.
Micronized progesterone does not appear to be associated with breast Menomin Forte În România risk when used for less than 5 years with limited data suggesting an increased risk when used for longer duration.
A retrospective Cox proportional hazards analysis from Richard Neapolitan endorsed the reduced risk breast Menomin Forte În România with conjugated equine estrogen usage alone, but also suggested that conjugated equine estrogen with medroxyprogesterone acetate was associated with a risk reduction in breast Menomin Forte În România and that bioidentical hormone therapy was not associated with a statistically significant effect.
For women who previously have had breast Menomin Forte În România, it is recommended to first consider other options for menopausal effects, such as bisphosphonates or selective estrogen receptor modulators SERMs for osteoporosis, cholesterol-lowering agents and aspirin for cardiovascular disease, and vaginal estrogen for local symptoms. Observational studies of systemic HRT after breast Menomin Forte În România are generally reassuring. If HRT is necessary after breast Menomin Forte În România, estrogen-only therapy or estrogen therapy with a progestogen may be safer options than combined systemic therapy. With androgen therapy, pre-clinical studies have suggested an inhibitory effect on breast tissue though the majority of epidemiological studies suggest a positive association.
HRT is associated with an increased risk of ovarian Menomin Forte În România , with women using HRT having about one additional case of ovarian Menomin Forte În România per 1, users. In the WHI, women who took combined estrogen-progesterone therapy had a lower risk of getting colorectal Menomin Forte În România. However, the Menomin Forte În Românias they did have were more likely to have spread to lymph nodes or distant sites than colorectal Menomin Forte În România in women not taking hormones. There appears to be a significantly decreased risk of cervical squamos cell Menomin Forte În România in post menopausal women treated with HRT and a weak increase in adenocarcinoma.
HRT can help with the lack of sexual desire and sexual dysfunction that can occur with menopause. Decreased libido and sexual dysfunction are common issues in postmenopausal women, an entity referred to hypoactive sexual desire disorder HSDD; its signs and symptoms can both be improved by HRT. For most women, the majority of change occurs during the late perimenopausal and postmenopausal stages.
Testosterone is present in women at a lower level than men, peaking at age 30 and declining gradually with age; there is less variation during the menopausal transition relative to estrogen and progesterone.
A global consensus position statement has advised that postmenopausal testosterone replacement to levels that approximate premenopausal levels can be an effective treatment for HSDD. Safety information for testosterone treatment is not available beyond 2 years of continuous therapy however and dosing above physiological levels is not advised. In the setting of this limited data, testosterone therapy has not been associated with adverse events. Not all women are responsive, especially those with preexisting sexual difficulties. Pain or discomfort with sex appears to be the most responsive component to estrogen.
The effectiveness of hormone replacement can decline in some women after long-term use. In various placebo-controlled studies, improvements in vasomotor symptoms, emotional response, sleep disturbances, physical symptoms, and sexual desire have been seen, though it also carries a similar risk profile to conventional HRT.
For prevention, the WHI suggested that HRT may increase risk of dementia if initiated after 65 years of age, but have a neutral outcome or be neuroprotective for those between 50—55 years. With regards to treatment, randomized trials have shown that HRT improves executive and attention processes outside of the context of dementia in postmenopausal women, both in those that are asymptomatic and those with mild cognitive impairment.
There is a large decrease in hip fracture risk during treatment; this persists after HRT is stopped, though to a lesser degree. Hormone replacement therapy in the form of estrogen and androgen can be effective at reversing the effects of aging on muscle. Side effects in HRT occur with varying frequency and include: . The following are absolute and relative contraindications to HRT: . The extraction of CEEs from the urine of pregnant mares led to the marketing in of Premarin , one of the earlier forms of estrogen to be introduced.
Beginning in , studies began to show that without a progestogen, unopposed estrogen therapy with Premarin resulted in an 8-fold increased risk of endometrial Menomin Forte În România , eventually causing sales of Premarin to plummet. The Women’s Health Initiative trials were conducted between and and were the first large, double-blind , placebo-controlled clinical trials of HRT in healthy women. Other risks include increased endometrial Menomin Forte În România , gallbladder disease, and urinary incontinence , while benefits include decreased hip fractures , decreased incidence of diabetes , and improvement of vasomotor symptoms.
There is also an increased risk of dementia with HRT in women over 65, though at younger ages it appears to be neuroprotective. After the cessation of HRT, the WHI continued to observe its participants, and found that most of these risks and benefits dissipated, though some elevation in breast Menomin Forte În România risk did persist. The arm of the WHI receiving combined estrogen and progestin therapy was closed prematurely in by its Data Monitoring Committee DMC due to perceived health risks, though this occurred a full year after the data suggesting increased risk became manifest.
In , the arm of the WHI in which post-hysterectomy patients were being treated with estrogen alone was also closed by the DMC. Prior studies were smaller, and many were of women who electively took hormonal therapy. One portion of the parallel studies followed over 16, women for an average of 5. This WHI estrogen-plus-progestin trial was stopped prematurely in because preliminary results suggested risks of combined CEEs and progestins exceeded their benefits. The first report on the halted WHI estrogen-plus-progestin study came out in July Initial data from the WHI in suggested mortality to be lower when HRT was begun earlier, between age 50 to 59, but higher when begun after age In older patients, there was an apparent increased incidence of breast Menomin Forte În România , heart attacks , venous thrombosis , and stroke , although a reduced incidence of colorectal Menomin Forte În România and bone fracture.
At the time, The WHI recommended that women with non-surgical menopause take the lowest feasible dose of HRT for the shortest possible time to minimize associated risks. As a result of these findings, the number of women taking HRT dropped precipitously.
In when the first WHI follow up study was published, with HRT in post menopausal women, both older and younger age groups had a slightly higher incidence of breast Menomin Forte În România , and both heart attack and stroke were increased in older patients, although not in younger participants.
Breast Menomin Forte În România was increased in women treated with estrogen and a progestin, but not with estrogen and progesterone or estrogen alone. Treatment with unopposed estrogen i. The WHI also found a reduced incidence of colorectal Menomin Forte În România when estrogen and a progestogen were used together, and most importantly, a reduced incidence of bone fractures. Ultimately, the study found disparate results for all cause mortality with HRT, finding it to be lower when HRT was begun during ages 50—59, but higher when begun after age The authors of the study recommended that women with non-surgical menopause take the lowest feasible dose of hormones for the shortest time to minimize risk. The data published by the WHI suggested supplemental estrogen increased risk of venous thromboembolism and breast Menomin Forte În România but was protective against osteoporosis and colorectal Menomin Forte În România , while the impact on cardiovascular disease was mixed.
Genetic polymorphism appears to be associated with inter-individual variability in metabolic response to HRT in postmenopausal women. The WHI reported statistically significant increases in rates of breast Menomin Forte În România , coronary heart disease , strokes and pulmonary emboli. The study also found statistically significant decreases in rates of hip fracture and colorectal Menomin Forte În România. The results were almost universally reported as risks and problems associated with HRT in general, rather than with Prempro, the specific proprietary combination of CEEs and MPA studied.
After the increased clotting found in the first WHI results was reported in , the number of Prempro prescriptions filled reduced by almost half. Following the WHI results, a large percentage of HRT users opted out of them, which was quickly followed by a sharp drop in breast Menomin Forte În România rates. The decrease in breast Menomin Forte În România rates has continued in subsequent years. The other portion of the parallel studies featured women who were post hysterectomy and so received either placebo progestogen or CEEs alone.
This group did not show the risks demonstrated in the combination hormone study, and the estrogen-only study was not halted in However, in February it, too, was halted. Several other large studies and meta-analyses have reported reduced mortality for HRT in women younger than age 60 or within 10 years of menopause, and a debatable or absent effect on mortality in women over Though research thus far has been substantial, further investigation is needed to fully understand differences in effect for different types of HRT and lengths of time since menopause.
There are five major human steroid hormones: estrogens, progestogens, androgens , mineralocorticoids , and glucocorticoids. Estrogens and progestogens are the two most often used in menopause. In women with intact uteruses , estrogens are almost always given in combination with progestogens, as long-term unopposed estrogen therapy is associated with a markedly increased risk of endometrial hyperplasia and endometrial Menomin Forte În România. There are many combined formulations which include both estrogen and progestogen. Specific types of hormone replacement include:  .
Tibolone — a synthetic medication available in Europe but not the United States— is more effective than placebo but less effective than combination hormone therapy in postmenopausal women.
It may have a decreased risk of breast and colorectal Menomin Forte În România, though conversely it can be associated with vaginal bleeding, endometrial Menomin Forte În România, and increase the risk of stroke in women over age 60 years. Vaginal estrogen can improve local atrophy and dryness, with fewer systemic effects than estrogens delivered by other routes. Dosage is often varied cyclically to more closely mimic the ovarian hormone cycle, with estrogens taken daily and progestogens taken for about two weeks every month or every other month, a schedule referred to as ‘cyclic’ or ‘sequentially combined’. Alternatively, ‘continuous combined’ HRT can be given with a constant daily hormonal dosage.
The medications used in menopausal HRT are available in numerous different formulations for use by a variety of different routes of administration:  . More recently developed forms of drug delivery are alleged to have increased local effect lower dosing, fewer side effects, and constant rather than cyclical serum hormone levels.
This in turn prevents an increase in clotting factors and accumulation of anti-estrogenic metabolites, resulting in fewer adverse side effects, particularly with regard to cardiovascular disease and stroke. Bioidentical hormone therapy BHT is the usage of hormones that are chemically identical to those produced in the body.
Although proponents of BHT claim advantages over non-bioidentical or conventional hormone therapy, the FDA does not recognize the term ‘bioidentical hormone’, stating there is no scientific evidence that these hormones are identical to their naturally occurring counterparts. Bioidentical hormones can be used in either pharmaceutical or compounded preparations, with the latter generally not recommended by regulatory bodies due to their lack of standardization and regulatory oversight. Bioidentical hormones in pharmaceuticals may have very limited clinical data, with non randomized controlled prospective trials to date comparing them to their animal derived counterparts. Some pre-clinical data has suggested a decreased risk of venous thromboembolism , cardiovascular disease , and breast Menomin Forte În România.
A retrospective Cox proportional hazards analysis has suggested that, in distinction to previous studies, conjugated equine estrogen and medroxyprogesterone acetate are associated with a risk reduction in breast Menomin Forte În România, while bioidentical hormone therapy is associated with slightly increased risk. After 64 patient deaths and harmed patients from a meningitis outbreak due to contaminated steroid injections, Congress passed the Drug Quality and Security Act , authorizing creation by the FDA of a voluntary registration for facilities that manufactured compounded drugs, and reinforcing FDCA regulations for traditional compounding.
In the United Kingdom, on the other hand, compounding is a regulated activity. The Medicines and Healthcare products Regulatory Agency regulates compounding performed under a Manufacturing Specials license and the General Pharmaceutical Council regulates compounding performed within a pharmacy. All testosterone prescribed in the United Kingdom is bioidentical, with its use supported by the National Health Service. There is also marketing authorisation for male testosterone products.
National Institute for Health and Care Excellence guideline 1. The footnote adds: „at the time of publication November , testosterone did not have a United Kingdom marketing authorisation for this indication in women. Bio-identical progesterone is used in IVF treatment and for pregnant women who are at risk of premature labour.
These favorable publications emphasized the benefits and downplayed the risks of its HRT products, especially the „misconception” of the association of its products with breast Menomin Forte În România. Following the publication of the WHI data in , the stock prices for the pharmaceutical industry plummeted, and huge numbers of women stopped using HRT. According to Fugh-Berman , „Today, despite definitive scientific data to the contrary, many gynecologists still believe that the benefits of [HRT] outweigh the risks in asymptomatic women.
This non-evidence—based perception may be the result of decades of carefully orchestrated corporate influence on medical literature. The s showed a dramatic decline in prescription rates, though more recently they have begun to rise again.
Conjugate equine estrogen, in distinction, has a potentially higher thrombosis risk and is now not commonly used in the UK, replaced by estradiol based compounds with lower thrombosis risk. Oral progestogen combinations such as medroxyprogesterone acetate have changed to dyhydrogesterone, due to a lack of association of the latter with venous clot.
From Wikipedia, the free encyclopedia. Redirected from Menopausal hormone therapy. This article is about hormone replacement therapy in menopause. For other forms, see Hormone therapy. See also: Testosterone medication § Women. Common [ edit ] Headache Upset stomach , stomach cramps or bloating Diarrhea Appetite and weight changes Changes in sex drive or performance Nervousness Brown or black patches on the skin Acne Swelling of hands, feet, or lower legs due to fluid retention Changes in menstrual flow Breast tenderness, enlargement, or discharge Sudden difficulty wearing contact lenses. See also: Sex-hormonal agent and List of sex-hormonal medications available in the United States.
Main article: Bioidentical hormone therapy. See also: Medical ghostwriter. PMID PMC ISSN Women’s Health. S2CID Mayo Clinic Proceedings. Cleveland Clinic.
J Am Osteopath Assoc. Endocrine Practice. Retrieved 1 March Archived from the original on Retrieved Retrieved 4 March Committee on Gynecologic Practice. J Clin Endocrinol Metab. The Cochrane Database of Systematic Reviews.
ISSN X. National Health Service, United Kingdom. Am J Clin Dermatol. Rejuvenation Res. Effects of hormone replacement therapy on sexual psychophysiology and behavior in postmenopause. The New England Journal of Medicine.
International Menopause Society Consensus Statement”. Gynecological Endocrinology. Thrombosis Research. The Journal of Sexual Medicine. August Current Opinion in Hematology. International Journal of General Medicine. PLOS Med. Iako se često smatra da je menopauza povezana s porastom bolesti srca , to se prvenstveno događa zbog starenja i nema direktnu vezu sa menopauzom.
Kod nekih žena kod kojih su bili prisutni problemi, poput endometrioze ili bolnih perioda , oni postaju manje izraženi nakon menopauze. Menopauza je obično prirodna promena. Obično nije potreban specifičan tretman. Tokom rane tranzicije menopauze, menstrualni ciklusi ostaju pravilni, ali se interval između njih počinje produžavati. Nivo hormona počinje da varira. Ovulacija se možda neće dogoditi sa svakim ciklusom.
Tokom prelaska u menopauzu, menstruacijski obrazac može pokazati kraće odstupanje ciklusa za 2—7 dana;  i dalje su mogući duži ciklusi.
Uočavanje ili krvarenje mogu jednostavno biti povezani s vaginskom atrofijom, dobroćudnim ranim polipom ili lezijom ili mogu biti funkcijskii odgovor endometrijuma. Evropsko društvo za menopauzu i andropauzu objavilo je smernice za procenu endometrija, koji je obično glavni izvor kapljanja ili krvarenja. Međutim, kod žena u postmenopauzi bilo koje genitalno krvarenje je alarmantni simptom koji zahteva odgovarajuću studiju kako bi se isključila mogućnost malignih bolesti.
Ostali fizički simptomi menopauze uključuju nedostatak energije , bol u zglobovima , ukočenost ,  bolove u leđima ,  povećanje dojki ,  bolove u dojkama ,  lupanje srca ,  glavobolju ,  vrtoglavicu ,  suvoći , svrbež kože,  stanjivanje, trnci kože, debljanje ,  mokraćnu inkotenciju ,   hitnost mokrenja , obrasci isprekidanog spavanja,   jako noćno znojenje ,  vrući valunzi. The Medical Clinics of North America. PMID Obstetrics and Gynecology Clinics of North America.
Menopause: a biocultural perspective [Online-Ausg. New Brunswick, N. ISBN Yale University Press.
J Clin Epidemiol. Hum Biol. Quality of Life Research. JSTOR National Institute on Aging. The menopausal transition: interface between gynecology and psychiatry [Online-Ausg.
Menopauza — Википедија
Menopauzacunoscută ca perioada criticăreprezintă acea perioadă din viața unei femei atunci când ciclurile menstruale se opresc și nu mai poate avea copii. Înainte menopauzei, ciclurile menstruale ale unei femei sunt neregulate. În preajma menopauzei apar adesea bufeurile ce durează de obicei Menopauză wikipedia 30 de secunde și zece minute și pot fi asociate cu tremurături, transpirații și o erupție Menopauză wikipedia pătată în roșu. Unele probleme prezente anterioare precum Mnopauză sau Menopauză wikipedia menstruale dureroase s-ar putea îmbunătăți odată cu menopauza. Menopauza este de Menopauză wikipedia o schimbare naturală. Alte cauze includ intervenția chirurgicală de eliminare a ambelor ovare sau wiikipedia tipuri de chimioterapie.
De obicei, tratamentul specific nu este necesar. Însă, unele simptome pot fi îmbunătățite cu ajutorul tratamentului. În ceea ce privește bufeurile, se recomandă evitarea fumatului, cafeinei sau alcoolului. Dormitul într-o cameră răcoroasă și utilizarea unui ventilator pot ajuta. În timp ce MHT era în trecut recomandat în mod obișnuit, acum este recomandat doar la persoanele cu simptome importante deoarece există îngrijorări legate de efectele secundare. De la Wikipedia, enciclopedia liberă. Accesat în 8 martie
Menopauza predstavlja završetak reproduktivne sposobnosti kod osoba ženskog pola. Dolazi do prestanka oogeneze. Menopauza je wikioedia pojava kod starijih Menopauză wikipedia. Menopauzapoznata i kao klimakterij i klimaksvreme je u životnom dobu žena kada menstruacijski period prestaje trajno i žene više ne mogu rađati. Obično se javlja u dobu između U retkim slučajevima, ženski jajnici prestaju da funkcionišu u veoma ranom uzrastu, u periodu od puberteta do 40 godina Menopauză wikipedia. Ova pojava je poznata kao prerano zatajenje jajnika.
Mneopauză se ne smatra normalnom posledicom starenja. Usled nejasnoća u rukovođenju podacima u mnogim oblastima sveta, najstarije doba javljanja menopauze nije precizno poznato.