Menopause is a natural stage in a woman's life, marked by the cessation of menstruation and a decline in sex hormones: estrogen, progesterone, and testosterone. These hormonal changes can lead to physical and emotional symptoms that affect quality of life. Hormone Replacement Therapy (HRT) aims to compensate for these hormonal deficiencies to relieve symptoms and prevent certain complications such as osteoporosis and vaginal atrophy.
What are the signs and symptoms of menopause?
- Hot flashes and night sweats
- Sleep disturbances
- Fatigue, decreased libido
- Mood changes
- Vaginal dryness
- Weight gain, joint pain
What are the causes of menopause?
Menopause results from the gradual decrease in ovarian reserve and the decline in sex hormones.
Influencing factors may include:
- Age (45–55 years old)
- Genetics
- Smoking
- Certain medical conditions or treatments (e.g., cancer)
How is menopause evaluated?
- Anamnesis: history of symptoms and medical background
- Questionnaire: Menopause Rating Scale (MRS)
- Blood tests: FSH, LH, estradiol, progesterone, free testosterone, DHEA-S, AMH
What is the role of progesterone in women?
It is the key hormone of the menstrual cycle, which stabilizes mood and promotes sleep.
Symptoms related to a deficiency:
- Irritability
- Pain
- Mood swings
- “Spotting” and irregular cycles
- Sleep disturbances
- Anxiety
- Breast tenderness
What is the role of estradiol in women?
It is the key hormone for maintaining the health of bones, skin, heart, and brain. It also influences libido and mood.
Symptoms related to a deficiency:
- Hot flashes and night sweats
- Vaginal dryness
- Decreased libido
- Chronic fatigue
- Memory and concentration problems
- Osteoporosis
- Joint pain
- Depression or irritability
- Dry skin and brittle hair
What is the role of testosterone in women?
This male sex hormone is also present in women and influences muscle mass, libido, energy, and motivation.
What are the possible treatments?
- Hormone Replacement Therapy (HRT): combined or alone
- Forms: tablets, patches, gels, creams
- Local hormonal creams: specifically for vaginal dryness
- Personalized HRT, using the minimum effective dose.
- Regular monitoring: blood pressure, weight, blood tests, and mammography.
- Annual re-evaluation: adjusting doses based on symptoms and monitoring for side effects.