The first symptoms related to a decrease in the production of estrogen, the main female hormone, can appear ten years before menopause. Worse: problems like hot flashes, night sweats and sleep disturbances, among others, often last more than a decade after the end of menstrual cycles – with a very negative impact on the quality of life of any woman. A new study reviewpublished yesterday in the “Canadian Medical Association Journal”, advances in the rescue of hormone replacement therapy, recommending the treatment for those who do not have risk factors, as explained by the doctor Iliana Lega, professor at the University of Toronto and co-author of the work:

“Perimenopause and postmenopause can lead to physical and mental suffering. Despite the existence of several forms of intervention, the fear linked to the risk of hormone replacement therapy, combined with the lack of knowledge of the existing alternatives, has prevented many patients from benefiting from any type of treatment”.

The Women’s Health Initiative, the study that cast doubt on hormone replacement, spent 21 years being questioned because its reference contained flaws. However, the damage was considerable: the information caused a large number of doctors to stop prescribing the treatment to their patients.

In column published in April, the blog had previously featured work by researchers at Massachusetts General Hospital showing the same type of relationship between age at menopause, hormone therapy use, and Alzheimer’s disease: high levels of the protein tau, present in the disease process, had been observed only in women who started hormone replacement therapy late.

Today, there is evidence of a possible reduction in the risk of coronary artery disease through replacement, in the case of patients under 60 or who start treatment early.

According to the survey, the main benefits of replacement are:

1. Reduction of hot flashes by up to 90% in patients with moderate to severe symptoms.
2. Improved lipid profile and possible reduced risk of type 2 diabetes.
3. Reduced risk of bone fractures.

1. Although previous studies have indicated an increased risk of breast cancer, this is low for people aged 50 to 59 and for those starting replacement therapy within the first ten years after menopause.
2. Other studies show an increased risk of having a stroke in women over 60 who started replacement therapy ten years after menopause.
3. Those who have a risk factor (history of breast cancer and endometrial cancer subtypes, coronary artery disease, or prothrombotic mutation) or who do not want treatment can use non-hormonal therapies to relieve symptoms.