Only your doctor can prescribe the appropriate treatment based on hormones after having discussed all the risks and benefits.

Remarks on HRT:
1. When should I take hormone replacement therapy (HRT)
Treatment of menopausal hormone replacement (or HRT) at menopause have demonstrated during the 2004 recommendations of new (renewed by a French study of Inserm dated November 19 and 04 of 2005).
However, according to a new survey from Inserm (2005) HRT are not all identical, we distinguished between HRT with estrogen alone or in combination HRT estrogen and micronized progesterone (identical in structure to natural progesterone) and these two treatments (hormones estrogen alone and micronized) would present no (or less likely) to cause breast cancer in patients that conventional HRT.

For conventional HRT (combination estrogen progestin synthesis) doctors recommend taking hormones at menopause only when the patient feels hot flashes, most of it should not cons-indications in the patient (see below) which should always be informed by the medical risk-benefit ratio of prescribing hormone replacement therapy (HRT), duration of treatment should not exceed 3 years. You can also think, with the consent of your doctor, a natural alternative herbal,>> more.

Such caution in prescribing of HRT followed up 40% of breast cancers in HRT treatment, 40% may seem a lot but if we are talking about 5 women out of 1,000 aged 55 who develop breast cancer with or without HRT, we can speak of 7 women 2 more with HRT, and it is very little, hence the difficulty of taking HRT or not in case of severe symptoms of menopause, but only Your doctor can really tell you about this risk-benefit ratio.

Taking hormones to fight against osteoporosis is unproven and thus only for this indication is not recommended to take hormone replacement.

Contraindications against taking hormone replacement:
> Women not taking hormone replacement during the five years after the onset of menopause (eg if a woman decides to start HRT 60 years having had the menopause at 50 years, there is a cons – indication, because it has been over five years, ten years, it has not been “in contact” with hormones, endorsed or HRT)
> Tobacco, if a woman smokes
> From Hypertension
> From HDL cholesterol <0.9 mmol / l > Cholesterol> = 6.2 mmol / l
> Triglycerides> = 2.2 mmol / l>> non-comprehensive list of all cons, indications for complete info please read the package insert of your HRT

2. HRT and sleep interesting remark
Failure to follow a hormone replacement therapy (HRT) at menopause does not prevent sleep problems caused in this period of life.

If nocturnal sweating (hot flashes) can be reduced by hormone replacement therapy or natural medicine for menopause, sleep disorders can not however be treated with HRT as evidenced by a survey (of 2005) Researchers from the world of Michigan (USA).

credit to:  naturosante

Etymological, the term menopause means “cessation of rules.” Menopause or climacteric is a normal physiological process that marks the end of the fertile period. The cessation of ovarian function and secretion of female hormones – estrogen and progesterone – causes cessation of menses.

According to the Dictionary of Medicine Flammarion, “menopause is the time of the climacteric woman normally between 50 and 55, characterized by suppression of ovarian function and the total disappearance of menstruation. It is recognized that menopause installed where there were no rules for a year. After the surgical removal of ovaries (castration) in a woman yet settled, which follows the menopause is called artificial. ”

Menopause is preceded by a long transition period that begins at the age of 40 years and in which appear the first biological changes. This transition corresponds to the premenopausal and perimenopausal.

- The premenopausal means the period during which hormonal fluctations produce menstrual irregularities. It can vary from months to several years, it usually lasts 5 years.
- Perimenopause is the “period of one year immediately prior to menopause during which begins endocrinological signs characterizing biological and clinical approach of the menopause.” (Definition of Lucien Chaby extracted from his book on Menopause, Collection Dominos, Flammarion)

Symptoms of menopause

The bone changes are cardiovascular events with the two major medical problems of menopause. The reduced bone mass in women from the age of 30 years and postmenopausal estrogen deficiency accentuates this phenomenon. In the early years after menopause, bone mass decreases annually by 2.5% for 3 or 4 years to reach 0.75% next year.

For most women, the entry into menopause occurs by menstrual irregularities sometimes accompanied by mood disorders and hot flashes, before final adoption of rules. Hot flashes are a symptom that best characterizes the entry into menopause. They appear in nearly 50% of women. These are sudden sensations of heat rising from the top of the body to the face, followed by significant sweats and chills. Their duration is short (rarely more than a few minutes).

Estrogen deprivation is responsible for other manifestations of menopause:
- Tingling, muscle and joint pain, headaches, palpitations, dizziness,
- Neuropsychiatric events: sleep disturbance, fatigue, nervousness, irritability, loss of confidence, anxiety, memory loss, concentration difficulties,
- Sexual disorders: dyspareunia, vaginal dryness,
- Weight problems,

- Aging skin.

Treatment for menopause

Hormone replacement therapy (HRT)

HRT is offered to premenopausal women for whom menopause or cause significant discomfort. It is particularly indicated for women with early menopause and / or surgery. It is also recommended for women at risk of osteoporosis or cardiovascular disease increased.
Over 1.7 million French benefit from hormone replacement therapy (HRT) which is
17% of postmenopausal women. Considering women between 50 and 65, one out of three deals.
The THS is to supply the body with the missing hormones that are no longer producing ovaries namely estrogen and progesterone. It acts on the endometrium in the same way as did the ovarian hormones before menopause.
The administration of such treatment requires an assessment prior to the well-known hormonal status of the patient and assess the lack of information-cons.

The non-hormonal treatments

Many menopausal women can not for reasons gynecological or general benefit from this therapy. Others fear the treatment.
Many non-hormonal products are active on hot flashes. The herbal medicine and homeopathy are particularly interesting as a new drug, raloxifene. Nutrition also plays an important role during menopause.
Among the alternative treatments, isoflavones, more known as phyto-estrogens, are a good alternative. These effects have been noted in epidemiological studies on Asian women who had a lesser symptoms of menopause than Western women. Because of this difference: the Asian populations consuming soy in large quantities. Soy is rich in isoflavones. The intake of two doses of 76 mg of isoflavones per day showed a significant reduction in hot flashes from the first month of treatment (source: General – News therapeutic, No. 2170, 25/01/02).

The menopause

There are two cases of menopause:
- When a woman has undergone ovary removal, or oophorectomy,
- When menopause occurs earlier among women treated for example against breast cancer (chemotherapy).

1. The risk of pregnancy persists
Caution. At this stage it is recommended to take measures to avoid unwanted pregnancies.
Although perimenopause occurs in a significant decrease in the fertility of women, the risk of pregnancy persists.

The possibility of pregnancy is 10% approximately 40 to 44 years and 2-3% in women aged 45 to 49 years. Even after 50 years the risk of pregnancy in perimenopause is less than zero.

The wisest course is to use some method of contraception until 12 months after the last natural menstruation.

In a recent survey across the country, it was found that over 50% of women between 40 and 50 do not use any contraceptive method and 80% is because they believe they no longer get pregnant at this age.

Because of this lack of information, pregnancy at this stage of life are often not scheduled, so are rarely desired.

There is a mixture of feelings, from fear of social rejection and / or family by becoming pregnant at this age, to the concern of a complicated pregnancy or a baby with some type of malformation.

And it is true that complications of pregnancy and delivery increase with age, as well as birth defects in the fetus.

2. And perimenopause birth control
Counseling. The choice of a contraceptive method should be supervised by a physician.

Natural Contraceptives
Due to frequent irregularities of menstruation in perimenopause, natural methods, which are based on the probable date of ovulation, the method of periodic abstinence, that of Ogino, or basal temperature are of little use, for be very inefficient and cumbersome.

Barrier Contraceptives
The methods that pose a barrier to the passage of sperm, such as diaphragms, spermicidal creams or condoms, may be safe (effectively about 98%) for women in perimenopause.

Condoms also provide an advantage to women without a stable partner, which is protection against diseases transmitted by sexual routes, especially to AIDS.

The IUD in women approaching menopause is a practical, effective, reversible, and can be easily inserted where they had children. Although the IUD can increase the amount of menstrual flow and sometimes enhance existing complaint among these women, the risks associated with IUDs are practically negligible.

Irreversible method of sterilization
In perimenopause sterilization methods such as tubal ligation in women and vasectomy in men can be very adequate measures of family planning during this time. However, it depends on the proximity of menopause and women’s preference.

It is obvious that perform a tubal ligation, a woman of 50 years, which probably lacks a short time in order to be withdrawn definitively rule would in principle be misplaced.

It would be different if women had 42, and that theoretically would be missing nearly a decade to reach menopause, and during that time would always present the risk of pregnancy.

Furthermore, we must remember that this method is irreversible and could only be done if the woman was very sure of not wanting to conceive more children.

Today tubal ligation is performed through an instrument called a laparoscope. It is a small surgical procedure that has very few complications, requires the patient’s hospitalization and recovery is very rapid, and there is hardly a discreet scar in the navel area.

Hormonal contraceptives
More than 30 years since the publication of scientific work which has suggested the use of oral hormonal contraceptives (AHO) for women over 35 years increased the risk of thromboembolic disorders (thrombophlebitis, for example).

As a result, neither doctors nor women prescribed wanted to take them. But we must not forget that these studies were performed with the old pills, which had a very high dose of hormones.

Also, do not take into account what kind of women are given, ie whether they were smokers, if they had high blood pressure, or had some other risk factor.

Pills today pills called “new generation” containing much smaller amounts of hormones and their formulations are quite different. By oral hormonal contraceptives (the pill), mainly those of low doses of estrogen are considered an excellent method of contraception in perimenopause, and are now the most frequently chosen by physicians and by women.

Besides offering nearly 100% certainty in preventing pregnancy, is helpful in correcting the hormonal imbalance between estrogen and progestin present in the perimenopause.

Also help regulate menstrual cycles, prevention of breast abnormalities, reduce uterine cancer and ovarian cancer, and in some way, decrease bone loss, thus contributing to the prevention of osteoporosis.

Oral contraceptives are made with synthetic estrogen, unlike those used in the treatment of climacteric disturbances, which are natural. So while the latter prevents cardiovascular disease, those can cause an increased risk of cardiovascular and thromboembolic disease, when used by women with a history of these diseases or smokers over 40 years.

Furthermore, this risk is multiplied when there are both metabolic disease, hypertension, or liver cancer.

… In short, women should expect from the health professional, to tell you the advantages and disadvantages of each métodoy together to choose the most effective and most suited to the characteristics of the couple.

3. The morning after pill
The morning after pill, rather than a contraceptive method should be interpreted as an occasional or emergency measure interceptive, since its objective is to prevent the implantation of the fertilized egg.

Therefore, this procedure should be reserved for those occasions when the relationship occurs in the period of ovulation in the absence of a contraceptive method, or for example, when a condom breaks.

It has been marketed in Spanish pharmacies postcoital contraception pill. This drug, sold by prescription, it takes high doses of progestin (levonorgestrel) and creates a very unfavorable uterine condition, preventing a fertilized egg continues its development.

Should be initiated as soon as possible, no later than 72 hours after intercourse, if it was done in the fertile period of the cycle (midcycle, around ovulation).

Not to be confused with RU-486, a medical abortion because it acts at a more advanced embryonic chain. ie pregnancy interrupted at the onset of embryonic development.

Today, as most common regimen, is used to take two tablets once a half-dose hormonal contraceptive (50 mcg ethinyl estradiol) followed within 12 hours of two tablets.

The percentage of efficiency of this method is around 98 to 99.8%. It is possible and should not cause concern for nausea, vomiting, or breast tenderness, because these symptoms are secondary to high dose of estrogen intake.