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World Menopause Day organised on Friday 18 October by WHO calls on all nations to make post-menopausal health a priority in research and public health.
Menopause is defined as the end of a woman’s reproductive period. Menopause causes dramatic changes in the emotional and physical life of women. It usually begins at around fifty. The rapid drop in the production of progesterone and oestrogen causes symptoms of varying degrees of discomfort, such as hot flushes, tiredness, insomnia, etc., which hormone replacement therapy attempts to decrease.
For many years hormone replacement therapy (HRT) was praised to the skies, although today it is much criticised, but it remains the most effective way of treating menopause symptoms.
HRT also helps prevent osteoporosis, but can have side effects, particularly venous thromboembolic events (blood clots in the veins) and strokes. The formulation, dosage and method of administering vary considerably from country to country, so it is difficult to evaluate. Although improvement in the quality of life is the main advantage of HRT, the risk/benefit ratio is still controversial. Risks are low in healthy users aged 50 to 59 as long as contraindications are respected. However, long-term use or starting treatment in older women can lead to an increased number of serious side effects. For a better understanding of the risk/benefit analysis of HRT, researchers are studying changes and risks associated with menopause and its treatments using large cohorts. Pierre-Yves Scarabin*
and his team (“Hormones and Cardiovascular Disorders” Inserm, UMRS 1018
) has shown that transdermic oestrogens avoided many venous thromboembolic events associated with oral oestrogens. This is a major breakthrough in the safety of using HRT, since pulmonary embolism causes about a third of potentially fatal events due to oral oestrogens. For further information on HRT, please contact Pierre-Yves Scarabin
, Inserm research director, head of the team Hormones and Cardiovascular Diseases – Inserm Unit 1018 Research Centre in Epidemiology and Public Health.
Inserm performed the ESTHER study (EStrogen and THromboEmbolism Risk) from 1999 and 2006 to evaluate the impact of the administration route of oestrogens and the role of progestogens on the thromboembolism risk in menopaused women aged 45 to 70. * Pierre-Yves Scarabin is to give a plenary conference at the 14th World Congress on Menopause organised by the International Menopause Society to be held in Cancun eron 1-4 May 2014
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