1.4 CME

Manajemen Menopause: Terapi Hormonal dan Non-Hormonal

Pembicara: Dokter Isha Rani

Direktur Obstetri dan Ginekologi, Citizens Medical Centre (CMC), Jharkhand

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Keterangan

It is vital to middle-aged and older women's health to comprehend the role of menopausal hormone therapy (MHT) and non-hormonal alternatives in treating vasomotor symptoms, sleep disturbances, and genitourinary symptoms following menopause.

Ringkasan

  • Menopause, derived from Greek words meaning cessation of monthly cycles, is a natural aging process where ovaries produce less estrogen and progesterone, ending a woman's reproductive ability. It's diagnosed after 12 months of amenorrhea, typically around age 51, but can be premature before age 40. The reproductive life is divided into premenopause, perimenopause, menopause, and postmenopause.
  • Changes in menopause include physical appearance (skin elasticity loss, weight gain, hair changes, voice deepening), vasomotor symptoms (hot flashes, night sweats), increased cardiovascular risk, bone density loss leading to osteoporosis, digestive issues like constipation, and urinary symptoms due to thinning of the urethra and bladder.
  • Genital organs undergo changes such as decreased uterus and cervix size, reduced vaginal and cervical discharge, smaller ovaries, increased androgen secretion, and thinner vaginal membrane. Psychological changes include headaches, irritability, mood disturbances, fatigue, memory loss, depression, and anxiety, often influenced by societal and cultural beliefs.
  • Hormone replacement therapy (HRT) can relieve menopause symptoms by replacing estrogen. Common drugs include estrogen and progesterone, used in combination to prevent uterine lining overgrowth. HRT is administered through oral tablets, subdermal implants, estrogen gels, transdermal patches, and vaginal creams.
  • Non-hormonal treatments involve lifestyle changes such as continuous exercise (including Kegel exercises), guidance and counseling, dietary changes (calcium supplementation, vegetables, avoiding oily food). HRT has risks, including endometrial and breast cancer, venous thromboembolism, and disrupted lipid metabolism. Tibolone is presented as a steroid with fewer estrogenic side effects.

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