Modern Menopausal Hormone Treatment: Facts and Myths About Sex Hormones

Description

This unique book is structured to give the reader a comprehensive view to understand the decline of hormones at midlife and the risks and benefits of evidence based hormonal treatments. The difference between bio-identical and synthetic hormones is shown. With this book the author intends to restore the trust of the mostly positive effects of hormone treatment during menopause. In this book effective hormone treatments that may be carried on for years are discussed. Those hormones may even prevent age related diseases (arthralgia, osteoporosis, cardiovascular diseases) if started at the right time frame directly after menopause, known as "window of opportunity".  This book fills a gap for medical health providers and can be of benefit for all women searching evidence-based information and answers on hormone menopausal changes and treatments. The book provides the reader with case histories to show how different women are at the menopausal transition, and what the doctor has to consider in the choice of investigation and treatment. Foreword Preface About the Book Contents About the Author Abbreviations Chapter 1: Midlife Crisis During the Female Hormonal Transition, a Theme with Variations 1.1 How It Feels When Sex Hormones Are Declining 1.2 Resilience, the Ability to Cope with Difficulties 1.3 The Menopause Rating Scale (MRS) 1.4 Symptoms and Apprehensions 1.4.1 Hot Flushes 1.4.2 Sleeping Disorders 1.4.3 Mental Disorders 1.4.4 Sexual Problems 1.4.5 Physical Disorders 1.5 Cultural, Social and Ethnic Differences in Climacteric Symptoms and Treatments 1.6 Summary for the Health Professional 1.7 Summary for the Climacteric Woman References Chapter 2: Hormones 2.1 What Are Hormones? 2.2 The Sex Hormones 2.2.1 Oestrogens 2.2.2 Androgens 2.2.3 Progesterone 2.3 Hormonal Changes from the Conception Until the Postmenopausal Period 2.3.1 Conception 2.3.2 The Foetus 2.3.3 The Newborn Female Baby 2.3.4 Childhood 2.3.5 Prepuberty 2.3.6 Adolescence 2.3.7 The Mature Woman 2.3.8 The Menopausal Transition 2.3.9 Perimenopause 2.3.10 Menopause and the Postmenopause 2.4 Other Important Hormones, Which Decrease with Age 2.4.1 Growth Hormone 2.4.2 Melatonin 2.5 Hormones That Are Important All Through Life 2.5.1 Thyroid Hormones 2.5.2 Insulin 2.5.3 Leptin 2.5.4 Stress Hormones 2.6 Summary for the Health Professional 2.7 Summary for the Climacteric Woman References Chapter 3: Menopause Treatments with Hormones 3.1 Treatment of Age-Related Hormone Deficiency in Menopause 3.1.1 Oestradiol 3.1.1.1 Oral Oestradiol (a) 3.1.1.2 Transdermal Oestradiol (b) 3.1.1.3 Vaginal Oestradiol 3.1.2 Oestriol 3.1.3 Progesterone 3.1.3.1 Oral Micronized Progesterone 3.1.3.2 Vaginal Progesterone 3.1.3.3 Percutaneous Progesterone 3.1.4 Androgens 3.1.4.1 Testosterone 3.1.4.2 DHEA 3.1.5 Phytoestrogens 3.1.6 Progestogens 3.1.7 Conjugated Equine Estrogens 3.2 Hormonal Treatment of Gynaecological Disorders During the Menopausal Transition 3.2.1 Progestins as Monotherapy 3.2.2 Progestogens + Oestradiol/Ethinyloestradiol (OC, Oral Contraceptive Pills) 3.3 Advantages and Disadvantages in the Use of Different Menopausal Hormone Treatments 3.4 Hormonal Treatment in Menopause After Cancer 3.5 Summary for the Health Professional 3.6 Summary for the Climacteric Woman References Chapter 4: Treatment with Female Hormones: Rise and Fall, Confusion and Comeback 4.1 Positive Attitudes to Female Hormones Until 2002 4.2 The Impact of the WHI Study, Misinterpretation and Confusion 4.3 Protests Against Female Hormone Treatment 4.4 Body-Identical Hormone Replacement Therapy: The European Development 4.5 Bio-identical Hormone Replacement Therapy (BHRT): The American Development 4.6 The Renaissance of the Hormonal Treatment 4.7 Summary for the Health Professional 4.8 Summary for the Climacteric Woman References Chapter 5: The Window of Opportunity 5.1 Hormone Treatment, a Health Promotion and Disease Prevention Strategy 5.2 The Timeframe for Optimal Hormone Treatment During Menopause 5.3 Health Benefits with Menopausal Hormone Treatment 5.3.1 Cardiovascular Diseases 5.3.2 Osteoporosis 5.3.3 Joint and Muscle Complaints 5.4 Health Strategies and Treatment Even at Late Postmenopausal Age 5.4.1 Life Style 5.4.2 Exercise for Both Body and Mind 5.4.3 Diets 5.4.4 Mental Balance 5.5 Summary for the Health Professional 5.6 Summary for the Climacteric Woman References Chapter 6: Web-Based Advice at Any Price 6.1 The Enormous Impact of the Internet as a Source of Health Information 6.1.1 Information 6.1.2 Education 6.1.3 Pitfalls with Uncontrolled Health Therapies 6.2 Health Investigations on the Internet 6.2.1 Laboratory Tests 6.2.2 Internet Doctors 6.3 Health Apps (Applications) 6.4 Future Artificial Intelligence (AI) for Health Care 6.5 Summary for the Health Professional 6.6 Summary for the Climacteric Woman Reference Chapter 7: The Menopause and Sexuality 7.1 Sexuality and Ageing 7.2 Sexual Problems Arising During the Menopausal Transition 7.2.1 Psychological Problems 7.2.2 Physical Problems 7.2.3 Hormonal Problems 7.3 Therapeutic Approaches Towards Sexual Problems 7.3.1 Sex Therapy 7.3.2 Hormone Therapy 7.4 “Men-Pause” After Menopause 7.5 Cultural Differences in Sexuality and Ageing 7.6 Silver Sex 7.7 Summary for the Health Professional 7.8 Summary for the Climacteric Woman References Chapter 8: Therapeutic Tools for Managing the Complicated Menopause Patient 8.1 The First Consultation, Listen to the Patient’s History 8.2 The Physical Examination and Laboratory Findings 8.3 A Multidisciplinary Approach 8.4 Compliance and Long-Term Strategy for Optimizing Health 8.5 Summary for the Health Professional 8.6 Summary for the Climacteric Woman References Chapter 9: Five Different Women and Problems to Solve During Menopause 9.1 Marlene: The Unexpected Menopause 9.1.1 Her Story 9.1.2 Her Medical Background 9.1.3 Her Complaints 9.1.4 Her Assumptions 9.1.5 My Clinical Examination 9.1.6 My Medical Assessment 9.1.7 My Medical Advice 9.1.8 My Recommended Medical Treatment 9.2 Irene: Burnout and Premature Ovarian Insufficiency (POI) 9.2.1 Her Story 9.2.2 Her Medical Background 9.2.3 Her Complaints 9.2.4 Her Assumptions 9.2.5 My Clinical Examination 9.2.6 My Medical Assessment 9.2.7 My Medical Advice 9.2.8 My Recommended Medical Treatment 9.3 Anna: Typical Perimenopausal Problems 9.3.1 Her Story 9.3.2 Her Medical Background 9.3.3 Her Complaints 9.3.4 Her Assumptions 9.3.5 My Clinical Examination 9.3.6 My Medical Assessment 9.3.7 My Medical Advice 9.3.8 Three Months Later 9.3.9 New Medical Assessment 9.3.10 My Medical Advice 9.3.11 My Recommended Medical Treatment 9.4 Erna: Polycystic Ovarian Syndrome (PCOS) and Bleeding Problems 9.4.1 Erna’s Medical Background 9.4.2 Erna’s Complaints 9.4.3 Erna’s Assumptions 9.4.4 My Clinical Examination 9.4.5 My Medical Assessment 9.4.6 My Medical Advice 9.4.7 3 Weeks Later 9.4.8 New Clinical Examination 9.4.9 My Medical Advice 9.4.10 Recommended Treatment 9.5 Miriam: Early Menopause and an Unexpected Chronic Disease 9.5.1 Her Story 9.5.2 Miriam’s Medical Background 9.5.3 Miriam’s Complaints 9.5.4 Miriam’s Assumptions 9.5.5 My Clinical Examination 9.5.6 My Medical Assessment 9.5.7 My Medical Advice 9.5.8 Medical Treatment 9.5.9 Three Weeks Later 9.5.10 New Medical Assessment 9.5.11 My Medical Advice 9.5.12 Recommended Treatment References Chapter 10: Frequently Asked Questions About the Menopause 10.1 No. 1: Does Menopausal Hormonal Treatment Cause an Increased Risk for Breast Cancer? 10.2 No. 2: What Can I Do to Minimize My Risk of Developing Breast Cancer? 10.3 No. 3: Does the Risk of Cancer Increase Right from the Start of Hormone Treatment? 10.4 No. 4: Can Previous Hormone Treatment Provoke the Development of Oestrogen Sensitive Breast Cancer? 10.5 No. 5: Is It Possible to Have MHT Treatment for Menopausal Complaints After Successful Breast Cancer Treatment? 10.6 No. 6: Does Treatment with Bio-identical Progesterone Increase the Risk of Endometrial Cancer in the Uterus? 10.7 No. 7: Is Weight-Gain During Menopause Caused by Oestrogens? 10.8 No. 8: Is Hormone Treatment Dangerous for the Heart and the Blood Vessels? 10.9 No. 9: Can Women with a History of Thrombosis Have Menopausal Hormonal Treatment? 10.10 No. 10: When Should I Start Hormone Treatment? 10.11 No. 11: When Should I Stop Hormone Treatment? 10.12 No. 12: Do Climacteric Symptoms Disappear with Time in All Women? 10.13 No. 13: Do I Miss Out on Something if I Refuse MHT Despite My Climacteric Complaints? 10.14 No. 14: Should I Take Hormone Treatment if I Do Not Have Climacteric Symptoms or Complaints? 10.15 No. 15: Are Professional Recommendations Concerning MHT Still as Follows: Smallest Dose and the Shortest Treatment Duration? 10.16 No. 16: Is Progesterone the Same as Progestin? 10.17 No. 17: When Is Bio-identical Progesterone Indicated? 10.18 No. 18: Can Progesterone in the Form of Cream, Applied on the Skin, Replace the Progestin Pills My Doctor Prescribed? 10.19 No. 19: Are Bio-identical Hormones Biological, Natural Hormones Found in Some Plants? 10.20 No. 20: Are There No Side Effects of Bio-identical Progesterone on Account of It Being Identical with the Hormone Produced in Our Body? 10.21 No. 21: Can I Start Hormone Treatment more than 10 Years After Menopause? 10.22 No. 22: What Are Your Optimal Recommendations During and After Menopause for Keeping Young and Healthy as Long as Possible? References