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HORMONAL REPLACEMENT THERAPY: DOES AGING
LIMIT THERAPEUTIC BENEFITS?
CECI MENDES CARVALHO LOPES
CLÍNICA GINECOLÓGICA DO HCFMUSP
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Therapy?
Estrogens?
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Therapy?
Estrogens?
Progestogens?
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Therapy?
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HRT• Better quality of life
– Acting positively on
• Symptoms• Lipids• Bone mass• Skin
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HRT• Better quality of life
– Acting positively on• Symptoms• Lipids• Bone mass• Skin
– But there are risks and adverse effects!• Thromboembolism• Cancer
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HERS II (Cardiac events/ 10000)
NS
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What to conclude?
• It seems there is cardioprotection – if HRT is iniciated in early menopause
• Indeed it is the best choice for symptoms
• It is beneficial to genitourinary problems
• Prevents genitourinary atrophy
• Preserves bone mass
• Maintains skin appearance
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Until when?
• It is a permanent question
– Good until it is beneficial
– The minimum dose, the minimum time
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Until when?
• It is a permanent question
– Good until it is beneficial
– The minimum dose, the minimum time
... ??? ...
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Which hormones?
• Estrogens– Conjugated equine estrogens?
• Progestins– Medroxyprogesterone?
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Which hormones?
• Estrogens– Conjugated equine estrogens?– 17β-estradiol?
• Progestins– Medroxyprogesterone?– Dydrogesterone?– Drospirenone?– Trimegestone?
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Which hormones?
• Estrogens– Conjugated equine estrogens?– 17β-estradiol?
• Progestins– Medroxyprogesterone?– Dydrogesterone?– Drospirenone?– Trimegestone?
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Which hormones?
• Estrogens– Conjugated equine estrogens?– 17β-estradiol?
• Progestins– Medroxyprogesterone?– Dydrogesterone?– Drospirenone?– Trimegestone?
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Treatment without hormones?
• One medicine to each problem
• Results maybe not so good
• Less risk?
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Treatment without hormones?
• One medicine to each problem
• Results maybe not so good
• Less risk?
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