Monthly Archives: July 2022

Easy-to-read medicine information about menopause hormonal therapy what it is, how to take it safely and possible side effects.

During menopause, the amount of oestrogen produced by a woman's body drops and this can cause symptoms associated with menopause such as hot flushes, night sweats, sleep problems, muscle and joint pains, mood changes, vaginal dryness and discomfort with sex. Read more aboutmenopause.

Menopause hormonal therapy (MHT) is the use of hormone therapy (tablets, patches or cream) to replace the oestrogen that your ovaries no longer make during and after menopause. It can help relieve some of the symptoms of menopause.

The main factor in deciding which MHT to use will depend of whether you still have a uterus or whetherit has been removed surgically (an operation called hysterectomy).

In addition, the choice of MHT will depend on your individual overall balance of benefit, risk, symptoms and convenience.

Image credit: MHT Australasian Menopause Society

Menopause hormonal therapy is not recommended in certain situations, such as for women who have a history of breast cancer, are at risk of heart disease, or have had a blood clot or are high risk of having a blood clot. Ask your doctor whether menopause hormonal therapy is right for you there are also other non-hormone options that can help with menopausal symptoms.

Menopause hormonal therapy is available as oestrogen alone or as oestrogen with progestogen. It is also available in different formulations such as creams, pessaries, tablets and skin patches. Some of these are used every day, while others may be used only for a few days or once or twice a week.

The following are examples ofmenopause hormonal therapy products available in New Zealand. The choice of product depends on your individual circumstances and preferences. When using MHT, use the lowest dose that eases your symptoms for the shortest time and get your treatment reviewed at least once every year to assess whether to continue it or not.

Read more about Ovestin cream and pessaries.

These patches are applied to your skin 1 or 2 times a week:

Without treatment, menopausal symptoms such as hot flushes, night sweats, sleep problems and headaches may last fora few years.Most women manage their menopause symptoms themselves, but some may need help from their doctor. MHT has been found to:

When assessing the risks associated with MHT, remember that not all women have the same risk of these effects.

For most women with moderate to severe symptoms, the benefits appear to outweigh the risks for those who are less than 10 years out from menopause or aged less than 60.

MHT can cause side effects such as breast tenderness, fluid retention, mood changes, menstrual spotting and bleeding. If you get any of these side effects, talk to your doctor as you may need a change of dose. MHT does not cause weight gain.

Contact your doctor immediately if you get any of the following symptoms while taking MHT:

If you are taking MHT and have recently had surgery or a leg injury and you are unable to walk around, contact your doctor for advice.

If you are taking MHT and decide to stop, ask your doctor how to stop safely. You may need to stop slowly over several weeks.

Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)?Report a side effect to a product

Many women consider using complementary therapies such as phytoestrogens. These oestrogen-like compounds are found in all plants but are in highest quantities in legumes, including beans and soy products. Some women find these compounds helpful, although scientific studies have found them no better than a placebo. A lack of response after 6 weeks should be seen as a reason to stop.

Similarly,scientific studies have also found the following to be no better than a placebo:black cohosh, dong quai, evening primrose oil, red clover and ginseng. Due to possible adverse effects on your liver, it is recommended that black cohosh treatment be ceased after 6 months.

All complementary therapies may have side effects and may interact with prescription medicines, so tell your doctor if you are using or planning to use these.

The following linkshave more information on MHT. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.Menopause Family Planning, New ZealandMenopause health information Australasian Menopause SocietyMenopause and HRT Patient Info, UKFacts about menopausal hormone therapyNational Institutes of Health, US

Medsafe Consumer Information Sheets:TrisequensKliogestKliovanceProgynovaEstradotClimaraPremarin

Hormone replacement therapyNZ FormularyMenopausal hormone therapy where are we now?BPAC, NZ, 2019Long term hormone therapy for perimenopausal and postmenopausal womenCochrane Database Syst Rev. 2012 Jul 11;7,Marjoribanks J, Farquhar C, Roberts H, et al.British menopause society & womens heath concern recommendations on hormone replacement therapyPanay N et al,May 2013

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Hormone replacement therapy (HRT) | Health Navigator NZ

For several decades, the role of hormone-replacement therapy (HRT) has been debated. Early observational data on HRT showed many benefits, including a reduction in coronary heart disease (CHD) and mortality. More recently, randomized trials, including the Women's Health Initiative (WHI), studying mostly women many years after the the onset of menopause, showed no such benefit and, indeed, an increased risk of CHD and breast cancer, which led to an abrupt decrease in the use of HRT. Subsequent reanalyzes of data from the WHI with age stratification, newer randomized and observational data and several meta-analyses now consistently show reductions in CHD and mortality when HRT is initiated soon after menopause. HRT also significantly decreases the incidence of various symptoms of menopause and the risk of osteoporotic fractures, and improves quality of life. In younger healthy women (aged 50-60 years), the risk-benefit balance is positive for using HRT, with risks considered rare. As no validated primary prevention strategies are available for younger women (<60 years of age), other than lifestyle management, some consideration might be given to HRT as a prevention strategy as treatment can reduce CHD and all-cause mortality. Although HRT should be primarily oestrogen-based, no particular HRT regimen can be advocated.

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Hormone-replacement therapy: current thinking - PubMed

Pune, India, June 29, 2022 (GLOBE NEWSWIRE) -- The global hormone replacement therapy market size was USD 13.40 billion in 2020. The market is projected to grow from USD 14.17 billion in 2021 to USD 21.49 billion in 2028 at a CAGR of 6.1% in the 2021-2028 period. This information is provided by Fortune Business Insights, in its report titled, Hormone Replacement Therapy Market, 2021-2028."According to our expert analysts, the market is witnessing growth, owing to its development in several other hormone-associated illnesses concerned with diverse age groups that are impacting both, women as well as men.

Industry Developments:May 2021: Myovant Sciences GmbH declared that it gained sanction from the U.S. FDA for hormone therapy Myfembree as a treatment for uterine fibroid bleeding. The drug unveiled by Myovant is set to give uninterrupted competition to Abbvie with an extra dosing benefit.

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Hormone replacement therapy is vital for patients with growth hormone scarcities, women experiencing menopausal conditions, elderly population having hypogonadism, and other patients. The treatment is obtainable in several forms, which involve skin and buccal patches, injectable, and tablets, and others. Attributed to the increase in implementation of these products across the world, numerous manufacturers are emphasizing on the development of the progressive drug delivery systems such as vaginal estrogen drugs as well as transdermal estrogen patches. This is expected to bolster the hormone replacement therapy market growth.

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A hormone replacement therapy is a treatment to replace the natural hormone when the body does not produce enough hormone. The hormonal replacement therapy is generally used to treat the menopause symptoms and to protect long term health. During the menopause, the female hormone level goes up and down. This can cause various symptoms, such as night sweat and vaginal dryness.

Thus, hormone replacement therapy helps to balance the level hormone among the females. In addition to this, hormone replacement therapy also helps in the prevention of cardiovascular diseases and osteoporosis after menopause in females. In addition to this, the hormone replacement therapy also reduces the chance of various diseases, including diabetes and bowel cancer. In male hormone replacement therapy, testosterone hormone is given to the man. Testosterone hormone is responsible for the development of male sex organs and producing male characteristics such as muscularity and facial hairs.

Hormone replacement therapy is generally used to balance the level of progesterone and estrogen hormone in females. Currently, the combination of drugs is used for hormone replacement therapy. The hormone replacement therapy can be given to various forms, including oral, parenteral, and transdermal. Oral intake of hormone drug is one of the most common routes of administration in the hormone replacement therapy.

Hormone therapy, including estrogen therapy and combined estrogen/progesterone therapy, has been currently approved by the Food and Drug Administration (FDA) for the treatment of osteoporosis among the females. There are many companies present in the market who are offering a variety of medicines for the hormone replacement therapy for both male and females.

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Therapy Type, Indication, Route of Administration, Distribution Channel, and Region are studied for the Market

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The report offers a holistic evaluation of the hormone replacement therapy market along with present trends and forthcoming expectations to launch approximate investment profits. Moreover, a detailed examination of any forthcoming opportunities, threats, competitions or driving aspects is also conversed in the report. Step by step, methodical regional review is offered in the report.COVID-19 influences have been added to the report to aid investors and business owners to perceive an amplified knowledge of the existing threats. The key players in the market are distinguished, and their tactics to bolster the market growth are mentioned in the report.

Regional Insights:The market in North America was worth USD 7.07 billion in 2020 and held the maximum hormone replacement therapy market share. Moreover, the market is anticipated to lead the global market, owing to an increase in the occurrence of menopause and growth hormone scarcity illnesses.Europe is the second dominant region, owing to an escalation in the hormonal conditions in women experiencing menopausal symptoms, older people undergoing hypothyroidism, and increase in growth hormone ailments.Asia Pacific is projected to appear as one of the biggest suppliers of the product coupled with the highest CAGR in future.

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With 6.1 % CAGR, Hormone Replacement Therapy Market Size worth USD 21.49 billion by 2028 Industry Trends - Benzinga

Women with lower levels of two sex hormones may be at increased risk of experiencing obstructive sleep apnea (OSA) in middle age, according to a new study.

The findings, published June 22 in PLOS ONE, showed that postmenopausal women with double the average estrogen concentration had as much as a 23% decrease in the odds of snoring. Women with double the average progesterone concentration had a 9% decrease in the odds of snoring.

"Our study is important, as it is another building block on the way to individualized hormone substitution for postmenopausal women," said Kai Triebner, PhD, postdoctoral fellow at the University of Bergen, Norway, and senior author of the article. "The observed associations had already been suspected by smaller studies, and now we finally were able to prove them in a large population-based cohort with very precise measurements of their hormone status."

OSA is marked by snoring, irregular breathing, and/or gasping. The condition can lead to poor sleep quality and is associated with an increased risk of cardiovascular conditions, including ischemic heart disease and stroke.

Previous studies have shown that estrogen and progesterone mitigate the symptoms of OSA. Triebner and his colleagues sought to evaluate the protective association between hormones and sleep on a population level.

The new study included 774 women (age, 4067 years) from the 20102012 European Community Respiratory Health Survey. The women responded to two questionnaires about respiratory health and sleep and gave blood for hormone analysis of progesterone and three types of estrogen: 17-estradiol, estrone, and estrone 3-sulfate.

Women with hormonal irregularities, such as endometriosis, and those taking exogenous sex hormones through replacement therapy or contraception were excluded from the study.

Among the total group, 551 reported snoring. Of those, 411 had additional symptoms of OSA, such as irregular breathing, gasping, or a disturbing snore. Triebner and his colleagues determined the average estrogen and progesterone concentrations of all women in the study. Women with double the average estrogen concentration had a 19% decrease in odds of snoring.

With regard to individual forms of estrogen, women with double the average serum concentration of 17-estradiol, estrone, and estrone 3-sulfate had a 17% to 23% decrease in odds of breathing irregularity. Women with double the average serum concentration of progesterone had a 9% decrease in the odds of snoring and a 12% decrease in the odds of waking up with a choking or gasping sensation.

"By adjusting our model for BMI [body mass index] and alcohol consumption, we found that the results of the study [the effect of hormones on the risk of OSA] were not influenced," Triebner told Medscape Medical News.

Triebner's team did not give women exogenous estrogen or progesterone to observe individual changes in sleep behavior.

"The path to a good hormone replacement therapy is not yet paved," Triebner said. "What may be beneficial for one woman might be actually harmful to the other. The next steps are considerably more research on how to properly administer an individualized hormone therapy to women."

Vincent Joseph, PhD, a sleep researcher at Laval University, Quebec, Canada, said the findings were unsurprising.

"The mechanisms have been addressed, at least partially, in animal studies, showing effects on key structures in the brain and elements of the peripheral nervous system that are involved in the control of respiration," Joseph, who was not involved in the study, told Medscape.

However, the results provide a much stronger case to support the link between the variation of hormone levels and sleep apnea in women, Joseph added.

Triebner and Joseph reported no relevant financial relationships.

PLoS One. Published online June 22, 2022. Full text

Arianna Sarjoo is an intern at Medscape and a biology major at Boston University.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

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Lower Hormone Levels Linked to Risk of Sleep Apnea - Medscape