Treatment Regimens for the Menopause

The chapter includes a brief history of, and the interpretation offered by early Greek and other physicians in ancient times, regarding the changes which occurred in older women, together with a brief list of the many therapies available to early physicians to treat these women, from antiquity till the discovery and introduction of estrogen in the 20th century. Also included is a review of the more recent development of bio-identical and synthetic hormones for use in managing symptoms of hormone deficiency. The reason for using hormone therapy with the benefits identified and the improved health outcomes following use of long-term hormone therapy are listed. A brief comment is also made regarding the exploitation by the media and some health care providers of those adverse results identified in the Women’s Health Initiative study in 2002 and Million Women Study in 2003 and their role in modifying the use of hormone therapy for postmenopausal women. Because of the fear that women using hormone therapy will develop Breast Cancer, Alzheimer’s Dementia or Cardiovascular Disease the role of estrogen/progestin therapy on these outcomes is also briefly mentioned. The necessity for beginning therapy during the ‘window of opportunity’ is explained. The development, and the advantages, of various routes for delivery of hormones in order to reduce the risk of any adverse response to HRT are also discussed. The value of using HRT and other therapies for preventing and treating osteoporosis is presented and finally the most common alternative therapies currently being promoted for treating post-menopausal symptoms are critiqued.

Keywords: Estrogen, progestins, testosterone, benefits, cardiovascular protection, dementia, osteoprotection, adverse, breast cancer, alternative therapies, antidepressants, other therapies.