Menopausal Therapy: Modern View of the Problem
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pausal Therapy: Modern View of the Problem M. S. Selikhova* Volgograd State Medical University, Volgograd, 400131 Russia *e-mail: [email protected] Received March 28, 2019; revised April 22, 2019; accepted May 7, 2019
Abstract—The persistent, modern trend of increasing average life expectancy dictates the need to implement an antiaging strategy, one of the components of which for women is menopausal therapy. The protective effect of menopausal therapy for the cardiovascular system upon its use before the age of 60 years has been proven. The low frequency of use of menopausal hormone therapy (MHT) in Russia is mainly associated with the hormone-phobia of patients and doctors, especially with oncological risk. However, the data published in recent years have demonstrated a low risk of cancer of the breast, ovaries, cervix, and endometrium, even with prolonged use of MHT. Modern, microdosed medications, including dydrogesterone and progesterone as a pregestational agent, also minimize the risk. There are currently no restrictions on the duration of MHT use. According to the results of a meta-analysis of 23 studies involving 39 049 people, for 191340 people/year, menopausal therapy that began before the age of 60 reduced total mortality by 30%. Keywords: menopause, cardiovascular system, oncological risk, the duration of menopausal hormone therapy DOI: 10.1134/S2079057020030157
One of the achievements of modern medicine is a steady trend of increasing average life expectancy, which is currently 75–80 years in developed countries. According to demographers’ forecasts, every fifth person in the world will be over 65 years old by 2030, and the average life expectancy will be 96.4 years by 2050 [36]. At the same time, some authors indicate in their studies that the morbidity rate of the population of old age (60–74 years) is two times higher and almost six times higher in senile age (75 years and older) than in young people. At present, it is considered unreasonable for patients of older age groups to refuse adequate medical care; in addition, the active implementation of a strategy for antiaging therapy to maintain the quality of life and increase the geroprotective properties of the body is recommended [12, 18]. For this purpose, modern medicine recommends the use of cellular technologies and geroprotectors; however, nutritional correction, adequate physical activity, the prevention and correction of lipid metabolism disorders, arterial hypertension, and osteoporosis are no less significant components of this strategy. Studies on gender differences in the frequency of development of particular pathologies, including pathologies caused by age-related changes, have recently appeared. Studies by R. Giuseppe [27] proved that there are fundamental biological differences in vascular function, which was clinically confirmed by the increasing number of existing differences in clinical manifestations and treatment outcomes of cardiovascular pathology between men and women. Women
have a different therapeutic response to t
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