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Hormonalna terapia zastępcza - skuteczność i bezpieczeństwo
w świetle badań klinicznych
Hormone replacement therapy (HRT) - efficacy and safeness on the background of clinical trials. Menopause is a consequence of ovarium function inhibition and is accompanied by a number of clinical symptoms. The use of hormone replacement therapy (HRT) is the gold standard in the management of moderate-to-severe menopause-associated vasomotor symptoms (i.e. hot flashes, night sweats), vaginal dryness, sleep disturbances, changes in libido, mood changes, and fatigue. Clinical studies suggest also reductions osteoporotic fractures, and colorectal cancer or the risk of developing Alzheimer's disease. Such studies have also suggested an increased risk for breast cancer, endometrial carcinoma and gallbladder disease, and possibly coronary heart disease and stroke as well as venous thromboembolic disease. According to the literature use of oral HRT therapy causes a 2-3-fold increased relative risk for thromboembolic events in perimenopausal women. The risk of thromboembolic complications is dependent on the type of estrogen and progesteron. The number of unfavourable adverse events may be effectively reduced by changing the route of HRT administration, from oral to dermal, decreasing the dose of oestrogen component and/or changing the type of progesterone component and reducing the time of used. Implementation of HRT treatment should in every cases be individualized and based on the woman's needs and expectations as well as must be considered all other circumstances such as the age, coexisting diseases, risk factors which can influence on the effectiveness of hormonotherapy.