Current Topics in Menopause

Treatment Regimens for the Menopause

Author(s): Barry G. Wren

Pp: 326-384 (59)

DOI: 10.2174/9781608054534113010015

* (Excluding Mailing and Handling)

Abstract

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.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 873443466 and j.to_ip >=873443466 )) and ((j.from_date <= 1740676072 and j.to_date >= 1740676072 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 4802) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 873443466 and j.to_ip >=873443466 )) and ((j.from_date <= 1740676072 and j.to_date >= 1740676072 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 4802) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 873443466 and j.to_ip >=873443466 )) and ((j.from_date <= 1740676072 and j.to_date >= 1740676072 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 4802)
      800μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 1177 and `b`.`banner_from_date` <= 1740676072 and `b`.`banner_to_date` >= 1740676072 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.08msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 1177
      • 3: 1740676072
      • 4: 1740676072
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='c5a93e7ce239cc249ea623ef8c6a7d56'
      220μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    12Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        RsO5rBvYpCnWmPFMt99OMMQiprffJF32vBmFihiQ
        uc_cart_id
        c5a93e7ce239cc249ea623ef8c6a7d56
        _previous
        array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/4802" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/4802
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:8 [ "accept-encoding" => array:1 [ 0 => "gzip, deflate" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] "connection" => array:1 [ 0 => "keep-alive" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] ]
        request_cookies
        []
        
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Thu, 27 Feb 2025 17:07:52 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IjlCWjVFNDhEdklrai8xRVY1RlcrYnc9PSIsInZhbHVlIjoiOEJPZkpKNGtPNnVBQTI4NnJBTlFrL1Fsd2RDRTA0WmVyd29zUzYwbFhwUHhGbXVVSG1NZG4rUFhSYWwzMS8rZ2pUZXpUWHNnN2N3L2svaDRUbkVkMGp4Y2hMUm1TbjhQcHVmUmpKVjhuOFJPMVVaV1Fsby95ZC9WRFNLM2wxSkwiLCJtYWMiOiI4YjlhZjgzYWE0ODYxNjg3YjQ5M2ZlOTQ4ZGMwYTY1ZmVkNTc3MjU3MWE3MDAxNGNlNjBkYjFjNmIyMmU3MzE4IiwidGFnIjoiIn0%3D; expires=Sun, 02 Mar 2025 05:07:52 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IjlCWjVFNDhEdklrai8xRVY1RlcrYnc9PSIsInZhbHVlIjoiOEJPZkpKNGtPNnVBQTI4NnJBTlFrL1Fsd2RDRTA0WmVyd29zUzYwbFhwUHhGbXVVSG1NZG4rUFhSYWwzMS8rZ2pUZXpUW" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjI5Qkh6bzlkeU1HVmNwSEo0cFJ0Snc9PSIsInZhbHVlIjoibG9RcFhqQ2tqUEo0YWNVdzkrWEtGY1p1RFJtMWJhM2JpMHhCOWtxdENzSzArSnZTb2xYMnRyMGVNSU5CaHkxTWVJRjZpbXRMVCtORWtQMHJQZWVMMCtEem9BTmk3cWw5cnJjTGltVzV6dmJ6aEorN3hJNGt0Z2loVmlTaWx5ZjAiLCJtYWMiOiI5ZTRhM2ZmOWI0ZDMxZTkyZWE5NGEzNGIxY2ViMmI0MzcxMjAwNDAzZWFmMzYxOTU2M2RlZWMwNzU3ZDIwOTgyIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IjI5Qkh6bzlkeU1HVmNwSEo0cFJ0Snc9PSIsInZhbHVlIjoibG9RcFhqQ2tqUEo0YWNVdzkrWEtGY1p1RFJtMWJhM2JpMHhCOWtxdENzSzArSnZTb2xYMnRyMGV" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IjlCWjVFNDhEdklrai8xRVY1RlcrYnc9PSIsInZhbHVlIjoiOEJPZkpKNGtPNnVBQTI4NnJBTlFrL1Fsd2RDRTA0WmVyd29zUzYwbFhwUHhGbXVVSG1NZG4rUFhSYWwzMS8rZ2pUZXpUWHNnN2N3L2svaDRUbkVkMGp4Y2hMUm1TbjhQcHVmUmpKVjhuOFJPMVVaV1Fsby95ZC9WRFNLM2wxSkwiLCJtYWMiOiI4YjlhZjgzYWE0ODYxNjg3YjQ5M2ZlOTQ4ZGMwYTY1ZmVkNTc3MjU3MWE3MDAxNGNlNjBkYjFjNmIyMmU3MzE4IiwidGFnIjoiIn0%3D; expires=Sun, 02-Mar-2025 05:07:52 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IjlCWjVFNDhEdklrai8xRVY1RlcrYnc9PSIsInZhbHVlIjoiOEJPZkpKNGtPNnVBQTI4NnJBTlFrL1Fsd2RDRTA0WmVyd29zUzYwbFhwUHhGbXVVSG1NZG4rUFhSYWwzMS8rZ2pUZXpUW" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjI5Qkh6bzlkeU1HVmNwSEo0cFJ0Snc9PSIsInZhbHVlIjoibG9RcFhqQ2tqUEo0YWNVdzkrWEtGY1p1RFJtMWJhM2JpMHhCOWtxdENzSzArSnZTb2xYMnRyMGVNSU5CaHkxTWVJRjZpbXRMVCtORWtQMHJQZWVMMCtEem9BTmk3cWw5cnJjTGltVzV6dmJ6aEorN3hJNGt0Z2loVmlTaWx5ZjAiLCJtYWMiOiI5ZTRhM2ZmOWI0ZDMxZTkyZWE5NGEzNGIxY2ViMmI0MzcxMjAwNDAzZWFmMzYxOTU2M2RlZWMwNzU3ZDIwOTgyIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IjI5Qkh6bzlkeU1HVmNwSEo0cFJ0Snc9PSIsInZhbHVlIjoibG9RcFhqQ2tqUEo0YWNVdzkrWEtGY1p1RFJtMWJhM2JpMHhCOWtxdENzSzArSnZTb2xYMnRyMGV" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "RsO5rBvYpCnWmPFMt99OMMQiprffJF32vBmFihiQ" "uc_cart_id" => "c5a93e7ce239cc249ea623ef8c6a7d56" "_previous" => array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/4802" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-27 17:07:52GET/chapter/48021121914