Research Shows Climacteric Symptoms Can Be Combated Using The Most Diverse Techniques
Climacteric is a period of a woman’s life that usually happens from 40 to 65 years of age and occurs when menstruation begins to become irregular, in a process that can last more than six months. This period of transition from climacteric to menopause can take from two to eight years. Menopause begins after a year without menstruation and the woman may or may not have intense vasomotor symptoms, also known as hot flashes and other alterations, which are worse in the postmenopause, as explained by José Maria Soares Júnior, head of the Division’s Climacteric sector. of Gynecology at the Hospital das Clínicas and associate professor at the Faculty of Medicine at USP. “In post-menopause, with time, vasomotor symptoms tend to decrease spontaneously, in some women they begin to decrease and other symptoms appear, which are: Genital atrophy, pruritus, dryness, dyspareunia, urinary incontinence, urinary urgency. We call it postmenopausal genitourinary syndrome.”
When the patient has irregular and heavy menstruation, the treatment is hormonal, using progestogen, due to the lack of progesterone in the body. To minimize vasomotor symptoms, estrogen is used, which has risks, requiring a medical evaluation to verify that there is no precursor lesion of breast cancer or genital cancer, or any cardiovascular condition that prevents the use of estrogen, which helps with genitourinary symptoms.
Several methods can be used to minimize symptoms. “We have estrogen-only replacement for women who undergo hysterectomy, we have estrogen plus progestogen replacement for women who have a uterus, to protect the uterus from the action of estrogen in the long term, we can have only progestogen when we have irregular menstruation and another progestogen that we can use is tibolone, a progestogen different from the others, which we do not use before menopause and which helps with vasomotor symptoms.” The application can be orally, patches or creams.
care and attention
The climacteric is a phase in a woman’s life in which she passes from the reproductive to the non-reproductive period and in which the use of medication requires care and medical attention. It is already known that, nowadays, the woman has great benefits when using them when she has vasomotor symptoms, a condition that decreases the quality of life, but, if she does not have a good medical follow-up, the risks of having a thromboembolism, a heart attack, breast disease or, even in those cases where she stopped using the progestogen, endometrial cancer are big. If there is medical follow-up with physical examinations, assessing the changes that occur, with preventive measures to improve quality and lifestyle, especially with diet and physical activity, this can minimize the malaise, warns Soares.
Among the treatment innovations there is the laser – Hifu, Fraxx -, ablative and non-ablative energies, which can be an alternative to topical estrogen for women who do not wish to use the medication or vaginal creams. Ablative energies remove parts of the old mucosa or collagen and replace it with new. In these cases, we will have lasers such as CO2 lasers, which are deeper. But there are also lasers that are more superficial.
Non-ablative energies do not perform this removal, but cause a new cell, a new tissue to grow and also increase the amount of collagen. Hifu is one of them. A microfocused ultrasound that will cause collagen, cells and epithelium to proliferate, which improves the genital tract, decreases pain during sexual intercourse and also improves urinary incontinence. These are genitourinary syndrome treatments. Another technique that exists is radiofrequency, which can also be ablative and non-ablative. According to the climacteric specialist doctor, there is no energy superior to the other in the literature, they are an alternative to estrogen, and the use of the laser also has risks and it is necessary that the application be carried out by a trained professional, as it is not yet known. what can happen with its continued use.