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KMID : 0352819930090020115
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Kosin Medical Journal
1993 Volume.9 No. 2 p.115 ~ p.128
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Menopausal management ofa woman
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Abstract
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menopause is an event common to all women. For some women, it is not difficult, but for many it arrives with complication, bothphysilogical and psychological.
Although there is perhaps no gyneclolgic disoredr in which the indication for hormone therapy is more retional than in thetreatment of typical climacteric symptoms, especially the vasomotor group, it must be remembered that many syptoms
frequently
observed in menopausal women are not directly due to the endocrine readjustments ofthis period but are more logically explained as due to environmental and psychogenic factors.
Estrogen therapy is indicated for the control ofacute symptoms ofthe hot flush and insomnia. If treated soon after onset withadequate dosage, the symptoms can usually be controlled rapidly. As the menopausal woman is not totally estrogen
deficient,
but
only relatively deticient in respect to reproductive capacity, some women will not need constant low-dose estrogen replacement therapy as indicated in the premature menopausal patient.
Prophyactic estrogen therapy for the prevention of arteriosclerotic cardiovascular disease may be needed. For the patient at risk for osteoporosis, low-dose prophylactic estrogen therrapy may be needed. The action of estrogen on bone is to
prevent
calcium resorption, and there is little evidence that it sill stimulate new bone formation.
The twocardinal priciples of hormon therapy are most important in such olng-term treatment, as little "as necessary to control symptoms over as short as possible a duration"
Consequently, today a healthy fifty-year-old women can resonably expect to live for another thirty toforty years.
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