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Menopause and Treatments Export

Quality of Life Research, Vol. 9, No. 6. (2000), pp. 695-707.

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menopause

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Postmenopausal women comprise close to 10% of the world population. Their quality of life can be affected by menopausal symptoms or diseases associated with the postmenopausal period and by the effects, beneficial or negative, of curative or preventive therapies prescribed for these disorders. Many symptoms have been reported to be associated with menopause, but the question still remains of which are attributable to menopause and which to other causes. Osteoporosis and cardiovascular diseases (CVD) are directly associated with hormonal changes. Hormone replacement therapy (HRT) is the only treatment for which data on long-term use are available. Its curative effect on vasomotor symptoms and vaginal dryness is proven, as is the preventive efficacy on bone loss. Results concerning the prevention of fractures, of CVD and of Alzheimer's disease come from observational studies, and need to be confirmed. The risk of endometrial cancer associated with the use of unopposed estrogen is substantially mitigated by adding progestin. The findings of increased risk of breast cancer associated with HRT, based on observational studies, need to be confirmed. The risk/benefit ratio of HRT have mainly been estimated among populations living in industrialized countries. Bisphosphonates are effective only on osteoporosis, and the long-term effects of selective estrogen receptor modulators (SERMs) must be evaluated.


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