On November 8—9, 2019 in Tbilisi (Georgia) the I International Forum of Menopause Experts initiated by the Association of Gynecologists-Endocrlnologists of Ukraine was held. The expert working group included leading specialists in obstetrics and gynecology in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Uzbekistan and Ukraine. The experts presented data of their countries on the menopause management, experience in solving problems of this period of life. During medical counseling women special attention should be paid to the therapy timely start explaining the menopausal hormone therapy (MHT) benefits and risks, identifying age-dependent risks and ways to overcome them. MHT is the most effective and pathogenetically substantiated method for correcting menopausal disorders today. The MHT goal is to compensate partially for the deficiency of sex hormones using minimally optimal doses that can improve the woman’s general condition and ensure prevention of late metabolic disorders and osteoporosis. The MHT individualization depends on the patient’s age and menopausal status. For each stage of woman’s reproductive aging according to the STRAW+10 a balanced decision on choosing the regimen and dosage of the combined MHT with therapeutically effective low-dosage forms is required. MHT is recommended to be started mainly in perimenopause or in early postmenopause period but with the menopause duration not more than 10 years. It is necessary to evaluate the endometrium thickness using transvaginal sonography before the therapy. In perimenopause, it is preferable to start MHT in a combined cyclic regimen with an estrogen low dose. In postmenopausal women, it is preferable to start with an estrogen low dose followed by a continuous combined dosage regimen of estrogen and gestagen. A continuous assessment of the fractures risks is proposed in order to effectively prevent women’s osteoporosis in the postmenopausal period. Annual basic examinations are necessary throughout the entire period of the MHT use including measurements of weight, waist circumference, and blood pressure level, gynecological examinations, cytological examinations of cervical smears according to Papanicolaou, ultrasound examinations of the pelvic organs with determination of the endometrium thickness and structure, mammography.
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