Climacteric and Menopause
Treatment of sexual dysfunctions and loss of libido associated with aging
Graduate doctor at UnB
Specialist in Gynecology and Colposcopy
Post Graduation in Orthomolecular Practice in Medicine (PUC)
Extensive academic training in Brazil and abroad
Adept of Integrative Medicine
More than 25 Years Dedicated to the Care of Women
Climacteric hormonal transition.
Treatment of symptoms of hypoestrogenism (menopause) with control of weight and lean mass.
Treatment of sexual dysfunctions and loss of libido associated with aging.
Treatment of urine loss associated with decreased hormones.
Individualized hormone replacement safe
From the age of 45 most women begin to notice changes in menstrual cycle and flow, vaginal lubrication, and symptoms of premenstrual tension.
These changes reflect gametocytic insufficiency (decreased number of eggs or female gamete) and hormone insufficiency. The basic phenomenon is the decrease of primordial follicles throughout life. At birth, the ovaries have about one to two million follicles; when the first menstruation occurs (menarche) 400.00 and between the ages of 35 and 37, 25,000 and near the menopause (perimenopause) there are only about 1,000 follicles.
With the decrease in the number of follicles, the gametocytic insufficiency and then the hormone insufficiency (progesterone first and then estrogen) are installed.
The menstrual cycles become shorter (polimenorrhea) or longer (oligomenorrhea) and the amount of the flow may be more abundant (hypermenorrhea) or scarce (hypomenorrhea).
Menopause occurs between the ages of 40 and 55; before 40, is said to be premature (premature) and, after the age of 55, late.
The diagnosis is based on the clinical picture or on hormonal dosages.
The hormone replacement for treatment of menopausal symptoms and for genital atrophy can be prescribed with an improvement in the quality of life of the woman. The decision is always made by the patient after a complete gynecological examination including all necessary blood and imaging examinations such as mammography, transvaginal ultrasonography, bone densitometry, etc.
Depending on the climacteric phase, safe and hormone replacement can only be done with Progesterone or progestagens, only with Estrogen associated or not with progestagens, and Androgens may also be used. The treatments are individualized varying in the routes of administration (oral, transdermal or vaginal); in the dosage; the combination of hormones and the duration of treatment.
It is possible that, in the future, the optimal selection of patients will pass through genetic tests (genetic polymorphism and estrogen metabolism).
At the present time of the medicine the frank dialogue with the doctor, the physical examination, the laboratory results and the imaging reports guide the hormonal therapy that can be used safely.
Dr. Ana Luiza participates annually in courses (Harvard School of Medicine) and international congresses to verify the effectiveness and benefits of hormonal, non-hormonal and phytotherapeutic therapies in the treatment of menopause. This continuous update allows her to be “up to date” in everything that refers to Gynecological Endocrinology.
What is hormone replacement therapy?
Hormonal Replacement Therapy (HRT) is the treatment indicated for women in menopause and climacteric and consists of medicating them with the female hormones, since those produced by your body are already insufficient to maintain the female structure without the symptomatology described above. Thus, women who have a uterus can be medicated with the combination of estrogen and progesterone. In hysterectomized women (who have withdrawn the uterus), hormone replacement is done with estrogen alone.
For whom is it indicated? And what are the contraindications of HRT?
It is indicated for all women with symptomatology that compromises quality of life.
It is contraindicated in cases of severe hepatic or renal disease, myocardial infarction, stroke, breast cancer, urogenital cancer, decompensated diabetes, uncontrolled hypertension, unidentified vaginal bleeding, acute liver disease, uterine fibroids, endometriosis, and gallstones.
In menopause, is the woman more susceptible to osteoporosis?
The woman in the menopause has as a late event the osteoporosis due to the loss of calcium and alteration of the bone microarchitecture. In that case, it is recommended to do hormone replacement, take calcium, vitamin D and sun, as well as practice physical exercises.
Many women complain about lack of libido in menopause? How to deal with it?
It really is a common complaint, and several factors interfere with it, such as the lack of hormone and the myth of asexual old age. In these cases, hormone replacement may favor women, especially if associated with androgen (male hormone), to begin again sexual life with satisfaction.
Can menopause interfere with a woman’s emotional life?
Menopause causes psychological and vasomotor phenomena that interfere with emotional life. If very pronounced, in addition to hormonal therapy, one can make use of antidepressant and psychotherapy.