Professional paper
IMPROVING WOMENS’ HEALTH: EVIDENCE BASED RECOMENDATIONS FOR HORMONAL REPLACEMENT THERAPY
Danijela Daus-Šebeđak
orcid.org/0000-0003-3300-4502
; Specijalistička ordinacija obiteljske medicine „Dr. Danijela Daus-Šebeđak“,ambulanta Podvinje, Slavonski Brod
Mladenka Vrcić Keglević
; Zaklada za razvoj obiteljske medicine, Črešnjevec 32, Zagreb
Abstract
The aim of this article is to present the evidence based conclusions and recommendation on hormonal replacement therapy (HRT) in peri- and postmenopausal women and to explore the Croatian situation.
Methods. First, we did a literature search (predominantly the independent resources, such as The Canadian Task Force on Preventive Health Service, the US Preventive Services Task Force and
The Cochrane library). To investigate the Croatian situation, we extracted morbidity data related to the menopausal problems, N97 diagnoses (ICD-10), registered in family medicine (FM) and in women
health service (WHC) from the Croatian Health Statistics Yearbooks (1995-2012). From the Reports on pharmaceuticals’ usage (Croatian Agency for Pharmaceuticals and Medical Substances) we extracted data on usage of sexual hormones and related substances (2004-2012).
Results. According to the literature, the risk of HRT overcomes the benefits. A rise in myocardial infarction, stroke, venous thromboembolism, breast cancer, gallbladder diseases and urine
incontinence has benn documented. Lowered was the risk of osteoporotic fractures (significantly), and of diabetes type 2 and colorectal cancer (insignificantly). In Croatia some 6-12% of
morbidity registered in WHC and in FM was due to menopausal problems (N97, ICD-10). Up to 38% of all menopausal problems were registered in FM. This trend was continuously decreasing in FM, but
not in the WHC.
Conclusion. HRT has a strong unfavorable impact on many chronic conditions, and it should be applied in cases of severe hot flushes and sweats only. This should be implemented in Croatia, especially in the
WHC.
Keywords
Hrčak ID:
136260
URI
Publication date:
13.3.2015.
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