pattern of menopause in Kuwait and the need for hormone replacement therapy

To evaluate the pattern of menopausal symptoms in Kuwait and the need for hormone replacement therapy. Methodology: Two hundred and sixty-one postmenopausal women who attended the menopause clinic in a three year period form the subjects of the evaluation. This included detailed history, physical examination, and blood for hormone, lipoproteins and glucose profile, and high vaginal swabs, cervical smears and mid stream urine for urine culture. Mammography and CT scan were done for some patients. The median age for natural menopause was 49.5 years. Hot flushes were the commonest feature in 90% of the patients. Other features included night sweats, musculo-skeletal and psychological symptoms. The FSH and LH were generally high; >20 iu/L. About 14-27% of the patients had high risk lipoprotein indices concomitant with developing coronary heart disease. The CT scan revealed that 27.5% of the women had low mineral bone density in the risk range for developing osteoporosis. Menopausal symptoms in Kuwait have the same pattern as in western countries. Hormone replacement therapy is acceptable by women. Its general use among postmenopausal women is therefore recommended

One-year follow-up of post menopausal women on hormone replacement therapy in Kuwait

The objective of this study was to evaluate the effect of hormone replacement therapy in 261 postmenopausal women in Kuwait 1 year after starting treatment. The investigations were carried out from June 1992 to June 1994. Combined estrogen and progesterone were used by 50.6% of the women while estrogen implants were used by 18%, transdermal therapeutic system [TTS] patches by 10.3%, natural estrogen by 10.0%, Livial by 6.1%, and estrogen cream by 5.0%. The side effects of HRT were few and mild. Nine of the 27 patients on TTS patch had allergic skin reactions. Significant reduction in the vasomotor symptoms of hot flushes, night sweats and palpitations was achieved in 80-90% of the patients; 31-37% experiencing total elimination of symptoms. Although there was appreciable reduction in the musculoskeletal, psychological and sexual dysfunction symptoms, relief was significantly better for the vasomotor symptoms [p <0.01]. There was a significant reduction in the levels of FSH and LH, and an increase in estrogen levels [p < 0.001], but no significant change was recorded in the lipoprotein profile [p > 0.05]. In conclusion, hormone replacement therapy has a significant place in the alleviation of climacteric symptoms in this community