ABSTRACT
Hormone replacement therapy (HRT) significantly decreases the frequency and intensity of vasomotor symptoms (VMS). It is recommended to evaluate clinical efficacy of HRT on VMS. The absence of reduction in VMS after adaptation of the modalities of the HRT suggests the possibility of atypical VMS. They should be evoked in the following clinical circumstances: when they do not give way with an adapted HRT (compliance and good use); when they appear or reappear long after menopause; when there are changes to the usual VMS; when they are associated with other functional signs. A first and second-line assessment is offered, after an interview and a detailed clinical examination, which will guide further explorations. The treatment is above all etiological when the results are positive. When the results are negative, an adaptation of the HRT can be proposed.
Subject(s)
Hot Flashes , Postmenopause , Diagnosis, Differential , Estrogen Replacement Therapy , Female , Hot Flashes/drug therapy , Hot Flashes/therapy , Humans , MenopauseABSTRACT
The incidence of venous thromboembolism (VTE) increases with age with an annual incidence of 1.25/1000 women in the 40-59 age group. Menopausal hormone therapy (MHT) may also increase the risk of VTE. This risk must be assessed during the first consultation before initiating MHT and assess each renewal of the MHT. MHT with oral estrogen combined (or not) with progestin increases the risk of VTE by about 70%. Using transdermal estrogen does not appear to increase the risk of VTE in women. VTE risk appears to be modulated by the type of progestin combined in MHT. The risk of VTE associated with MHT with transdermal estradiol appears to be safe in women using micronised progesterone and pregnane derivatives and higher in women using norpregnane derivatives . To limit the risk of VTE associated with MHT, transdermal estradiol use is recommended. In women at risk of VTE, MHT with oral estrogen is contraindicated. MHT with transdermal estradiol associated (or not) with micronised progesterone or dydrogesterone may be used in women with low or moderate risk of VTE.
Subject(s)
Estrogen Replacement Therapy , Postmenopause , Estrogen Replacement Therapy/adverse effects , Estrogens/adverse effects , Female , Humans , Menopause , Progestins/adverse effectsABSTRACT
An in situ hybridization technique using digoxigenin labelling was developed to study B19 infection. By using appropriate DNA probes, transcription of structural and non-structural genes was detected in bone marrow cell cultures. Such a simple system is useful to the study of B19-cell interactions in non-permissive cell lines.
