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PEER-REVIEW | HORMONE REPLACEMENT THERAPY |


PELLET THERAPY AS A HORMONE REPLACEMENT METHOD


HORMONAL


Renata Britto explains the benefits of hormonal replacement therapy using subdermal implants of oestradiol and testosterone


ABSTRACT As women are now living longer, they spend on average one third of their lives in post menopause. Unfortunately, this means their lives are impacted by a number of conditions related to their altered hormone levels, including osteoporosis. The benefits of the use of oestradiol and androgen


RENATA L. BRITTO MD, PHD Department of Gynecology, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil


email: renatalopesbritto@gmail. com


to society1 D . A physiological decrease in circulating levels of sex hormone-binding


KEYWORDS Postmenopausal women, hormone replacement therapy, subdermal implants, hormonal pellet, oestradiol, testosterone


34 ❚


globulin (SHBG) occurs near menopause, together with an increase in the activity of the aromatase enzyme in certain tissues in order to encourage tissue- specific oestrogen production through androgenic precursors. This mechanism is the principal pathway of oestrogen production in menopause. Therefore, the most physiological manner in which to replace oestrogens and androgens in postmenopause is to increase the bioavailability of the endogenous androgenic precursors, a preferable alternative to providing exogenous oestrogens. Only 2% of testosterone, the free fraction not bound to SHBG, exerts a biological role on tissue, and oral oestrogen therapy increases the production of SHBG, diminishing the effects of endogenous testosterone and accelerating the appearance of symptoms of androgen deficiency2


. January/February 2015 | prime-journal.com


subdermic implants have been demonstrated in publications resulting from studies and the results converge towards an improvement of the lipid profile and increase in the bone mineral density in the patients in post menopause.


UE TO THE INCREASE IN THE number of women who survive on average one-third of their lives after menopause, osteoporosis, worsening of the lipid profile, and hypoandrogenic symptoms have become conditions of high cost


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