"The prescriptions of THM have decreased by 80% since 2002, says Professor Florence Trémollières, head of the Menopause Center of the University Hospital of Toulouse. Only one in ten women is treated today, compared to one in two previously.
When this treatment happened in the early 1990s, the craze was important. No more hot flashes , vaginal dryness and increased risk of osteoporosis .
Menopause and THM: the latest reassuring studies
The publication of high-profile US studies incriminating THM in the increase of heart attacks and breast cancer has thrown a cold. But "their results are questionable, said Dr. Patrice Lopes, president of the Gemvi (Study Group on menopause and hormonal aging), because they were performed on women who started too late treatment. In addition, the THM prescribed in the United States is not the same as that given in France (natural progesterone and oral dermal estrogen. "The latest studies on the" French THM "are reassuring.
"Breast cancer is particularly correlated with the duration of hormonal impregnation . It depends on the age of the first period , the menopause and the duration of the treatment, explains Prof. Geneviève Plu-Bureau, of the gynecological endocrinology unit of the Cochin hospital. A recent study of more than 80,000 postmenopausal women shows that a 5-year THM does not pose a risk. After 8 years, there is an increase in risk, but it is low.
Hormonal treatment for: maintained bone stock
"Since the disaffection with the THM, I see 60-year-old women with fractures every day, never before," says Pr Trémollières. Half of women already have bone fragility when they reach menopause. Without THM, demineralization of the skeleton accelerates rapidly because estrogen plays an important role in maintaining bone capital.
A French study proved in 2010 that women treated at the beginning of menopause have a risk of fracture halved.
Hormonal treatment for: a better protected heart
The Elite study published in March 2016 clearly indicates that THM reduces cardiovascular risk, provided that it starts treatment at the beginning of menopause.
"THM slows down atherosclerosis, so it reduces the threat of infarction, while it escalates theoretically over the years," says Pr Trémollières.
Hormonal treatment as a shield for the brain
" Alzheimer's disease affects men and women equally up to the age of 75," says Professor Florence Pasquier of the neurology department at Lille University Hospital. But after, women are more affected because of their hormonal deficiency since the beginning of their menopause.
A Finnish study in March 2017 showed that women treated had a lower risk of dementia than untreated women: - 38% vascular dementia and - 17% Alzheimer's disease.
Hormonal treatment for: better sleep
An estrogen deficiency erodes the quality of sleep . The THM therefore improves it necessarily. "By eliminating night sweats, it avoids awakenings by discomfort during the night and it also increases the duration of deep slow sleep, the most recuperative," says Dr. Gabriel André, a gynecologist-obstetrician in Strasbourg. In addition, it reduces snoring and breathing pauses due to sleep apnea.
Although THM seems to bring a lot of benefits, the treatment decision should be made on a case-by-case basis with the doctor, depending on the symptoms, the medical and family history of each. In the absence of contraindications, it must be put in place quickly, within 5 years after stopping the rules according to the Gemvi.
