Menopausia: panorama actual de manejo

  • Luis Ernesto Pérez A. Universidad Militar Nueva Granada
  • Ingrid C. Rojas Universidad Militar Nueva Granada
Palabras clave: menopausia, terapia de reemplazo hormonal, alteraciones sexuales, enfermedades cardiovasculares, osteoporosis, cáncer de mama

Resumen

Aún existe, desde 2002, una marcada disminución en el uso de terapia hormonal clásica (TH), para el manejo de la menopausia, debido a los riesgos determinados en el estudio Iniciativa de salud para las mujeres (WHI: Women’s Health Initiative). No obstante, revisiones del WHI y evidencias actuales determinan que la TH: (a) es la terapia más efectiva de los síntomas vasomotores, de sus potenciales consecuencias (disminución en calidad del sueño, irritabilidad, reducción en calidad de vida), y para tratar la atrofia urogenital. (b) Previene la osteoporosis y en pacientes con endotelios sanos, reduce el riesgo de hipertensión arterial, diabetes II y enfermedad coronaria, siendo el cociente beneficio/ riesgo mayor cuando se inicia tempranamente al sucederse el hipoestrogenismo. (c) Existe la tendencia a utilizar dosis mínimas, estrógenos no orales y progestágenos puros, para disminuir sus riesgos. (d) Tibolona y paroxetina son las mejores alternativas para tratar los síntomas vasomotores. (e) Finalmente, los cambios a estilo de vida saludable son coadyuvantes excelentes de la TH en el manejo de los síntomas menopaúsicos y en la prevención de las enfermedades crónicas de la postmenopausia, las cuales ameritan tratamientos específicos.

Biografía del autor/a

Luis Ernesto Pérez A., Universidad Militar Nueva Granada
Profesor Titular, Facultad de Medicina, Universidad Militar Nueva Granada, Hospital Militar, Bogotá, DC, Colombia
Ingrid C. Rojas, Universidad Militar Nueva Granada
Médico general, Universidad Militar Nueva Granada, Bogotá, DC, Colombia

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Biografía del autor/a

Luis Ernesto Pérez A., Universidad Militar Nueva Granada
Profesor Titular, Facultad de Medicina, Universidad Militar Nueva Granada, Hospital Militar, Bogotá, DC, Colombia
Ingrid C. Rojas, Universidad Militar Nueva Granada
Médico general, Universidad Militar Nueva Granada, Bogotá, DC, Colombia

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Cómo citar
Pérez A., L. E., & C. Rojas, I. (2011). Menopausia: panorama actual de manejo. Revista Med, 19(1), 56–65. https://doi.org/10.18359/rmed.1226
Publicado
2011-06-30
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