title: [Hormone therapy in menopause: when not to use].
abstract: Menopause is defined as the permanent cessation of menses, as a result of the loss of ovarian follicular function or of surgical removal of ovaries. The mean age for occurrence of natural menopause is around 50 years. Estrogen deficiency has been associated with vasomotor symptoms, urogenital atrophy, and cognitive impairment, as well as increased risk of chronic degenerative diseases such as osteoporosis and Alzheimer's disease. Estrogen therapy remains the most effective treatment for the management of vasomotor symptoms and urogenital atrophy. Progesterone or progestins should be added to estrogen treatment in women with uterus, in order to antagonize the estrogen-induced endometrial proliferation. In turn, in specific clinical conditions hormone therapy is not recommended. In the present article, the authors critically focus these clinical conditions in which hormone therapy should not be used.
authors.affiliation: Unidade de Endocrinologia Ginecológica, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2350, Porto Alegre, RS. spritzer@ufrgs.br
authors.forename: Poli Mara
authors.initials: PM
authors.lastname: Spritzer
authors.forename: Maria Celeste Osório
authors.initials: MC
authors.lastname: Wender
mesh_terms: D001943:Breast Neoplasms / Q000139:chemically induced; D002277:Carcinoma / Q000139:chemically induced; D000075202:Contraindications; D016889:Endometrial Neoplasms / Q000139:chemically induced; D015914:Estrogen Replacement Therapy; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008593:Menopause / Q000187:drug effects*; D011164:Porphyrias / Q000139:chemically induced; D012307:Risk Factors; D013923:Thromboembolism / Q000139:chemically induced
vernacular_title: Terapia hormonal na menopausa: quando não usar.