1. HORMONAL REPLACEMENT THERAPY: DOES AGING LIMIT THERAPEUTIC BENEFITS? CECI MENDES CARVALHO LOPES CLÍNICA GINECOLÓGICA DO HCFMUSP

4. Therapy? Estrogens?

5. Therapy? Estrogens? Progestogens?

6. Therapy?

7. HRT Better quality of life –Acting positively on Symptoms Lipids Bone mass Skin

8. HRT Better quality of life –Acting positively on Symptoms Lipids Bone mass Skin –But there are risks and adverse effects! Thromboembolism Cancer

9. HERS II (Cardiac events/ 10000) NS

11. What to conclude? It seems there is cardioprotection –if HRT is iniciated in early menopause Indeed it is the best choice for symptoms It is beneficial to genitourinary problems Prevents genitourinary atrophy Preserves bone mass Maintains skin appearance

12. Until when? It is a permanent question –Good until it is beneficial –The minimum dose, the minimum time

13. Until when? It is a permanent question –Good until it is beneficial –The minimum dose, the minimum time... ???...

14. Which hormones? Estrogens –Conjugated equine estrogens? Progestins –Medroxyprogesterone?

15. Which hormones? Estrogens –Conjugated equine estrogens? –17β-estradiol? Progestins –Medroxyprogesterone? –Dydrogesterone? –Drospirenone? –Trimegestone?

16. Which hormones? Estrogens –Conjugated equine estrogens? –17β-estradiol? Progestins –Medroxyprogesterone? –Dydrogesterone? –Drospirenone? –Trimegestone?

17. Which hormones? Estrogens –Conjugated equine estrogens? –17β-estradiol? Progestins –Medroxyprogesterone? –Dydrogesterone? –Drospirenone? –Trimegestone?

18. Treatment without hormones? One medicine to each problem Results maybe not so good Less risk?

19. Treatment without hormones? One medicine to each problem Results maybe not so good Less risk?

21. ceci.lopes@hcnet.usp.br