THE SECRET OF A “HAPPY” MENOPAUSE? A PERSONALIZED THERAPY

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The menopause is not a disease, but a physiological moment of life that coincides with the end of fertility. During this phase that can last several months or years many women complain disorders for which exist proper cares to ensure a good quality of life. A hormone replacement therapy (HRT) is absolutely recommended and MD Alessandro Albiero, gynecologist, explained us how is important – further the prevention – to implement a therapeutic strategy as soon as possible.

What to do when approaching this delicate moment for many women?

“Generally the menopause occurs from 45 to 55 years-old, but early and late menopauses are not rare. Already a few months before the end of menstruations can be observed alterations of the menstrual cycle and is just in this period that the ovaries decrease their activity with a lower production of estrogens. This decrease can provoke some disorders or symptoms, both neurovegetative (hot flush, profuse sweating, palpitations and tachycardia, changes in blood pressure, sleep disorders, vertigo, vaginal dryness and genital itching), and psychoaffective (irritability, unstable mood, fatigue, anxiety, demotivation, concentration and memory disorder, reduction of sex drive). The most important consequences of estrogens decrease are: increase of cardiovascular risk (heart attack, cerebral stroke, hypertension) and osteoarticular diseases, in particular the increase of osteoporosis incidence. Therefore the menopause prevention must actually begin much earlier, from the puberty implementing a healthy lifestyle, correct diet and constant sport activity. However, when the menopause occurs with an important symptomatology, creating a hard discomfort, then a hormone replacement therapy must be performed. This kind of therapy has to be introduced selectively, that is not necessarily administered to all women, and has to be personalized, or rather, aimed at lightening every type of symptom. The most common and annoying symptom is certainly that defined “hot flush” caused by an increase of adrenaline in the brain. Now recognized as risk factor, for a patient who suffers in the following years might develop the arterial hypertension and for this should not be underestimated at all. The women who suffer it are about the 40% and in the 90% of treated cases with a proper hormone replacement therapy the menopauses disappear. An appropriate and personalized therapeutic approach allows to make the patient feel better, improving her quality of life and sleep. In order to get the maximum of advantages it is important to begin this therapy as soon as possible”.

A personalized therapy to restore a good living, but how long is it?

“The hormone replacement therapy must be continued at least for 5 years to get the maximum of advantages. It may be extended for other 5 years up to a maximum of 10 years. Then it must be abandoned because the oncologic and cardiovascular risks increase. It has to be administered for a limited period of time, varying the prescriptions depending on the symptoms that the patient each time shows. It may involve cardiovascular and sexual troubles as the reduction of sex drive and this can represent a family problem, or vaginal dryness that involves a painful intercourse and can be resolved even thanks to the use of  creams. So it is essential to follow the patient during all this course precisely to ensure her more and more a best standard of living”.

THE CARDIOVASCULAR PREVENTION BECOMES A MUST FOR THE SUMMER

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It is definitely not a fashion fact, but it is certain that for some people the cardiovascular prevention has to become a necessary condition, a seasonal must from which it’s not possible to escape.

In the summertime the heatwaves, especially if there is a moist heat, can represent a real threat for persons with heart diseases. The overheat indeed favors the dilation of blood vessels at the peripheral level overloading the heart for the increase of circulating volume. Moreover, the vasodilation combined with the dehydration, due to the excessive sweating, can cause important pressure drops. So it’s time to do something about it, or rather it is recommended to prevent any danger drinking much water and avoiding the hottest hours. It is a fact that these indications are already known, so it is important that even those who do not suffer heart problems, but who can be defined at risk, undergo a series of preventive tests, also before the summer.

What are these tests?

Besides a specialized cardiologic visit it is necessary to follow some hematochemical tests, as the glycosylated hemoglobin for diabetic patients; the microalbuminuria that fixes the presence of small quantities of albumin in urine that occurs when there is a damage in renal organ in hypertensives. Finally the lipid profile for who suffers of dyslipidemia, that is a quantitative and qualitative alteration of fats circulating in the blood. To these tests must be added the instrumental ones as: electrocardiogram and electrocardiogram to define the organ damage in hypertensives; echo-color Doppler of overaortic truncus indicated for diabetic and dyslipidemic patients.

Which patients must undergo a periodic activity of prevention?

These are patients who show one or more not controled cardiovascular risk factors, as, for example, the hypertensives patients with high pressure values, or dyslipidemic patients with not controled blood cholesterol levels, the diabetic patients with glycosylated hemoglobin values beyond the threshold and finally all those who are familiar with this type of diseases or the alcohol and tobacco consumers as the smokers.

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European Mako Council Virtual Meeting

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The Clinica San Francesco continues in its role of reference for the robotic surgery in Europe, despite the complicated period due to Covid19.

MD Piergiuseppe Perazzini, Director of the Orthopaedics and Traumatology Functional Unit, was invited as faculty member at the European Mako Council Virtual Meeting, the virtual event, organized by the firm Stryker, that gathered the major European specialist in the orthopaedic field. MD Perazzini, during several sessions by videoconference held on 18th, 25th and 30th June 2020, met his European colleagues, discussing remotely on the results achieved in the last few years and offering his advice thanks to the wide experience using the robot in operating room. The doctor is the European pioneer of robotic orthopaedic surgery, having been the first in Europe (and second worldwide after USA) to have carried out a robotic partial knee replacement (2011) and robotic total hip replacement (2012).

The Clinic, since 2013, is seat of CORE (European Centre for Robotic Orthopaedics) and in 2019 it was recognized by the Veneto Region as Reference facility for the robotic orthopaedic surgery.