Menopause, every woman experiences it differently
For all, common is the need to counter vasomotor symptoms such as hot flashes, which impair relationship life, and prevent the onset of serious diseases such as osteoporosis and cardiovascular disease. This was revealed in a survey conducted by GfK Italy for MSD Italy.
After years of no major therapeutic breakthroughs, thanks to a commercial agreement Between Pfizer and MSD, the first in a class of drugs, dubbed TSEC, arrives in Italy, Tissue Selective Estrogen Complex or Tissue-Selective Estrogen Complex, Hormone Replacement Therapy without progestin, a combination Of conjugated estrogen and bazedoxifene that reduces menopausal symptoms.
The “resigned” tolerate it, the “serene” live it quietly, but the “eternal girls” and the “performers” take action to find solutions. As many women as there are ways to experience menopause. The path is common to all: what changes are the experiences, the speed with which treatment is arrived at, the expectations toward treatment and the degree of satisfaction.
Just as the severity of symptoms changes, which affects whether or not a therapy is taken. In fact, all women over 50 share a fear of menopausal symptoms, which can compromise their quality of life in the short, medium and long term. This is stated by the research “Women and menopause” conducted by GfK Italia on behalf of MSD Italia, the results of which are being presented today at the 17th World Congress of the International Society of Endocrinological Gynecology – ISGE.
One of the major factors that reduce compliance with the use of Hormone Replacement Therapy is progestin intolerance 1 . Now, for women for whom progestin-containing therapy is not appropriate, thanks to an agreement between Pfizer and MSD, Duavive arrives in Italy ® , the first in a class of drugs, TSEC, Tissue Selective Estrogen Complex or Estrogen Complex, that can effectively counteract the most troublesome menopausal symptoms: hot flashes, night sweats, and sleep quality. Problems that, according to the survey, compromise physical well-being but also the sexual sphere and relationship life.
The drug is a combination of a selective estrogen receptor modulator (SERM), bazedoxifene, and natural estrogens. The benefit is twofold: with estrogen the drug maintains the benefits of hormone therapy and with bazedoxifene it reduces the risk of endometrial hyperplasia.
“This is an important therapeutic innovation effective in counteracting symptoms related to estrogen deficiency, indicated for women with uterus for whom progestin therapy is not appropriate” he states Andrea Riccardo Genazzani, Full Professor of Gynecology and Obstetrics, University of Pisa and President ISGE – International Society of Gynecological Endocrinology. “It is a combination of conjugated estrogen and bazedoxifene. Therefore, hormone therapy without progestin. Conjugated estrogens replace the lack of estrogen production in menopausal women and alleviate menopausal symptoms. Because estrogen promotes endometrial growth, its effects, if not counteracted, increase the risk of hyperplasia and cancer of the endometrium’endometrium.
Hence the need for the addition of bazedoxifene, which acts as an estrogen receptor antagonist in the uterus, greatly reducing the estrogen-induced risk of endometrial hyperplasia in nonhysterectomized women. In fact, bazedoxifene is a selective estrogen receptor modulator that, depending on the tissues in which these receptors are expressed, can either act as a receptor antagonist (inhibitory effects), as in breast and endometrial tissue, or act as an agonist on other tissues, with a stimulatory effect on the receptors)“.
Hormone Replacement Therapy (HRT) based on estrogen and progestin has long been used to control and mitigate menopausal effects. However, its safety profile and tolerability are still under discussion, and according to research findings, the reasons why it is not used are mainly twofold: some women do not want to take hormones and they are opposed to the use of drugs for menopausal symptoms, which is considered a natural event that must be accepted.
On the other hand, on the other side of the scale, the reasons why women who have started HRT do not abandon the therapy are reduced symptoms, decreased risk of osteoporosis, and cardiovascular problems.
“HRT Is indicated for women with moderate-severe symptoms associated with menopause – comments Chiara Benedetto, Full Professor of Gynecology and Obstetrics, University of Turin – the benefits of Hormone Replacement Therapy manifest themselves rapidly in terms of improvement in women’s quality of life and in the medium to long term as prevention against certain diseases that increase in women after menopause, particularly osteoporosis, cardiovascular and degenerative diseases. However, HRT must be started immediately after menopause so that the estrogen taken can exert its protective effect on all organs involved (blood vessels, skin, brain, skin, mucous membranes, urinary tract etc.) and prevent the appearance of a series of changes that over the years lead to the onset of serious diseases“.
Although life expectancy has increased, the age at which natural menopause occurs has not changed significantly in recent years. Today, a woman spends about 30 years, or nearly a third of her life, in post-menopause. Many women regard this stage as the concrete manifestation of aging, others as the beginning of a new era of their existence: in any case, menopausal women represent the largest social group today, also in view of the increased longevity of women.
“How a woman perceives and experiences the arrival of menopause depends largely on what she has sown and what she has received over the years. Everything depends on the experience of each woman – emphasizes Scarlett Nappi, Associate Professor of Obstetric and Gynecological Clinic, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia – a fact, this, which is clearly noted in the survey carried out by MSD, from which the concept of menopause emerges as a phenomenon declined between nature and culture. Because, in the face of an event written into women’s natural biology, the social, cognitive, and emotional aspects related to women’s lived experience and experience cause them to face and confront this phase of life differently in order to find solutions.
The real problem lies precisely in the difficulty of the approach, given the different manifestations of menopause symptoms in women or the different experiences on the part of each of them, and sometimes the doctor may not be prepared to deal with and treat menopause with its many facets, while the woman wants a doctor who also knows how to listen to her“.
The combination of conjugated estrogen and bazedoxifene will allow many postmenopausal women, for whom progestins are not appropriate, access to therapy.