SUMMARY :
Because of the life expectancy increase (80 years) and the relative fixity menopause
age of, the number of menopausal women is increasing. In fact many of these
women live the third of their life in a chronic estrogenic deprivation situation,
which can cause, in a short term, a deterioration of life quality and, in a
middle and long term an accelerated ageing of the global woman system (heart,
bone, brain and skin).
It is now established that treatment by estrogens is effective in treatment
of climateric disorders and prevention of post menopausal osteoporosis. The
treatment by estrogens would also have a positive influence on Alzheimer disease
and a prevent effect on colon cancer.
However, his important role in cardiac protection has been recently putting
in order by the HERS which represents the only controlled study in our service.
In the other side, long utilization of estrogens increases the risk of endometrial
cancer and probably breast cancer to. The risk of endometrial cancer decreased
when using treatment containing progestative drug but his effect on breast cancer
is controversial.
Furthermore this doubt on relationship between hormonal treatment and breast
cancer ends to development of treatment alternatives for breast protection.
It is utilization of specific estrogens receptors modulators (SERM) and specific
activity steroids (SAS) which is represented by tibolone.
These drugs have targeted effects on some organs (osteoporosis prevention for
twice and treatment of climacteric disorders for tibolone) but do not offer
all of benefits which is now reference of menopause treatment during the five
first years.