Menopause in women with chronic immunosuppressive treatment – how to help those patients

Abstract

Women after organ transplantation with chronic immunosuppressive therapy or after bone marrow transplantation without such therapy are a growing group of patients. Although their problems in the peri-and postmenopausal period are the same as in healthy women, due to the primary disease and treatment applied they represent a huge challenge from the point of view of their hormonal treatment of menopause. Transplanted women have no particular contraindications for hormonal therapy use. General contraindications, however, such as arterial hypertension, thrombosis in medical history, diabetes, endometriosis, myomas, or active neoplastic disease, have a higher incidence in this group of patients than in healthy women, which significantly influences the possibility of using hormonal therapy. On the other hand, taking into consideration the predisposition for premature menopause in this group, in combination with chronic immunosuppression, it predisposes these patients for higher cardiovascular disease incidence and bone density loss, so hormonal therapy would be highly advisable. Therapy management in transplanted patients requires special care and close monitoring of the transplanted organ. Saving lives with organ transplantation is one of the greatest achievements of contemporary medicine. For long-term improvement of their quality of life, emphasis should be put on regular diagnostic examinations, early detection of abnormalities, and introduction of effective treatment.

Differential analysis of quantitative proteome and acetyl-proteome profiling between premenopausal and postmenopausal ovarian tissues

“…Peri- and post-menopausal women often show multiple menopausal signs and symptoms, among which the most common during menopausal transition are hot flushes, night sweats, recurrent fatigue, and even memory loss and mild depression [ 40 – 42 ]. For severe symptoms, hormone therapy is used for alleviation or treatment [ 43 , 44 ]. Currently, multiple surveys, meta-analyses and epidemiological studies have explored the potential factors related to menopause and its potential side effects on healthcare and life quality of elderly women and their families [ 45 , 46 ].…”

Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study

“…Moreover, menopause results in metabolic changes that contribute to increase risk of cardiovascular diseases: increase in Low Density Lipoprotein (LDL) and triglycerides and decrease in high density lipoprotein (HDL), weight gain are associated with a correspondent increase in incidence of hypertension and diabetes [ 9 , 10 ]. Oestrogens deficiency leads to an accelerated period of bone loss which can result in osteoporosis, contributing to increase the morbidity [ 11 , 12 ]. Considering the detrimental role of menopausal symptoms, several compounds were already tested to counteract them and ameliorate postmenopausal quality of life.…”

Research on Establishment of Abnormal Phlegmatic Syndrome with Premature Ovarian Failure Rat Model and Effects of Balgham Munziq Treatment

“…The ovarian transplantation is doable, but due to the destruction of gonads in the course of treatment preparing for transplantation or the emergence of rejection, it is not widely chosen in the clinical treatments. Even if it is, POF patients who suffered from ovarian transplantation treatment would enter the premature menopause earlier [ 17 ].…”