indications of climara
Climara (estradiol) Hormone replacement therapy for the improvement of signs and symptoms of estrogen deficiency resulting from natural menopause or castration. Prevention of postmenopausal osteoporosis.
contraindications
Climara (estradiol) HRT should not be started in the presence of the following conditions. If any of these conditions occur during the use of HRT, treatment should be discontinued immediately: • Pregnancy and lactation • Undiagnosed vaginal bleeding • Breast cancer or suspected • Pre-malignant conditions or malignancies or suspected if affected by sex hormones • Presence or history of liver tumor ( benign or malignant) • Active deep vein thrombosis, thromboembolic disorders or documented history thereof. • Hypersensitivity to any of the Climara patch components.
What is Climara and why is it used?
Loss of ovarian function accompanied by a decrease in estrogen production leads to a menopausal syndrome characterized by vasomotor-vegetative and organic symptoms. Hormone replacement therapy aims to eliminate these complaints. Among all physiological estrogens, estradiol is the most potent, with the highest affinity for the estrogen receptor. Like other steroid hormones, estrogen exerts its effect by regulating the transcription of a limited number of genes, especially in estrogen-sensitive target organs such as uterus, hypothalamus, pituitary, vagina, urethra, breast, bones (osteoclasts). Following its diffusion across the cell membrane, estradiol binds to the estrogen receptor with high affinity. Following the activation of the estradiol ligand, translocation of the hormone receptor complex into the nucleus occurs. This complex has DNA sequences (hormone response elements) that accelerate transcription of neighboring genes. is connected. Although the exact number of proteins produced by estrogen is not known, it is estimated to be between 50-100. Following menopause, estradiol production in women is severely reduced. The remaining estradiol is produced primarily by the aromatization of androstenedione, one of the precursors produced in the adrenal cortex, and, to a lesser extent, from testosterone via the aromatase enzyme, estrone, respectively. and synthesized as estradiol. Estrone is converted to estradiol by the enzyme 17-hydroxysteroid-dehydrogenase. Both enzymes are found in fat and muscle tissues and liver. While the estradiol/estrone ratio is over 1 in premenopausal women, it is about 0.2 in postmenopausal women. Climacteric complaints can be ameliorated by an estrogen replacement therapy in which an average of 25-100 μg estradiol per day is given transdermally.
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