Quality of life in postmenopause

S obzirom da se produljuje očekivani životni vijek, žene su u stanju stalnog manjka estrogena jednu trećinu života, a ako računamo da pad estrogena i simptome koje on uzrokuje žene počinju proživljavati i 2-8 godina ranije, taj udio se penje na polovicu. Pad estrogena i drugih spolnih hormona u perimenopauzi i kasnijoj postmenopauzi izaziva razne simptome koji uvelike smanjuju kvalitetu života, ne samo zdravstvenu, nego i emocionalnu, seksualnu i socijalnu domenu, a na udaru je posljedično i radna sposobnost. Kvalitetu života u postmenopauzi danas se najviše procjenjuje različitim upitnicima koje žene uglavnom ispunjavaju same ili uz pomoć svoga liječnika. Upitnici mogu procjenjivati utjecaj na kvalitetu života specifično uzrokovan menopauzalnim simptomima ili se pak procjenjuje generalno zadovoljstvo kvalitetom života na koje direktno ili indirektno simptomatologija menopauze ima utjecaj. U ranoj postmenopauzi najčešće prijavljeni simptomi su oni vazomotorni, problemi sa spavanjem, umor, depresija, gubitak libida, a u kasnoj postmenopauzi se glavna simptomatologija očituje kroz učinke dugotrajnog manjka estrogena koji dovode do povišenog kardiovaskularnog rizika, osteoporoze te pojave dijabetesa tipa 2 koji, bez obzira na povezanost s postmenopauzom, mogu sniziti kvalitetu života. Hormonska nadomjesna terapija najučinkovitije do sada poboljšava kvalitetu života, kratkoročnim učincima na subjektive simptome rane postmenopauze, a dugotrajnim učincima na posljedice kasne postmenopauze.Considering prolonged life expectancy, women are nowadays in a state of constant estrogen deficiency for one third of their lives. If we take into account that the decline in estrogen levels and the symptoms caused by it begin 2-8 years earlier, this proportion rises to a half. The decline in estrogen and other sex hormone levels in perimenopause and postmenopause causes various symptoms that greatly reduce quality of life, not only regarding health, but also emotional, sexual and social domain, which consequently negatively affects work ability. The quality of life in postmenopause is nowadays mostly evaluated by various questionnaires that women fulfill by themselves or with their doctors' help. Questionnaires can evaluate the impact on quality of life that is specifically caused by menopausal symptoms or assess general life quality satisfaction which is affected by direct or indirect menopausal symptomatology. In early postmenopausal women, the most frequently reported symptoms are hot flashes, sleep disorders, fatigue, depression, libido decrease. In late postmenopause the main symptomatology is manifested through the effects of prolonged estrogen deficiency which leads to increased cardiovascular risk, osteoporosis and type 2 diabetes. Hormone replacement therapy is the most efficient therapy in postmenopausal quality of life improvement with its short-term and long-term decrease of symptoms caused by estrogen deficiency