Demographic, social and economic effects of menopause hormonal therapy

• Guzel E. Ulumbekova
• Irina Yu. Khudova

Abstract

In 85% of women menopause is associated with pathological symptoms as "hot flashes" and other vasomotor symptoms, vulvovaginal atrophy, higher risk of depression and anxiety. Also, this period of women's life is associated with constantly increasing risk of chronic and severe conditions such as: osteoporosis and fractures, diabetes and cardio-vascular diseases. Menopause hormonal therapy is used as for relieve of symptoms as well for decreasing risk of chronic conditions. In this article demographic, social and economic effect of menopause hormonal therapy (MHT) are assessed and calculated in relation to risks associated to therapy. It is shown that MHT decrease vasomotor symptoms by 75%, decrease of osteoporosis related hip fractures by 30%, reduce number of new cases of diabetes by 30% and cardiovascular mortality by 12-54%. Moreover, one scientific study showed decrease of all-cause mortality in group of women taking MHT in the age of 50-59 years by 31%. The economic effect calculated in terms of the number of days of medically related absenteeism and saved lives was 9.1 bln rubles. Rub per year even only 1.3% women in age between 45-69 years take this type of treatment in Russian Federation. Taking into account the possible risks of this type of treatment (which in economic terms is less significant than the effect of therapy), as well as the cost of purchased medicines, effect of taking MHT is 3.97 billion rubles per year. Currently, the use of MHT in the Russian Federation as a percentage of women aged 45 to 69 years is 2.5 times lower than in the EU countries, where this share is 3.4%. If in the Russian Federation the same number of women will be treated as in developed countries, the medical, demographic and economic effects will increase by 2.5 times compared to the current level. And in the ideal scenario, in case of MHT treatment will be prescribed to all women with severe symptoms of menopause (10.7% aged 45 to 59 years) and excluding those who have contraindications to the appointment of this therapy, these effects will increase by 4.8 times.

Keywords:symptoms and long-term risks of menopause, effects of menopause hormonal therapy, risks of menopause hormonal therapy, prevention of work productivity loss, prevention of diabetes cases, decrease of cardio-vascular mortality

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