[Phytoestrogens--an alternative to hormonal replacement therapy]. / Fitoestrogeny--alternatywa hormonalnej terapii zastepczej.

Perimenopausal period is associated with the reduction of endogenous estrogens which might lead to many disorders of general health in women. Traditional hormone replacement therapy (HRT) is effective for controlling vasomotor symptoms and reducing the risk of cardiovascular disease and osteoporosis in postmenopausal women. However, according to the latest studies, many women are reluctant to initiate this therapy because of concerns regarding the benefits and risks considering contraindications and side effects of it. Therefore, a lot of studies were carried out to find the influence of phytoestrogens on menopausal symptoms. Phytoestrogens are defined as naturally occurring compounds, found in plants; they have a variety of activities: estrogenic and antiestrogenic. Could phytoestrogens be used as an alternative to hormonal therapies for the management of menopausal symptoms?

[The effect of transdermal hormone replacement therapy on vasomotor symptoms in perimenopausal women]. / Wplyw przezskórnej hormonalnej terapii zastepczej na objawy wypadowe u kobiet w okresie okolomenopauzalnym.

About 30% of female population in Poland is already in the perimenopausal age. The North American Menopausal Society has defined the menopause as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Perimenopausal period is often connected with vasomotor symptoms in women. In recent years, there has been a growing recognition among clinicians of the importance of learning more about how patients cope with the symptoms of their condition. The aim of the study was to evaluate the effect of hormone replacement therapy on vasomotor symptoms in perimenopausal women with the use of Kupperman Index. In a six-month (6 treatment periods, 28 days each) randomized study, 75 healthy postmenopausal women were assigned to receive 50 micrograms/day of continuous transdermal estradiol with sequential transdermal norethisterone acetate (NETA) in daily doses of 170 micrograms in a single transdermal patch. The average number of vasomotor symptoms per day measured with Kupperman Menopausal Index decreased from prestudy by over 90%. The substantial improvement in vasomotor symptoms assessed across time was apparent by week 12 of the treatment.

[Hormone replacement therapy--oral and transdermal administration]. / Hormonalna terapia zastepcza--podanie doustne i przezskórne.

Nowadays almost one third of women's life follows the cessation of menstruation. Therefore medical investigations are concerned with the improvement of women's quality of life in this period. Hormone Replacement Therapy is one of the possibilities of restoration women's premenopausal hormonal status. In the paper advantages and disadvantages of oral and transdermal administration of Hormone Replacement Therapy are presented.

[Family planning--the role of general practitioner in abortion prophylaxis]. / Planowanie rodziny--rola lekarza w profilaktyce aborcji.

According to World Health Organization, abortion is defined as an induced termination of pregnancy by use of medications or surgical interventions after implantation of the embryo and before the fetus is able to survive outside the maternal organism (before 22nd week of pregnancy). More than 75 millions of women experience unwanted pregnancy every year. Contraception for that group was either unavailable or the information about contraceptives use possibility was not efficient. Lack of conversation about family planning with the partner, rapes and inefficiency of contraceptives (8 to 30 millions women a year) might be other reasons. More than two-third such pregnancies are terminated by abortions. The number of women in reproductive age (15-44) is 1.38 million. Most of them are sexually active but not willing to have progeny. The decision of abortion is taken every year by 35 per 100 females (26 millions of legal abortions each year, 20 millions of illegal). By 1986, 36 countries introduced liberal abortion law that gives permission for abortion only for social, medical and personal reasons. The main law regulating the permission of abortion in Poland is a resolution of Family planning, embryo protection and conditions for conducting pregnancy termination from 1993, modified in 1997. In 1999, 151 abortion procedures were performed and that number is decreasing gradually. The development of so called "abortion basement", where unsafe abortion is usually performed, is a consequence of restrictive policy about the abortion law. In the last few years the holistic and individual approach to the patient has started to play an important role. Unfortunately, in the case of sexual education and knowledge of conscious family planning, medical services, and medical doctors especially, play only the minimal role. It seems to be essential in gynecological and general medicine practice to give information about different methods of family planning and protection against sexual transmitted diseases as well as to control patient's health when using contraceptives.

[Osteoporosis--pathogenesis and prophylaxis]. / Osteoporoza--patogeneza i profilaktyka.

Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a subsequent increase in bone fragility and susceptibility to fracture. In this paper some facts concerned with pathogenesis and prophylaxis of osteoporosis are presented.

[Influence of GnRH analogue on the intensification of endometriosis symptoms and infertility treatment]. / Wplyw analogu GnRH na stopien nasilenia objawów endometriozy oraz na rezultaty leczenia nieplodnosci.

OBJECTIVES AND STUDY DESIGN: The aim of this study was to evaluate the influence of the treatment with oral doses of 50 mg GnRH analogue on the intensification of endometriosis symptoms and infertility amongst women with evident symptoms of endometriosis in comparison with placebo group. A group of 34 women at the age from 18 to 45 were introduced into the study. The inclusion criteria for investigated population contained: endometriosis symptoms, endometriosis diagnosed by laparoscopy, its surgical or pharmacological treatment, negative pregnancy test score and regular menses. The patients were divided into 2 groups: investigated group and control group. Women completed "Diary" every day in which they estimated main endometriosis symptoms: dysmenorrhea, dyspareunia, pelvic pain and vaginal bleeding (according to Pain Grading Scale). The intensification of dysmenorrhea and vaginal bleeding was reduced in the investigated group in comparison with control one. These differences were statistically significant. Although the extremity of dyspareunia was decreased in two groups, this correlation was statistically significant only in the investigated group. Pelvic pain evaluation showed that its level was lower in the investigated group (p > 0.05). It was found that 11 women (investigated group) and 5 women (control group) got pregnant after the period of 12-week treatment. CONCLUSIONS: GnRH analogues have an efficient influence on the reduction of endometriosis symptoms. GnRH analogues could be used in the management of infertility.