What are the side effects of prednisolone tablets and liquid? How can you cope with them? What are the serious side effects that require immediate medical attention? Get the answers you need to use prednisolone safely.

Understanding the Risks: Common Side Effects of Prednisolone

Prednisolone is a powerful corticosteroid medication used to treat a variety of conditions, but it can also come with a range of side effects. The higher the dose and the longer you take it, the greater the chance of experiencing these side effects.

Coping with Common Prednisolone Side Effects

While the side effects of prednisolone can be challenging, there are steps you can take to manage them:

Weight Gain

Prednisolone can increase your appetite and cause your body to retain more water, leading to weight gain. To combat this, focus on eating well without increasing portion sizes and engage in regular exercise.

Indigestion

Taking prednisolone with food can help reduce the chances of stomach problems. Avoiding rich or spicy foods may also help, and your doctor may prescribe additional medication to protect your stomach.

Sleep Difficulties

Taking prednisolone in the morning can help ensure the levels are lowest at bedtime, reducing the impact on your sleep.

Restlessness

Similarly, taking prednisolone in the morning can help minimize the disruption to your sleep patterns and feelings of restlessness.

Excessive Sweating

Wearing loose clothing and using a strong anti-perspirant may help. If these measures don’t provide relief, talk to your doctor about trying a different medication.

Mood Changes

Prednisolone can affect your mood in various ways. If you’re finding it difficult to cope, be sure to discuss this with your doctor.

Recognizing and Addressing Serious Side Effects

While the common side effects of prednisolone can be managed, there are also more serious side effects that require immediate medical attention:

Signs of Infection

If you experience a high temperature, chills, a sore throat, or other signs of infection, call a doctor or contact the NHS 111 service immediately.

Symptoms of High Blood Sugar

Feeling sleepy, confused, very thirsty or hungry, and peeing more often can be signs of high blood sugar levels. Seek medical help right away.

Cushing’s Syndrome

Weight gain in the upper back or belly, a puffy “moon face,” severe headaches, and slow wound healing can indicate Cushing’s syndrome. Contact your doctor promptly.

Adrenal Gland Problems

Severe stomach upset, dizziness, muscle weakness, and mood changes may signal issues with your adrenal glands. Seek immediate medical attention.

Low Potassium Levels

Muscle pain or weakness, muscle cramps, and heart rate changes can be signs of low potassium levels. Contact your doctor right away.

Pancreas Problems

Severe stomach pain, back pain, or vomiting may indicate pancreas issues. Seek emergency medical care immediately.

Other Serious Concerns

Breathing difficulties, swelling, vision changes, and unusual bruising or bleeding also require prompt medical attention.

Navigating Mood Changes with Prednisolone

Prednisolone can also impact your mental health, leading to mood changes such as depression, anxiety, and even hallucinations. The higher the dose, the more intense these effects can be. If you experience any concerning mood changes, be sure to speak with your doctor or contact the NHS 111 service.

Rare but Serious Allergic Reactions

In rare cases, it’s possible to have a severe allergic reaction (anaphylaxis) to prednisolone. If you experience symptoms of a serious allergic reaction, such as difficulty breathing or swelling, call 999 or go to the nearest emergency department immediately.

Prioritizing Your Health and Safety

By understanding the potential side effects of prednisolone and taking appropriate steps to manage them, you can help ensure that you can safely and effectively use this medication to address your health concerns. Remember to communicate openly with your healthcare team and seek immediate medical attention if you experience any serious or concerning side effects.

Side effects of prednisolone tablets and liquid

The higher the dose of prednisolone that you take and the longer you take it for, the greater the chance of side effects. You’re less likely to get side effects if you take a relatively low dose of prednisolone daily.

If you have been taking prednisolone for more than a few weeks, check with your doctor before stopping it suddenly to reduce your chances of withdrawal side effects.

Some side effects, such as stomach upset or mood changes, can happen straight away. Others, such as getting a rounder face, happen after weeks or months.

Common side effects

These common side effects of prednisolone happen in more than 1 in 100 people. There are things you can do to help cope with them:

Weight gain

If you have to take prednisolone for more than a few weeks, it’s likely that you’ll put on weight. Prednisolone can make you hungrier and also can make you retain more water in your body.

Try to eat well without increasing your portion sizes. Regular exercise will also help to keep your weight stable.

Once you stop taking prednisolone, your appetite and the way your body retains water should return to normal.

Indigestion

Take prednisolone with food to reduce the chances of stomach problems. It may also help if you avoid rich or spicy food while you’re taking this medicine.

If symptoms carry on, ask your doctor if you may benefit from taking an additional medicine to protect your stomach.

Problems sleeping (insomnia)

Take prednisolone in the morning so the levels are the lowest at bedtime.

Feeling restless

If you’re feeling restless when you’re trying to sleep, take prednisolone in the morning so the levels are the lowest at bedtime.

Sweating a lot

Try wearing loose clothing and use a strong anti-perspirant. If this does not help, talk to your doctor as you may be able to try a different medicine.

Mild mood changes

Prednisolone can affect your mood in different ways. Talk to your doctor if you are finding it hard to cope.

Speak to a doctor or pharmacist if the advice on how to cope does not help and any of these side effects bother you or last more than a few days.

Serious side effects

You are more likely to have a serious side effect if you take a higher dose of prednisolone or if you have been taking it for more than a few weeks.

Call a doctor or call 111 straight away if you get:

• a high temperature, chills, a very sore throat, ear or sinus pain, a cough, more saliva or a change in colour of saliva (yellowish and possibly with streaks of blood), pain when you pee, mouth sores or a wound that will not heal – these can be signs of an infection
• sleepy or confused, feeling very thirsty or hungry, peeing more often, flushing, breathing quickly or breath that smells like fruit – these can be signs of high blood sugar
• weight gain in your upper back or belly, “moon face” (a puffy, rounded face), very bad headaches and slow wound healing – these can be signs of Cushing’s syndrome
• a very upset stomach or you’re being sick (vomiting), very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, loss of appetite and weight loss – these can be signs of adrenal gland problems
• muscle pain or weakness, muscle cramps, or changes in your heart rate – these can be signs of low potassium levels
• severe stomach pain, severe back pain, severe upset stomach or you’re being sick – these can be signs of pancreas problems
• breathlessness
• swelling in your arms or legs
• changes in your eyesight
• any bruising or bleeding that is not normal
• red or black poo

Immediate action required: Call 999 or go to A&E if:

Mood changes

You may notice mood changes and mental health problems while taking prednisolone.

Talk to your doctor or contact 111 if you have any mood changes including:

• feeling depressed
• feeling high, or moods that go up and down
• feeling anxious, having problems sleeping, difficulty in thinking, or being confused and losing your memory
• feeling, seeing or hearing things that do not exist (hallucinations)
• having strange and frightening thoughts, changing how you act, or having feelings of being alone

The higher the dose, the more intense the mood changes can be.

Go to 111.nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E if:

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to prednisolone.

Immediate action required: Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• your throat feels tight or you’re struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who’s unwell may also have a rash that’s swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Long-term side effects

Taking prednisolone for a long time can lead to side effects such as:

• thinner bones (osteoporosis)
• poorly controlled diabetes
• eyesight problems
• high blood pressure (hypertension)

Children and teenagers

Taking prednisolone at higher doses for a long time can slow down the normal growth of children and teenagers.

Your child’s doctor will monitor their height and weight carefully for as long as they’re taking this medicine. This will help them spot any slowing down of your child’s growth and change their treatment if needed.

Even if your child’s growth slows down, it does not seem to have much effect on their eventual adult height.

Talk to your doctor if you’re worried. They’ll be able to explain the benefits and risks of giving your child prednisolone.

Other side effects

These are not all the side effects of prednisolone. For a full list, see the leaflet inside your medicine packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 24 February 2022

Next review due: 24 February 2025

Short-Term & Serious Side Effects

Common short-term prednisone side effects include nausea, weight gain and headaches. More serious side effects include fetal toxicity, allergic reactions and high blood pressure. Prednisone side effects are more likely to occur with larger doses or long-term therapy.

Common Short-Term Prednisone Side Effects

Common side effects of prednisone tend to be mild, especially with lower doses and short-term use. They may last a few days to a few weeks. If side effects persist or worsen, talk to your doctor or pharmacist.

Women are more likely to experience prednisone side effects, which can vary in severity and type, depending on a person’s overall health, age and other medications they take.

Common prednisone side effects include:

• Acne
• 
  Blurred vision
• 
  Changes in behavior or mood
• 
  Dizziness
• 
  Elevated blood pressure levels
• 
  Elevated blood sugar levels
• 
  Fluid retention
• 
  Headache
• 
  Increased appetite
• 
  Insomnia or fatigue
• 
  Nausea
• 
  Restlessness and inability to stay still (akathisia)
• 
  Sleep problems
• 
  Swelling
• 
  Thinning skin
• 
  Vomiting
• 
  Weight gain

Many people take prednisone with only minor side effects — or none — but each method of taking corticosteroids can present its own unique side effects. In its liquid form, prednisone can cause a sore mouth, sore throat and stomach pain.

Other corticosteroids come as inhalers, as topical creams or as IV fluids. Fluticasone in asthma medications, such as Advair, comes in an inhaler. Hydrocortisone often comes as a cream. Methylprednisolone comes in tablet form, but medical providers can also deliver it intravenously for multiple sclerosis patients.

Serious Prednisone Side Effects

The most serious prednisone side effects usually include allergic reactions, infections, gastrointestinal issues and elevated blood sugar. These may occur when people take larger doses or take the medication for long-term treatment.

Some side effects and what to expect from them include:

Allergic Reactions:

The most prevalent reactions are hives, skin rashes, itching, difficulty breathing, and swelling of the lips, tongue or face. If you experience any of these symptoms, contact an urgent-care provider or your local emergency room.

Bone Loss:

One study showed that up to 40% on a long-term treatment of prednisone have enough bone loss to lead to a fracture. People can also experience osteonecrosis, which is death of bone tissue because of reduced blood flow to the joints. This often manifests as hip and knee pain, but it can become severe and may require surgery. Most people lose bone mass within the first six to 12 months of prednisone therapy.

Cardiovascular Issues:

Prednisone can cause irregularities in potassium, calcium and phosphate levels, potentially leading to high blood pressure and heartbeat irregularities. People who take medium-high doses may develop premature atherosclerosis, a buildup of cholesterol in the arteries.

Cushing Syndrome:

Too much cortisol can trigger Cushing syndrome, which redistributes fat within the body. Signs of Cushing syndrome include the distribution of fatty tissue around the midsection, between the shoulder blades and in the face. Children with Cushing syndrome have experienced impaired growth.

Gastrointestinal Problems:

People who take prednisone increase their risk of developing gastric ulcer formation, gastritis and GI bleeding. The risk is four times higher when someone takes prednisone and an NSAID (such as ibuprofen) together. Other side effects include fatty liver and pancreatitis.

High Blood Sugar:

Anyone who takes prednisone should get their blood sugar tested and monitored while taking it. The drug can cause an increase in fasting blood sugar, a side effect especially serious for people with Type 2 diabetes. Blood sugar metabolism usually returns to normal after the medication is stopped.

Infection Risk:

Taking prednisone can increase the chances of developing mild, serious or life-threatening infections. Larger doses increase the risk, especially doses for immunosuppression. Older age and taking other medications that also suppress the immune system increases the risks. Doses of 10 mg or lower pose the least risk.

Muscle Weakness:

Prednisone and other corticosteroids can cause muscle weakness in the legs and arms. Severe cases may require hospitalization. Stopping treatment and performing exercises usually reverses this side effect.

Skin Problems:

Even at low doses, prednisone can cause skin issues. These include skin thinning, acne, excess hair growth (hirsutism), hair thinning, face redness, stripe-like marks on the skin (stria) and impaired wound healing.

Vision Changes:

Blurry vision is the most common eye problem associated with prednisone, but it’s usually not serious. However, the risk of cataracts in both eyes increases for people who take more than 10 mg of prednisone daily for longer than a year. The drug also increases eye pressure, potentially leading to glaucoma or even permanent damage to the optic nerve.

Fetal toxicity is a valid concern for pregnant women who have a medical reason for taking prednisone. Autoimmune diseases, including lupus, rheumatoid arthritis and inflammatory bowel disease, are potentially more damaging to unborn babies than prednisone.

Researchers hint at a small increased risk of babies being born with a cleft lip or without a cleft palate when their mothers took corticosteroids in the first trimester of pregnancy. But medical providers need much more hard research to document fetal toxicity and other issues, such as a link to gestational diabetes, related to prednisone.

Adrenal Insufficiency

Increased cortisol from prednisone (and other corticosteroids) can cause adrenal glands to shut down, leading to adrenal atrophy (wasting away) and adrenal insufficiency. Adrenal insufficiency is when the adrenal glands don’t produce enough hormones.

The condition leads to Addison’s disease, a life-threatening episode characterized by low blood pressure, low levels of blood sugar and high levels of potassium.

Symptoms of adrenal insufficiency include:

• Abdominal pain
• 
  Anorexia or weight loss
• 
  Body pains
• 
  Diarrhea
• 
  Fatigue
• 
  Fever
• 
  Headache in the morning
• 
  Nausea
• 
  Poor growth and weight gain in children
• 
  Psychiatric symptoms

Addison’s disease presents when damaged adrenal glands produce insufficient amounts of cortisol or aldosterone.

Mental Health Side Effects

Early in treatment (within several days), prednisone may increase feelings of well-being, anxiety, hypomania or mild euphoria. With long-term therapy, however, people may develop depression. Psychosis, referred to as corticosteroid-induced psychosis, can occur at doses of 20 mg or more per day with long-term use.

Mental health issues start within 3 to 4 days after starting prednisone therapy, but they can occur at any time. Some people continue to have symptoms, including depression, even after therapy stops.

Children who get prednisone for acute lymphoblastic leukemia (ALL), may develop mood fluctuations, depression, manic behavior or euphoria. For most, symptoms go away when therapy concludes.

Prednisone Side Effects in Women and Men

Because corticosteroids, such as prednisone, impact hormones, they can affect men and women differently. Women are more likely to develop osteoporosis, a serious side effect from prednisone use. And women who are pregnant, who want to get pregnant or who are breastfeeding should not take prednisone.

For men, prednisone can cause erectile dysfunction and change testosterone levels. Some men reported reduced sperm counts and infertility.

Men and women experience similar side effects, including depression, mood swings and stomach pain. But overall, doctors need more research to understand the specific role of gender in reactions to corticosteroids.

How to Reduce Your Risk of Prednisone Side Effects

The best thing you can do to minimize side effects from taking prednisone is to maintain a healthy lifestyle. That means eating smart, exercising regularly and getting plenty of sleep.

While taking prednisone, you should avoid smoking and drinking alcohol, and add supplements to your diet.

Once you start on a course of prednisone, pay attention to signals your body sends. Weight gain, fluid retention, nausea, mood swings, sleeplessness and overall weakness are signs to watch. This is especially true for someone on a long-term treatment plan. Exercise helps with fluid retention, depression and high blood sugar.

Tips to help you manage, mitigate and reduce the risk of side effects include:

Fluid retention:

While it might seem counterintuitive, drinking more water helps maintain a proper fluid balance and reduce water retention. But if you notice ankle swelling, speak with your doctor.

Gastrointestinal symptoms:

Take your doses of prednisone with some food in your stomach. If the drugs irritate your stomach, mix in antacids for help.

Infection:

Prednisone and other corticosteroids suppress the immune system, which may need a boost. Stay updated on your vaccines, including an annual flu shot and for long-term vaccines and boosters for shingles, tetanus, pneumonia and COVID-19.

Insomnia:

Before relying on sleeping pills, develop a bedtime routine that includes relaxation techniques, such as guided meditation or deep breathing.

Osteoporosis:

Anyone who takes prednisone should increase their sources of calcium from supplements and food groups to offset bone loss. Peas, beans, lentils, almonds, sesame seeds, amaranth, dark leafy greens (such as collard greens and spinach), broccoli and Brussels sprouts are quality sources of calcium.

Weight gain:

Gaining weight while taking prednisone is a genuine concern, especially because one side effect from the medication is increased appetite. Monitor your food intake and develop a regular exercise routine.

Make time for other things you enjoy: reading, writing, fishing, hiking, dancing, crafting, painting, yoga, Pilates and tai chi can help people find balance. Community centers often have free or inexpensive classes several times a week.

How Prednisone Dosage Impacts Side Effects

Dosage and duration are two aspects of your prednisone prescription that affect the likelihood and severity of side effects.

The higher your dose of prednisone, the more likely you are to notice side effects. The same is true if you must take the medication for longer than 30 days. In fact, most side effects stem from long-term use.

Even if you experience negative side effects, don’t stop taking your prednisone. It is a strong medication, and doctors recommend a gradual step-down approach to end the prescription cycle.

Prednisone Side Effects

Please seek the advice of a medical professional before making health care decisions.

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Why Gaining Weight Rapidly Diet Menu Recipes

Weight changes are easy to explain if you start eating more (eat more calories) or if you reduce your physical activity (spend fewer calories) – you adjust your diet and / or increase physical activity, and your weight returns.

But what if nothing changes in your life, and the weight grows slowly and inevitably?

Lack of sleep

First, if you stay up late, you are more likely to eat more calories with supposedly small snacks or a glass of wine. For example, 1 chocolate candy = about 60 calories.

Second, if you don’t get enough sleep, your hormone levels can start to change, which in turn can increase hunger and appetite, and decrease satiety. Therefore, you can eat a little more – imperceptibly, but enough to gain weight.

Stress

When we feel stressed, our body releases cortisol (the stress hormone), which causes an increase in appetite. And, of course, high-calorie “snacks” at your fingertips. This combination is excellent ground for weight gain.

Antidepressants

Some antidepressants have the unpleasant side effect of weight gain. Talk to your doctor about changing your treatment plan if you have reason to believe that an antidepressant you are taking is causing weight gain. But never change or stop taking medications prescribed by your doctor without first talking to your doctor. Some people gain weight after the start of treatment only because they feel better and, as a result, their appetite improves, i.e. the medicine works exactly as you need it, you just need to pay more attention to what and how much you eat. Depression itself can cause weight changes.

Steroids

Anti-inflammatory steroids such as prednisone may cause weight gain. The main reasons for weight gain in this case are fluid retention and increased appetite. Some people may also experience temporary fat accumulation, such as on the face, abdomen, or buttocks, until they have taken it before. If you have been taking steroids for more than a week, do not stop taking them abruptly, as this can cause more serious problems than weight gain. Talk to your doctor first.

Medicines that can cause weight gain

In addition to steroids, some other prescription medicines can cause weight gain. For example, antipsychotics (used to treat disorders such as schizophrenia and bipolar disorder) and medicines to treat migraines, seizures, high blood pressure, and diabetes. Talk to your doctor to find medications that treat your symptoms and have no side effects for you.

Contraceptives

Contrary to popular belief, COCs (estrogen and progestin) do not cause permanent weight gain. It is believed that some women taking COCs may experience weight gain due to fluid retention, but this is usually temporary. If you continue to gain weight, talk to your doctor.

Hypothyroidism

If your thyroid gland does not produce enough of the vital hormones triiodothyronine (T3) and thyroxine (T4), you may gain weight. Possible additional symptoms in this case may be – unexplained fatigue, increased sensitivity to cold, dry skin, swelling of the face, hoarseness, change in voice, muscle weakness, muscle pain,

irregular menstruation, brittle hair, slow heart rate, memory impairment, cognitive impairment. When thyroid hormones are deficient, the metabolism slows down, which increases the chances of weight gain. Hypothyroidism medication treatment can stop weight gain.

Menopause

Most women gain weight during menopause, but hormonal changes may not be the only cause. As you get older, your metabolism slows down, which means you need fewer calories, and if your eating habits don’t change, you end up with a calorie surplus. Your level of physical activity may also decrease. But if more fat accumulates around the waist than on the hips and thighs, it may indeed be menopause.

Cushing’s syndrome

Long-term elevated levels of the hormone cortisol can lead to weight gain, a common symptom of Cushing’s syndrome. In this case, obesity is mainly observed on the face and waist. Possible additional symptoms may be – slight bruising on the cheeks, increased appetite, thin limbs, round face, dry skin, weak muscles and bones, acne, stretch marks…

Cushing’s syndrome can be acquired:

• You are taking steroids for asthma, arthritis, or lupus erythematosus.
• If your adrenal glands produce too much cortisol.

Polycystic Ovarian Syndrome (PCOS)

Also called Stein-Leventhal syndrome or hyperandrogenic chronic anovulation.

The exact causes of PCOS are unknown, but PCOS occurs due to hormonal or complex metabolic disorders and is mainly associated with insulin resistance.

PCOS is a common hormonal problem in women of childbearing age that affects a woman’s menstrual cycle and can cause extra body hair and acne. Women with this disease are resistant to insulin (the hormone that controls blood sugar), which in turn can lead to weight gain. Fat tends to accumulate around the abdomen, which also increases the risk of heart disease.

Smoking cessation

You can gain weight by quitting smoking. People who quit smoking gain an average of only 4.5–5 kg in weight. After a few weeks, your hunger should decrease and your weight should decrease as you reduce your calorie intake.

Tips on how to lose weight

The main thing is not to stress, yes, it may take time, but everything can definitely be fixed. If you are gaining weight, never:

• Do not stop taking your medication without first talking to your doctor, as this can be critical to your health. Keep in mind that there may be other reasons for weight gain, and it is your doctor who can best help you figure them out.
• Do not compare yourself to other people taking the same medicine. Not all people experience the same side effects when taking the same medications. Even if a drug causes someone to lose or gain weight, it is highly likely that it will affect you differently.
• Remember that weight gain often comes from water retention alone – it’s not fat that’s hard to get rid of. When you stop taking the medicine, the swelling caused by fluid retention will decrease. Reduce your salt intake while taking your medication. drink more water – this will help reduce the amount of water retention.
• If you suspect that your weight gain is due to any medication, talk to your doctor. In most cases, your doctor can replace your existing medication with another medication that may not have the same side effects.
• Find out the cause of weight gain. There are only three of them – a slowdown in metabolism, changes in well-being or the effect of drugs. If the reason is a slowdown in metabolism – do not rush metabolic activity.
• Never Turn Someone On a Fast Diet Losing weight quickly will only make things worse and it will take you much more time and effort to regain your weight.

Play, hormone! – MK

05/03/2010 at 17:13

Society

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“We are a special country in which the word “hormone” among the non-medical community and, unfortunately, among some medical ones, is associated with some kind of mythical harm,” says Vera SMETNIK, Honored Scientist of the Russian Federation, professor at the Academician Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology. In an interview with “MK”, dedicated to the problems of female menopause, Vera Petrovna tried to debunk this myth.

— Vera Petrovna, we are used to thinking that hormones do more harm than good. And they should be used only in the most extreme cases. As I understand it, you strongly disagree with this?

– I am very perplexed by the advertising of various drugs, which emphasizes: “The drug is natural, not hormonal.” Why make such an emphasis? With this unscientific, incorrect advertising, we are educating the population with a firm conviction that hormonal drugs are scary, harmful. When I meet colleagues at international congresses, I often hear: “Oh, are you from Russia? How did you manage to scare your women with the word “hormone” so much? When we consult Russian patients, they always clarify: “Is this a hormonal drug?” And if so, then it terrifies them!”

— But the side effects caused by the use of hormones are, to put it mildly, unpleasant. ..

– For some reason, it is believed that if I use hormones, I will become fat, go red spots, my hair will begin to grow all over my body. Do you know how it all started? In the mid-60s, the now known hormone prednisolone began to be widely used in clinical practice. This is an excellent remedy for certain conditions. However, side effects can always occur with any treatment. And if there is not sufficient control by medical personnel, these side effects can be pronounced. In the case of treatment with prednisolone, a side effect may occur in the form of the so-called drug-induced hypercortisolism, similar to the “hyperfunction” of the adrenal cortex, which is caused by excessive secretion of the hormone prednisolone. This effect manifests itself in the form of excess fat deposition, body hair growth, hypertension … For some reason, such side effects began to be attributed to all other hormonal drugs.

— Do other hormones never make you fat?

– There are a lot of hormones – and the thyroid gland, and sex, and insulin . .. But most people, hearing the word “hormone”, immediately begin to think about the symptoms of hypercortisolism. Meanwhile, over the years, a whole arsenal of hormonal contraceptives has appeared, a new generation of these drugs contains microdoses of hormones. Contraceptives have made it possible to seriously reduce the number of abortions and preserve the health of women. However, many of our women are still afraid of them, they say: it’s better to have an abortion! It’s just inexplicable! And the phrase “hormone therapy in the postmenopausal period” evokes the same reaction of fear and horror.

— As far as I understand, in this case the harm of hormones, to put it mildly, is exaggerated?

Let me start by explaining what postmenopause is. This is the period of persistent cessation of menstruation. If they are absent within a year, this allows us to diagnose “menopause”, and after a year or more, “postmenopause”. That is, we can only diagnose it retrospectively, after a year of observing a woman’s body. Why do women stop menstruating? Women’s ovaries, this extremely important gland, are not only a source of sex hormones, but also a carrier of the gene pool, since eggs are located in them. The ovaries are designed in such a way that over the course of life, the supply of eggs is gradually depleted. And by the age of 40-45, a woman has only a small number of eggs that are in such vesicles – follicles. In these follicles, female sex hormones are formed – estrogens, which are released in the first phase of the menstrual cycle and progesterone, which are released in the second phase. In a young woman, everything is aimed at preparing for pregnancy. Every month she prepares to become a mother, and when her period comes, “tears of blood” are shed over the failed conception. But during life, this follicular apparatus is depleted, the number of eggs and the level of sex hormones decrease. By the age of 50, the follicles are single, and menopause occurs. Of course, this happens individually for different women, the average age of menopause is 45-55 years.

However, there is a distinction between premature menopause (37-40 years), early (41-45 years) and late menopause (over 55 years). The ovaries of a woman whose menopause occurs later function longer, and female sex hormones are released longer – and this is a woman’s youth. The later menopause occurs, the longer the effect on the female body of female sex hormones. And their uniqueness lies in the fact that they have their “representations” (or receptors) in many, practically in all organs and tissues – in the skin, brain, heart, bones, etc. And in a young woman, during the menstrual cycle, these receptors receive the dose of hormones they need. They get used to receiving a certain dose for about 35-40 years – and that’s it, the clock has stopped. In a woman, unlike a man, the sex gland is turned off during life – and this is the great wisdom of nature. What if a woman could give birth for the rest of her life? After all, it is necessary to ensure not only conception, but also the bearing of the fetus for nine months. How can an aging organism provide good offspring? So, unlike spermatogenesis, eggs do not regenerate. By the way, only 0.1% of eggs are fertilized, the remaining 99.9% go into oblivion. Why then are there so many of them?

They are essential to create a selection of the best egg – the one and only. And during a lifetime, only 350-400 eggs are ready for fertilization. So nature has programmed the woman in such a way that during her life there is a depletion of the eggs and, accordingly, a deficiency of female sex hormones is created. Is this a norm or a pathology? Norm. But against the background of this normal period of life between youth and old age, which lasts 10-15 years, there is a most complex restructuring in all organs and systems. And at the center of this process is the “shutdown” of the ovaries, as a result of which the organs and systems in which there are receptors for female sex hormones also undergo a restructuring to a new hormonal regime. And any restructuring is fraught with the fact that weak links are torn first. If by this age a woman had some diseases – the gastrointestinal tract, the central nervous system, the musculoskeletal system, then if they were hidden, they begin to manifest themselves, and if they have already entered the chronic phase, they become aggravated more and more often. The so-called climacteric syndrome is characterized by symptoms that prevent a woman from living – hot flashes, excessive sweating, irritability, sleep disturbance, anxiety … Some may have symptoms from the cardiovascular system (high blood pressure), others from the central nervous system (depression, unreasonable fears), others from the skeletal system (osteoporosis), fourth from the genitourinary tract (urinary incontinence, problems in sexual life). The question arises – why such a large range of symptoms? Yes, because the representation of sex hormone receptors is in all organs and tissues, and where their density is higher, the most painful reactions to the decrease and absence of female sex hormones begin. Therefore, one can never say which organ will suffer during menopause. The frequency of the climacteric syndrome itself is 60-70%. And it is impossible to predict who will have it and how it will proceed, just as it is impossible to predict the age of menopause. Of course, the daughter often repeats her mother. But the daughter may have other illnesses, stresses, etc.

— Do doctors consider climacteric syndrome a disease?

– Of course, since this condition prevents a person from living. How to help in this case? We must start with the simplest things: unload a little at work and in the family, eat according to the regime, rest more often – that is, demobilize during this crucial period. Of course, such things are easy to advise and very difficult to implement. Sometimes patients begin to object to me: “But what about my children, grandchildren?” I answer them: “Do you want to be useful to them in the future? Then now we need to take a little breather. At this time, you need to step back a little and become selfish. As for medical support, with mild manifestations of the climacteric syndrome, doctors prescribe herbal preparations. If menopause is difficult, hormone replacement therapy is prescribed. Hormone therapy, like any other drug treatment, has its contraindications. However, over the years, scientists have worked out the minimum optimal doses of natural hormones that help with severe symptoms of menopause and are the prevention of such senile diseases as osteoporosis, atherosclerosis, and dementia.

— Does the use of hormones prevent the development of diseases?

“Our clinical practice shows that the early administration of hormone therapy can delay the manifestation of these diseases. For example, the incidence of osteoporosis in menopause is 30% – that is, every third woman we diagnose the so-called postmenopausal osteoporosis. However, we can postpone it and other degenerative diseases of old age by early initiation of hormone replacement therapy, which has a preventive effect. But if you start hormone therapy 6-7 years after the onset of the menopausal syndrome, when osteoporosis and sometimes Alzheimer’s disease have already developed, it is already useless. There is such an expression “window of therapeutic effect” – only an early start can bring, in addition to therapeutic, a preventive effect! And in this case, hormone therapy creates a good quality of life. Today published data of observations performed on a population of more than 40 thousand women: it is found that if women start hormone therapy before the age of 60, their life expectancy increases by 30-32%! If they begin such treatment after the age of 60, this does not affect life expectancy in any way. However, we do not prolong youth by prescribing high doses of hormones. We give patients minimal doses of hormones that are not comparable to the doses that a woman receives during her menstrual cycles.

— Still, what side effects can a woman face when receiving such hormone therapy?

– I repeat that there are contraindications to such treatment, as to any other. And before prescribing hormones, a woman must undergo a complete health examination in order to reduce the frequency of possible side effects. In addition, the doctor takes into account, for example, whether a woman has diseases of the gastrointestinal tract – then hormones are prescribed to her not in pills, but parenterally (in the form of gels, patches). There are a lot of drugs today, they are available in various convenient forms. But the legend of weight gain and hair growth has nothing to do with sex hormone replacement therapy.

HELP “MK”

Vera Smetnik, President of the Russian Associations of Gynecologists and Endocrinologists and the National Menopause Association, is interested in studying the effect of sex hormones on the reproductive organs, central nervous system, cardiovascular, bone and other body systems in the age aspect. A systematic study of the effect of sex hormone deficiency has made it possible to develop and implement regimens of hormone replacement therapy for osteoporosis, metabolic disorders (lipid, carbohydrate, mineral) for the prevention and treatment of diseases of the cardiovascular, central nervous system, bone systems and genitourinary tract, sexual and other functions. Vera Petrovna described the “ovarian exhaustion syndrome” and developed diagnostics and therapy for patients with this syndrome. The modes of non-surgical treatment of uterine fibroids, endometriosis, and polycystic ovaries are being improved. In recent years, regimens of hormone replacement and alternative therapy in menopause have been developed, and prevention and treatment of postmenopausal osteoporosis and genitourinary disorders are being studied in depth. The federal center “Health of women over 40 years old” has been created, which provides education for doctors in Russia and the CIS according to various programs, and treatment of patients.

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