Amaline - latest generation fillers for rejuvenation and contouring

Invasive cosmetology has become a worthy alternative to plastic surgery. The use of injectable formulations allows you to achieve correction of external data, rejuvenation, without breaking away from your usual life schedule. Reduced risks of side effects, a short rehabilitation period and an affordable cost of the procedure allow everyone to experience the effects of youth cocktails. Amaline filler is designed specifically for mesotherapy and biorevitalization. It is based on hyaluronic acid, synthesized in the laboratory, and does not contain protein elements. The formula helps prevent the development of allergic reactions and drug rejection. A special feature is the size of the hyaluron molecules; the finely dispersed structure eliminates uneven distribution of the filler during implantation.

Compound

The drug is based on hyaluronic acid. The absence of water allows the creation of long molecular chains. The presence of BDDE ester made it possible to increase the effectiveness of cosmetic correction and reduce the risks of side effects. Cross stitching of hyaluron chains provides a 3D effect. The content of crosslinkers turns the acid into a viscous gel. The single structure provides a protective barrier that prevents the destruction of enzymes under the influence of free radicals.

Product overview

The drug is based on hyaluronic acid, which is also part of human connective tissue. With age or under the influence of aggressive external factors, the amount of hyaluronate decreases sharply, which leads to loss of moisture and skin turgor.

The work of fillers is aimed at restoring water balance, and cell regenerative processes are launched. Moreover, there is a natural biostimulation of the production of natural collagen and elastin.

As an additional component, the composition includes BDDE ester, recognized as one of the less toxic, which is responsible for the consistency - in the syringe the drug is presented as a thick gel, which allows it to be used for facial contouring.

Buyanov Sergey Yurievich (Expert Doctor):

Hyaluronic acid itself has cross-linking molecules, resulting in a 3D effect. Thanks to this composition, an additional barrier is erected that prevents the breakdown of molecules under the influence of free radicals.

Manufacturer

NMTC International is a corporation consisting of several companies specializing in the cosmetology and medical industries. Operating in the domestic market since 2009. Raw materials from Europe and the USA are used for production. The research laboratory collaborates with practitioners. Innovative technologies guarantee the safety of drugs.

The company's products have been highly appreciated on the international market, comply with ISO 13485 quality standards, and a number of lines have CE certification.

Indications and effectiveness of use

Injection procedures are carried out to rejuvenate and improve the skin of the face and body. A wide range of products allows you to choose drugs for mesotherapy, biorevitalization, and contouring. With the help of fillers, it is possible not only to smooth out wrinkles and restore elasticity, but also to give relief to the cheekbones, volume to the lips, correct asymmetry, and various aesthetic imperfections.

Attention! It is used for contour plastic surgery from the age of 18; for the prevention and correction of age-related changes, it is prescribed at the age of 30–35.

Indications for use:

• wrinkles of different depths;
• dull, unhealthy complexion;
• oval line offset;
• asymmetry;
• undefined cheekbones;
• thin lips;
• dryness, peeling;
• enlarged pores;
• scars, scars.

As a result of the use of fillers, it is possible to achieve lasting rejuvenation, restore regeneration processes at the cellular level, improve facial features, and harmonize proportions.

How to choose a drug for biorevitalization -

Preparations for biorevitalization are currently produced by countless companies.
One of the main components for these purposes are hyaluronic acid (HA) molecules. Typically, the lifespan of chemically unmodified (unstabilized) HA molecules is only 24 to 48 hours. However, biorevitalizants are produced in the form of a viscous gel, which allows even unstabilized HA to be deposited for a slightly longer period, reducing the rate of its destruction. The properties of the drug are very dependent on the molecular weight of the HA chains. High molecular weight HA (from 1500 to 3300 kDa) moisturizes the skin well, but does not have a stimulating effect on fibroblasts. Low molecular weight HA has a stimulating effect on fibroblasts and angiogenesis, but rather weakly moisturizes tissues. At the same time, low-molecular HA is destroyed faster in the skin than high-molecular HA (unless, of course, it has been chemically modified). For example, the preparation “Ial-system ACP” contains stabilized low-molecular HA with a molecular size of 200 kDa.

According to the manufacturer, the degradation period of HA in this drug is 10 days, and given the size of the molecules, one can immediately understand that the drug mainly has a stimulating effect on fibroblasts, activating collagen synthesis in them, but the moisturizing effect of such a drug will be less pronounced than if we will use a drug with high molecular weight HA with a molecular size of, for example, 1800 kDa or more. Next we look at the percentage of HA content in the drug. For drugs with unstabilized HA, its optimal concentration is 1.8-2.0%, but if we are talking about drugs with stabilized HA, then 1.4% is enough.

Important: modern data suggests that preparations with hyaluronic acid should not be used more than once a month, because frequent administration of high concentrations of HA leads to - 1) increased production of the enzyme hyaluronidase, which accelerates the destruction of its own HA synthesized by fibroblasts, 2) enhances the activity of metalloprotease enzymes that destroy the intercellular matrix. Those. it turns out that you inject too much HA into the dermis, and the body reacts to this with a surge in the production of hyaluronidase, which will rapidly destroy not only the biosynthetic HA you introduce, but also its own endogenous HA produced by fibroblasts.

Therefore, it is worth using biorevitalizants with HA no more than once a month, alternating them, for example, with nucleotides. Or another option is to use biorevitalizants with stabilized HA, which has the property of gradually releasing chains of active hyaluronic acid without creating excessively high concentrations of active HA molecules in the tissues over a short period of time. Such drugs act gradually and over a longer period of time, and are usually administered once every 3-4 weeks. Examples of drugs are “Restylane Vital”, “Juvederm Hydrate”, “HyalRepair”, etc.

Mono-preparations with hyaluronic acid –

Below we give an example of the most famous monopreparations with hyaluronic acid. Please note that in any case it makes sense to take such drugs only up to 30-35 years of age. After this age, it is impossible to achieve good skin lifting or intensive rejuvenation using HA alone. More or less the effect will be noticeable only after a course of 4-5 procedures, and then only if your skin is in relatively poor condition. These drugs will not be particularly effective in case of photoaging, because These do not contain a complex of components to relieve oxidative stress.

• Restylane Vital and Restylane Vital Light (Sweden) are the first biorevitalizants in which the technology of chemical modification of HA (i.e., its stabilization) was applied. The preparations contain only 2% and 1.2% hyaluronic acid, respectively, and are used in patients with finely wrinkled type of facial aging: Restylane Vital - for more mature skin, and Restylane Vital Light - to prevent aging of younger skin. Reviews: these drugs are of high quality, but their composition is outdated, and they are suitable for no more than the prevention of age-related changes, and then only with a stretch.

• Juvederm Hydrate (USA) – contains 1.35% stabilized hyaluronic acid + antioxidant mannitol. The antioxidant is quite weak, so the drug is not very suitable for the treatment and prevention of photoaging. Reviews: in our opinion, Juvederm Hydrate should be used only for the prevention of aging in patients with fine wrinkles, and no older than 30 years. A course of at least 3-4 procedures performed once every 3 weeks will be more or less effective.
• The drugs “Ial-system” and “Ial-system ACP” are a line of two biorevitalizants produced in Italy. The drug "Ial-system" contains 1.8% of unstabilized low molecular weight hyaluronic acid (molecule size only 200 kDa). Accordingly, its effect occurs quickly, but will not be too long-lasting, and besides, such a drug moisturizes the skin less - compared to drugs based on high molecular weight HA. Available in 0.6 or 1.1 ml syringes.
  The second drug is “Ial-system ACP”. Available in 1.0 ml syringes and containing 2% partially stabilized low molecular weight HA (molecule size also 200 kDa). According to the manufacturer's information, HA remains in the skin a little longer - about 10 days, but this, of course, is still significantly less than the above-mentioned drugs from other brands. Reviews: in our opinion, Ial system biorevitalization is optimal only for the prevention of aging in patients no older than 35 years.

Combined preparations with HA (cocktails) –

The group of these drugs is so numerous that we will present only one of the many options - the Revofil Aquashine line of affordable drugs (made in Korea). Available in 2.0 ml syringes.

• Biorevitalizants Revofil Aquashine - the first option is “Aquashine”, containing unstabilized high molecular weight 1.5% HA, peptides, amino acids, vitamins and minerals, coenzymes (56 components in total).
  In our opinion, it is better to use in patients 35+; it gives a good lifting effect when used as a course. The second option is “Aquashine BR”, which additionally adds peptides that lighten the skin, and therefore it is well suited for hyperpigmentation, for example, for aged skin 45+, as well as for the treatment and prevention of photoaging. “Aquashine BTX” – suitable for ages 30+. It also has a similar composition, but peptides are additionally added to it, the effect of which is similar to Botox®, i.e. smooth out small facial wrinkles. Aquashine biorevitalization reviews: these drugs are suitable for patients with moderate age-related changes. Not suitable for patients with deformational/edema type of aging.

Powerful biorevitalizants for aging skin –

If your age is 40-45+ and you need a noticeable lifting effect and reduction in the depth of wrinkles, then hyaluronic acid, vitamins, minerals, amino acids and antioxidants alone are no longer enough. This requires nucleotides (DNA-RNA complexes), as well as peptides and growth factors. At this and even more so at an even more mature age, the dermis contains a significantly smaller number of fibroblasts, not to mention their activity. And if there are almost no fibroblasts, then there is nothing to stimulate. This is especially true for postmenopausal women.

• Nucleotide-based drugs – an example is NucleoSpire DNA-RNA from Mesopharm®. It contains nucleotides in a concentration of 2% and is available in syringes of 1.3 and 2.0 ml. Reviews: the drug gives a delayed but pronounced lifting effect, stimulates collagen production, and is used to correct hyperpigmentation, chrono- and photoaging. Suitable for intensive rejuvenation, can be used periodically in patients 35+ and regularly after 40-45 years. Suitable also for patients with deformational (edematous) type of skin aging. A similar drug based on nucleotides is Plinest (Italy). These drugs do not work for young people.

• “Meso-Wharton P199” - this drug contains not only nucleotides, vitamins (A, E, C, group B), trace elements and antioxidants, but also high molecular weight 1.5% hyaluronic acid (with a molecular size of 3300 kDa). This drug contains growth factors, as well as peptides that stimulate the proliferation of fibroblasts and stem cells in the dermis, and also enhance the production of new collagen by fibroblasts. Not for deformation/edema type of aging.

• The “HYALREPAIR” line – biorevitalizant “Hyalrepair -02” contains 1.4% stabilized HA, vitamin C and the main amino acids involved in collagen synthesis, these are proline, glycine and lysine. An excellent product for loose, finely wrinkled skin. The drug “Hyalrepair -04” - in addition to the same hyaluronic acid, contains vitamin C, glutathione and cysteine. This drug is well suited for the treatment of photoaging, copes well with the network of fine wrinkles, hyperpigmentation and rosacea. The course of these drugs usually consists of 3 procedures at intervals of 3 weeks.

• “Nucleospire Revitalizing Complex A” is a good biorevitalizant based on 1.8% unstabilized HA, with a large amount of antioxidants (vitamin C, glutathione, thioctic acid, coenzyme Q10), vitamin B5. This composition perfectly relieves oxidative stress after sun exposure, helps moisturize the skin, lighten hyperpigmentation and prevent its formation. Those. this drug is good for photoaging, optimal before and after vacation to hot countries. You can have 30+ regularly (and even 25+, but not often).

• 
  “Nucleospire Revitalizing Complex B” (Hydro Line Extra) is a good biorevitalizant also based on 1.8% unstabilized HA, contains 19 amino acids, all B vitamins, microminerals, and the antioxidant glutathione. If the previous drug is used for the prevention and treatment of photoaging (including at a moderately young age), then this drug is for aging skin and is intended to stimulate collagen production. Naturally, it is not as effective as Meso-Wharton P199, but it also costs 2 times less.

Important : for aging skin, only a course of biorevitalization (from 3 to 7 procedures) can give a good effect. Most often, the course is carried out not with one particular drug, but with a combination of several, and their choice for each woman will be individual.

Types of drugs

Amaline products include a wide range of fillers designed specifically for correction and rejuvenation.

Amalian II is a filler for correcting nasolabial lips and adding volume to the lips. The drug is based on hyaluronic acid; increased plasticity allows it to be used for various aesthetic purposes. The result lasts up to 9 months.

Amalian lashes is a product for eyelash lamination, manufactured in Germany. Allows you to make eyelashes thicker, longer, and strengthen the root system. Tested by allergists and ophthalmologists, used for nutrition and hair growth.

Karra - used in home care, also effective for mesotherapy. It is produced in the form of a solution, the concentration of hyaluron is 20 mg/ml. Prescribed for healing the skin of the face, arms, neck, thighs, and abdomen. Allows you to improve the color, structure, and increase the protective properties of the skin. It is also used in the treatment of alopecia. The result lasts for 3 months, the course consists of 6 procedures with an interval of 2-3 weeks.

Alpha is a solution for biorevitalization, mesotherapy, the content of hyaluronic acid is 15 mg/ml, the composition also contains peptides. Injections are performed into the deep dermal layers to restore firmness and elasticity of the skin. It is used to improve color, get rid of dryness and seborrhea, for the purpose of lifting with unexpressed ptosis. Also used in preparation for deep chemical peeling. The course is carried out similarly to the carra scheme, the result lasts about 3 months.

Beta filler is available in a volume of 2 ml, acid concentration 20 mg/ml. Implantation is carried out to a depth of 3 mm for the lower part of the face. Low density ensures the absence of side effects, the result lasts for six months.

Soft or gamma is a low-density filler, available in 1 ml, acid content 20 mg/g. The main purpose is fine wrinkles of the eyelids, lips, forehead area. The composition is distributed in the surface layers, the soft effect allows you to maintain the effect for up to 10 months with only 3 sessions.

Medium or delta - has a medium density due to cross-linking of the molecular chains of the acid. It is used to increase the volume and correct the shape of the lips, get rid of creases in the forehead, nasolabial, and interbrow folds of varying degrees of severity. For rejuvenation and correction, 1-2 sessions are enough, the effect lasts throughout the year.

Lambda, or hard, is prescribed for the correction of deep wrinkles, a fairly dense filler with a lifting effect. Implanted in the area of ​​the cheeks, cheekbones, and chin to restore oval lines. It also allows you to smooth out scars, scars, the effect lasts about 18 months, the course is 1-2 sessions.

Purchasing drugs

You can buy the drug from the Amaline line on any online portal that sells products and consumables for cosmetology.

However, in this case you should be extremely careful - you should first request a quality certificate, check the expiration dates and serial number.

A safer option is to purchase filler either on the official website of NMTC International or from the corporation’s intermediaries in the Russian Federation.

On average, the cost of drugs is as follows:

Instructions for administering the drug

The procedure can be entrusted to a plastic surgeon or dermatocosmetologist; only a doctor can assess the condition of the skin and determine the technique for administering the drug. The package is stored in the refrigerator, does not require dilution, and is removed from the refrigerator 20 minutes before the start of the procedure. The skin is cleansed, peeling agents may be used, and then treated with an antiseptic solution.

Important! After the procedure, the remaining drug is disposed of; subsequent storage is unacceptable.

Administration schemes:

1. Linear-retrograde is used to correct the eye area, cheeks, mouth, nasolacrimal groove, chin, and décolleté area. It involves several techniques - fan, tracer, mesh, tunnel. Allows you to cope with both superficial and deep age-related folds.
2. Bolus - used for volumetric modeling of the oval, cheekbones, and chin. The insertion depth is maximum, the active components of the filler reach the periosteum. The angle of inclination depends on the defect being corrected.

Description of the procedure

The procedure for introducing plastic fillers or biorevitalizants does not require the client to be hospitalized, so after it he can return to his normal life.

However, there are a number of subtleties that should be observed both before and after the procedure.

Preparation

After the specialist has collected a complete history, which has revealed the possibility of carrying out the procedure, it is necessary to adhere to a number of rules several weeks before the procedure in order to prepare the body.

• It is not allowed to consume alcoholic beverages or hot, spicy foods at least 7 days before the session.
• Also, within 3 weeks you will have to stop taking hormonal medications that can change your blood counts.
• During the day, smoking, as well as physical activity of any kind, is contraindicated.

Introduction technology

Depending on which area will be corrected, the method of performing the procedure will also vary.

• Linear-retrograde. A common injection technique for the eyes, mouth, cheeks, nasolacrimal groove, chin and décolleté. The result is aimed not only at combating minor defects, but also against fairly deep wrinkles. Includes both fan, mesh and tunnel needle immersion techniques.
• Bolus. It is used to sculpt the volume of the cheekbones and chin by injecting the drug as deeply as possible into the dermal layers. In some cases, it is possible to distribute the filler on the periosteum.

Duration of action

On average, one session takes 40 minutes. The time may increase depending on the size of the area being corrected, the desired result and the qualifications of the specialist.

The procedure itself consists of several stages.

1. Cleaning with a special antiseptic.
2. Anesthesia with targeted cream.
3. Opening the package and checking expiration dates.
4. Injection of the drug into the designated area.
5. Final disinfection.

How does the procedure work?

At the consultation stage, the doctor determines the range of tasks of the invasive method, the presence of contraindications, and allergic reactions to the components of the composition. Before carrying out, a number of conditions must be met:

• do not drink alcoholic beverages, hot, spicy foods for a week;
• give up physical activity and sports;
• the day before the event it is not recommended to smoke;
• You should also not take hormonal medications or drugs that affect blood counts for 3 weeks.

The procedure takes up to 40 minutes, after which there is no need to remain under the supervision of a doctor. It is important for the patient to pay attention to the expiration date and check the quality certificate. The package insert with the name of the drug is pasted into the injection passport; the date of administration, volume of the drug, and area of ​​administration are also indicated. The package is opened in the presence of the patient.

Stages of implementation:

1. The face is cleaned of makeup and treated with an antiseptic.
2. An Emla-type anesthetic cream is applied.
3. After 20 minutes, a solution or filler is injected according to the chosen technique.
4. The patient may feel a burning sensation during implantation.
5. After correction, the skin is re-treated with an antiseptic, and a light massage is performed to evenly distribute the drug.
6. To obtain the desired results, the doctor uses a minimum volume of 1 to 2 ml; if necessary, correction is carried out after 5–7 days.

Neauvia Organic

The contouring preparation, created by a group of Italian and Swiss scientists Neauvia Organic, is obtained from 100% pure hyaluronic acid. Thanks to such a pure composition, the drug is suitable for everyone! The high quality of the product has been recognized in almost 100 countries around the world, including Russia.

This hyaluronic acid is extracted from the bacterium Bacillus Subtilis, which is probiotic and non-pathogenic to humans. The purer the hyaluronic acid, the lower the risk of its rejection by the body. But the effect of contouring also depends on how strong and elastic the hyaluronic acid molecules are “shielded” among themselves. Traditionally, the cross-linking agents BDDE (butanediol diglycidyl ether) or DVS (divinyl sulfone) are used for this purpose. They cannot be used in large quantities. And a low cross-linking agent content reduces the duration and effectiveness of hyaluronic acid in tissues.

The scientists who developed the Newvia Organic line of organic fillers decided to use a new cross-linking agent - PEG (polyethylene glycol) polymer. It is widely known and has long been used in the pharmaceutical and medical markets, is non-toxic, and completely decomposes in tissues. PEG helps the filler stay in the skin for a long time. Does not cause adverse reactions. It is PEG that makes the Newvia Organic line the most biocompatible fillers with the human body. Their tissue rejection is reduced to almost zero. PEG reduces inflammation and granuloma formation.

At certain temperatures that can be reached during procedures in aesthetic hardware cosmetology, such as exposure to laser, ultrasound, and others, traditional hyaluronic acid filler begins to break down. But not Nyuvia fillers. PEG makes the acid much more resistant to heat without limiting the range of aesthetic treatments.

Newvia fillers also have amazing elasticity and plasticity. That is, the ability to change shape and size under the influence of external loads and maintain them or return to their original position. Therefore, each filler in the line adapts to the existing anatomical structures and at the same time maintains the required shape for long-term aesthetic correction. Nuvia fillers are able to create the desired volume without causing compression of surrounding tissue, thus always providing natural-looking results. In addition, there is almost no migration of filler in tissues.

In addition to hyaluronic acid, Newvia Organic contains calcium hydroxyapatite (it is also a component of Radiesse fillers). This naturally occurring mineral triggers the formation of new collagen in the skin. As a result, the density, firmness and elasticity of the skin improves, acquiring the ideal double effect of volume and hydration.

Nyuvia preparations are administered not only to the face area, but are also used to rejuvenate the skin of the hands, feet, other parts of the body, and intimate areas. The result lasts from 15 months to 2 years.

Newvia Organic is prescribed when needed:

• give the skin a healthy and fresh look, velvety;
• increase its natural firmness and elasticity;
• restore tone;
• smooth out small and medium wrinkles;
• rejuvenate the skin of the hands, other parts of the body, intimate areas.

Healing period

After injections, the face looks reddened, swollen, there is a burning sensation and painful sensitivity. To speed up healing and prevent side effects, you should follow your doctor’s recommendations:

• it is necessary to limit the contact of the face with other surfaces for the first day, use neutral gels and foams for washing;
• to speed up healing, use topical anti-inflammatory drugs;
• Do not consume salty, spicy foods, or alcohol for a week;
• for about 2 weeks it is not recommended to visit the sauna, solarium, swimming pool;
• limit exposure to the sun, use cream with spf protection factor.

Average cost of the procedure in Moscow clinics

In the capital's clinics, the Amalian line is often used due to the high quality of the products and the availability of certification. The price depends on the qualifications, experience of the doctor, as well as the medications used.

Cost in Moscow:

• mezo and biorevitalization from 5,000 to 10,000 rubles;
• correction with γ and β fillers from 12,000 to 15,000 rubles;
• medium, hard, omega from 22,000 to 30,000 rubles.

Abroad the cost is much higher, in Tallinn buy to filler 135–200 €.

Series advantages

There are several advantages of Amalain.

1. A wide range of use of drugs, the list of which includes biorevitalizants, gels for facial contouring and fillers for intimate plastic surgery, as well as products used in urogynecology.
2. Low risk of side effects.
3. High quality and safety, which is confirmed by gynecological and ROSS RU.AYU 64.B1 8362 certificates.

Buyanov Sergey Yurievich (Expert Doctor):

Buyanov Sergey Yurievich (Expert Doctor):

The main advantage of the Amalain gel line is its development in Russia. The composition and precise concentration were developed in relation to people living in the central zone of the Russian Federation.

Precautionary measures

Immediately after the procedure, the face looks reddened, swollen, lumps and painful sensitivity are felt. Such phenomena can persist for up to 3 days. All undesirable consequences go away on their own within 2 weeks. If stored for a long time, consult a doctor.

Consequences of the procedure:

• redness, papules;
• hematomas, swelling;
• burning, itching;
• tissue necrosis;
• granulomas;
• filler displacement;
• facial asymmetry;
• painful sensitivity;
• inflammation.

There are also restrictions for carrying out. It is important to identify contraindications at the consultation stage:

• pregnancy, lactation;
• menstruation;
• chronic diseases;
• diabetes;
• blood clotting disorder;
• tendency to form colloidal scars;
• allergy;
• autoimmune pathologies;
• elevated body temperature, cold.

Existing contraindications

In certain circumstances, injections may be prohibited. Let's look at the list of main contraindications - it is important to take them into account.

• In the corrected area, an inflammatory process is observed or there are signs of a dermatological disease.
• If you have an allergic predisposition.
• For benign vascular tumors (outwardly they appear in the likeness of blood drops visible through the skin).
• If the epidermis is damaged.
• During the rehabilitation period, up to a month, after mechanical facial cleansing.
• If blood vessels are close together (the procedure can be performed with the permission of the cosmetologist after examination).
• For tuberculosis, diabetes and asthma.
• During the acute stage of chronic diseases.
• With poor blood clotting.
• During pregnancy and during breastfeeding.
• With a tendency to form keloid scars.
• During menstruation.
• For autoimmune pathology, infectious/viral diseases.

Pros and cons of the procedure

Before carrying out the procedure, it is worth considering all the advantages and disadvantages of amalain preparations.

Advantages:

• safe, certified drug, meets international quality standards;
• affordable price;
• a series of fillers and solutions allows you to select an individual correction program;
• low molecular weight ensures economical consumption;
• the effect lasts for about a year;
• possibility of combination with other cosmetic procedures;
• short recovery period.

Flaws:

• the result depends on the experience and qualifications of the doctor;
• possible side effects;
• after biodegradation, repeated administration is required.

The whole truth about hormone replacement therapy

Murzaeva Irina Yurievna

Endocrinologist, Preventive Medicine Doctor

September 28, 2014

I take the liberty to describe the benefits and fears of prescribing hormone replacement therapy (HRT). I assure you - it will be interesting!

Menopause, according to modern science, is not health, it is a disease. Its characteristic specific manifestations are vasomotor instability (hot flashes), psychological and psychosomatic disorders (depression, anxiety, etc.), urogenital symptoms - dry mucous membranes, painful urination and nocturia - “night trips to the toilet”. Long-term effects: CVD (cardiovascular disease), osteoporosis (low bone density and fractures), osteoarthritis and Alzheimer's disease (dementia). As well as diabetes and obesity.

HRT in women is more complex and multifaceted than in men. If a man needs only testosterone for replacement, then a woman needs estrogens, progesterone, testosterone, and sometimes thyroxine.

HRT uses smaller doses of hormones than hormonal contraceptives. HRT drugs do not have contraceptive properties.

All the materials below are based on the results of a large-scale clinical study of HRT in women: Womens Health Initiative (WHI) and published in 2012 in the consensus on hormone replacement therapy of the Research Institute of Obstetrics and Gynecology. IN AND. Kulakova (Moscow).

So, the main postulates of HRT.

1. You can start taking HRT for another 10 years after the cessation of your menstrual cycle (taking into account contraindications!). This period is called the “window of therapeutic opportunity.” Over 60 years of age, HRT is not usually prescribed. How long is HRT prescribed? – “As much as needed” To do this, in each specific case, you need to decide on the purpose of using HRT in order to determine the timing of HRT. The maximum period for using HRT: “last day of life – last pill.”
2. The main indications for HRT are vasomotor symptoms of menopause (these are menopausal manifestations: hot flashes), and urogenital disorders (dyspariunia - discomfort during sexual intercourse, dry mucous membranes, discomfort during urination, etc.)
3. With the right choice of HRT, there is no evidence of an increase in the incidence of breast and pelvic cancer ; the risk may increase with a duration of therapy of more than 15 years! HRT can also be used after treatment of stage 1 endometrial cancer, melanoma, and ovarian cystadenomas.
4. When the uterus is removed (surgical menopause), HRT is given as estrogen monotherapy.
5. When HRT is started on time, the risk of cardiovascular diseases and metabolic disorders is reduced. That is, during hormone replacement therapy, normal metabolism of fats (and carbohydrates) is maintained, and this prevents the development of atherosclerosis and diabetes mellitus, since the deficiency of sex hormones in postmenopause aggravates existing ones and sometimes provokes the onset of metabolic disorders.
6. The risk of thrombosis increases when using HRT with a BMI (body mass index) = more than 25, that is, if you are overweight!!! Conclusion: excess weight is always harmful.
7. The risk of thrombosis is higher in women who smoke. (especially when smoking more than 1/2 packs per day).
8. It is advisable to use metabolically neutral gestagens in HRT (this information is more for doctors)
9. Transdermal forms (external, that is, gels) are preferable for HRT ; they exist in Russia!
10. Psycho-emotional disorders often prevail in menopause (which does not allow one to discern a psychogenic disease behind their “mask”). Therefore, HRT can be given for 1 month for trial therapy for the purpose of differential diagnosis with psychogenic diseases (endogenous depression, etc.).
11. In the presence of untreated arterial hypertension, HRT is possible only after stabilization of blood pressure.
12. Prescription of HRT is possible only after normalization of hypertriglyceridemia** (triglycerides are the second, after cholesterol, “harmful” fats that trigger the process of atherosclerosis. But transdermal (in the form of gels) HRT is possible against the background of elevated triglyceride levels).
13. In 5% of women, menopausal symptoms persist for 25 years after the cessation of the menstrual cycle. HRT is especially important for them to maintain normal well-being.
14. HRT is not a method of treating osteoporosis, it is a method of prevention (it should be noted that it is a cheaper method of prevention than the cost of treating osteoporosis itself).
15. Weight gain often accompanies menopause , sometimes an additional + 25 kg or more, this is caused by a deficiency of sex hormones and related disorders (insulin resistance, impaired carbohydrate tolerance, decreased insulin production by the pancreas, increased production of cholesterol and triglycerides by the liver). This is collectively called menopausal metabolic syndrome. Timely prescribed HRT is a way to prevent menopausal metabolic syndrome (provided that it did not exist before, before menopause!)
16. Based on the type of menopausal symptoms, it is possible to determine which hormones a woman lacks in her body, even before taking blood for a hormonal analysis. According to these signs, menopausal disorders in women are divided into 3 types: a) type 1 - only estrogen deficiency: weight is stable, no abdominal obesity (at the abdominal level), no decreased libido, no depression and urinary disorders and decreased muscle mass, but there is menopausal hot flashes, dry mucous membranes (+dysparium), and asymptomatic osteoporosis; b) type 2 (only androgen-deficient, depressive) if a woman has a sharp increase in weight in the abdominal area - abdominal obesity, increasing weakness and loss of muscle mass, nocturia - “night urge to go to the toilet”, sexual disorders, depression, but no hot flashes and osteoporosis according to densitometry (this is an isolated lack of “male” hormones); c) type 3, mixed, estrogen-androgen deficiency: if all the previously listed disorders are expressed - hot flashes and urogenital disorders are pronounced (dysparunia, dry mucous membranes, etc.), a sharp increase in weight, loss of muscle mass, depression, weakness - then there is not enough both estrogen and testosterone, both of which are required for HRT. It cannot be said that any of these types is more favorable than the other. **Classification based on materials from Apetov S.S.
17. The question of the possible use of HRT in the complex treatment of stress urinary incontinence in menopause should be decided individually.
18. HRT is used to prevent cartilage degradation and, in some cases, to treat osteoarthritis. An increase in the incidence of osteoarthritis with multiple joint lesions in women after menopause indicates the involvement of female sex hormones in maintaining the homeostasis of articular cartilage and intervertebral discs.
19. Estrogen therapy has been shown to be beneficial for cognitive function (memory and attention).
20. Treatment with HRT prevents the development of depression and anxiety , which often occurs with menopause in women predisposed to it (but the effect of this therapy occurs provided that HRT therapy is started in the first years of menopause, or better yet, premenopause).
21. I no longer write about the benefits of HRT for a woman’s sexual function, aesthetic (cosmetological) aspects - prevention of “sagging” of the skin of the face and neck, prevention of worsening wrinkles, gray hair, tooth loss (from periodontal disease), etc.

Contraindications to HRT:

Main 3:

1. History of breast cancer, current or suspected; If there is a hereditary history of breast cancer, a woman needs to undergo a genetic test for the gene for this cancer! And if the risk of cancer is high, HRT is no longer discussed.
2. History or current history of venous thromboembolism (deep vein thrombosis, pulmonary embolism) and current or history of arterial thromboembolic disease (eg, angina pectoris, myocardial infarction, stroke).
3. Liver diseases in the acute stage.

Additional:

• estrogen-dependent malignant tumors, for example, endometrial cancer or if this pathology is suspected;
• bleeding from the genital tract of unknown etiology;
• untreated endometrial hyperplasia;
• uncompensated arterial hypertension;
• allergy to active substances or to any of the components of the drug;
• cutaneous porphyria;
• dysregulated type 2 diabetes mellitus

Examinations before prescribing HRT:

• Taking an anamnesis (to identify risk factors for HRT): examination, height, weight, BMI, abdominal circumference, blood pressure.
• Gynecological examination, collection of smears for oncocytology, ultrasound of the pelvic organs.
• Mammography
• Lipidogram, blood sugar, or sugar curve with 75 g of glucose, insulin with calculation of the HOMA index
• Additionally (optional):
• analysis for FSH, estradiol, TSH, prolactin, total testosterone, 25-OH-vitamin D, ALT, AST, creatinine, coagulogram, CA-125
• Densitometry (for osteoporosis), ECG.
• Individually – Doppler ultrasound of veins and arteries

About the drugs used in HRT.

In women 42-52 years old with a combination of regular cycles with cycle delays (as a phenomenon of premenopause), who need contraception, who do not smoke!!!, you can use contraception instead of HRT - Jess, Logest, Lindinet, Mercilon or Regulon / or use an intrauterine system — Mirena (in the absence of contraindications).

Then they switch to HRT in a cyclic mode (with menstrual bleeding), and when the cycle stops, they switch to a continuous regimen of therapy.

Cutaneous etrogens (gels):

Divigel 0.5 and 1 g 0.1%, Estrogel

Combined E/G drugs for cyclic therapy: Femoston 2/10, 1/10, Climinorm, Divina, Trisequence

Combined E/G preparations for continuous use: Femoston 1/2.5 conti, Femoston 1/5, Angelique, Klmodien, Indivina, Pauzogest, Klimara, Proginova, Pauzogest, Ovestin

Tibolone

Gestagens: Duphaston, Utrozhestan

Androgens: Androgel, Omnadren-250

Alternative treatments include

herbal preparations: phytoestrogens and phytohormones. Data on the long-term safety and effectiveness of this therapy are insufficient.

In some cases, a one-time combination of hormonal HRT and phytoestrogens is possible. (for example, with insufficient relief of hot flashes by one type of HRT).

Women receiving HRT should visit their doctor at least once a year. The first visit is scheduled 3 months after the start of HRT. The doctor will prescribe the necessary examinations for monitoring HRT, taking into account the characteristics of your health!

Important! Message from the site administration about questions on the blog:

Dear readers! By creating this blog, we set ourselves the goal of giving people information on endocrine problems, diagnostic methods and treatment. And also on related issues: nutrition, physical activity, lifestyle. Its main function is educational.

Within the framework of the blog, in answering questions, we cannot provide full-fledged medical consultations; this is due to both the lack of information about the patient and the doctor’s time spent in order to study each case. Only general answers are possible in the blog. But we understand that not everywhere it is possible to consult with an endocrinologist at your place of residence; sometimes it is important to get another medical opinion. For such situations, when a deeper dive and study of medical documents is needed, at our center we have a format for paid correspondence consultations on medical documentation.

How to do it? Our center’s price list includes a correspondence consultation on medical documentation, costing 1,200 rubles. you can send scans of medical documents, a video recording, a detailed description, everything that you consider necessary regarding your problem and questions to which you want answers. The doctor will see if the information provided can give a full conclusion and recommendations. If yes, we will send the details, you will pay, and the doctor will send a report. If, based on the documents provided, it is impossible to give an answer that could be considered as a doctor’s consultation, we will send a letter stating that in this case, absentee recommendations or conclusions are impossible, and, of course, we will not take payment.

Sincerely, Administration of the Medical

Opinion of cosmetologists

On forums, cosmetologists share their experience of working with Amalain preparations.

The user writes about the need to wait for the recovery period and only then remove the filler.

The review indicates the consequences of the procedure; the result can be assessed after 2 weeks.

Users discuss drug dosages depending on the areas of administration.

Patient reviews

On the forums there are mostly positive reviews about the use of amalaine fillers and solutions.

The user writes about his good results after the injection of filler.

The review describes the sensations during the recovery period.

Participant about the advantages of Amalain in comparison with Teosial, but insufficient lip volume when injecting 1 ml.

The user writes about the drug’s tendency to roll off and dissolve quickly.

The participant writes that the drug absorbs water; if there are side effects, you should consult a doctor.

Other reviews can be found on the forum

Sculptra

The French innovative drug Sculptra has already been dubbed injection plastic surgery by cosmetologists. This is a biostimulator based on polylactic acid, which, entering the deep layers of the skin, starts the process of producing collagen types 1 and 3. It is also called “young collagen”.

Tests of the drug Sculptra show that three months after its introduction into the skin, the amount of collagen in it increases by 66.5 percent. The skin is noticeably tightened, deep folds and wrinkles disappear, and lost volume is restored. With the help of Sculptra, facial asymmetry is also ideally corrected. The drug thus fully lives up to its name!

It is important to recognize that facial aging is not an isolated process limited to nasolabial folds or sagging skin, but rather represents a collection of general changes in the skeleton, soft tissues and skin structures. Therefore, comprehensive rejuvenation is necessary, which involves not only the correction of nasolabial folds, but also the creation of a more youthful overall appearance. Sculptra is ideal for tightening the neck, décolleté, inner surfaces of the arms and legs, abdomen, buttocks - the main areas of the body where sagging skin structures are most pronounced.

The gradual restoration of volume can be an advantage for many patients who want to maintain individuality during the process of external transformation. Over time, polylactic acid completely disintegrates and is eliminated from the body naturally.

The effect after injections lasts for 2 or more years. From time to time, the patient may need to administer 1-2 additional bottles to look “perfect.” The interval between repeated injections varies widely from several months to several years.

Correction with the drug can be combined with the administration of neurotoxins. Laser and phototherapy can be used immediately after the injection of polylactic acid. It is also possible to combine Sculptra with photorejuvenation and laser therapy.

The sculpture is ideal for:

• correction of deep wrinkles;
• restoration of facial contours;
• smoothing asymmetry;
• harmonization of features;
• neck and décolleté lifts;
• the inner surfaces of the arms and legs, abdomen and buttocks.