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Файл:Перевод медицинского текста. Учебное пособие для подготовки к практическим занятиям по дисциплине «Иностранный язык»
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Text 16. Hormone replacement therapy (HRT)
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Picture 16. A treatment used to restore diminished hormone levels in women
Hormone replacement therapy (HRT) is a treatment to relieve symptoms of the menopause. It replaces hormones that are at a lower level as
you approach the menopause.
Benefits of HRT
The main benefit of HRT is that it can help relieve most of
the menopausal symptoms, such as: hot flushes, night sweats, mood
swings, vaginal dryness, reduced sex drive. Many of these symptoms pass
after a few years, but they can be unpleasant and taking HRT can offer relief
for many women. It can also help prevent weakening of the
bones (osteoporosis), which is more common after the menopause.
Risks of HRT
Some types of HRT can increase your risk of breast cancer. The benefits
of HRT are generally believed to outweigh the risks. But speak to a GP if you
have any concerns about taking HRT. Read more about the risks of HRT.
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How to get started on HRT
Speak to a GP if you're interested in starting HRT. You can usually
begin HRT as soon as you start experiencing menopausal symptoms and
will not usually need to have any tests first. A GP can explain the different
types of HRT available and help you choose one that's suitable for you.
You'll usually start with a low dose, which may be increased at a later stage.
It may take a few weeks to feel the effects of treatment and there may be
some side effects at first. A GP will usually recommend trying treatment for
3 months to see if it helps. If it does not, they may suggest changing your
dose, or changing the type of HRT you're taking.
Who can take HRT
Most women can have HRT if they're having symptoms associated
with the menopause. But HRT may not be suitable if you:
• have a history of breast cancer, ovarian cancer or womb cancer;
• have a history of blood clots;
• have untreated high blood pressure – your blood pressure will
need to be controlled before you can start HRT;
• have liver disease.
• are pregnant – it's still possible to get pregnant while taking HRT,
so you should use contraception until 2 years after your last period if you're
under 50, or for 1 year after the age of 50. In these circumstances, alternatives to HRT may be recommended instead.
Types of HRT
There are many different types of HRT and finding the right 1 for you
can be difficult.
There are different:
• HRT hormones – most women take a combination of the hormones
oestrogen and progestogen, although women who do not have a womb
can take oestrogen on its own;
• ways of taking HRT – including tablets, skin patches, gels and vagi-
nal creams, pessaries or rings;
• HRT treatment plans – HRT medicine may be taken without stop-
ping, or used in cycles where you take oestrogen without stopping but only
take progestogen every few weeks.
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A GP can give you advice to help you choose which type is best for
you. You may need to try more than 1 type before you find 1 that works
best. Find out more about the different types of HRT.
Stopping HRT
There's no limit on how long you can take HRT, but talk to a GP about
how long they recommend you take the treatment. Most women stop taking it once their menopausal symptoms pass, which is usually after a few
years. Women who take HRT for more than 1 year have a higher risk of
breast cancer than women who never use HRT. The risk is linked to all types
of HRT except vaginal oestrogen.
The increased risk of breast cancer falls after you stop taking HRT, but
some increased risk remains for more than 10 years compared to women
who have never used HRT. When you decide to stop, you can choose to do
so suddenly or gradually. Gradually decreasing your HRT dose is usually
recommended because it's less likely to cause your symptoms to come
back in the short term. Contact a GP if you have symptoms that persist for
several months after you stop HRT, or if you have particularly severe symptoms. You may need to start HRT again.
Side effects of HRT
As with any medicine, HRT can cause side effects. But these will usually pass within 3 months of starting treatment. Common side effects include:
breast tenderness, headaches, feeling sick, indigestion, abdominal (tummy)
pain, vaginal bleeding.
Alternatives to HRT
If you're unable to take HRT or decide not to, you may want to consider alternative ways of controlling your menopausal symptoms. Alternatives to HRT include:
• lifestyle measures, such as exercising regularly, eating a healthy di-
et, cutting down on coffee, alcohol and spicy foods, and stopping smoking;
• tibolone – a medicine that's similar to combined HRT (oestrogen
and progestogen), but may not be as effective and is only suitable
for women who had their last period more than 1 year ago;
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• antidepressants – some antidepressants can help with hot flushes
and night sweats, although they can also cause unpleasant side effects such
as agitation and dizziness
• clonidine – a non-hormonal medicine that may help reduce hot
flushes and night sweats in some women, although any benefits are likely to
be small.
Several remedies (such as bioidentical hormones) are claimed to help
with menopausal symptoms, but these are not recommended because it's
not clear how safe and effective they are. Bioidentical hormones are not the
same as body identical hormones. Body identical hormones, or micronised
progesterone, can be prescribed to treat menopausal symptoms.
Task 1. Answer the following questions
1. What is hormone replacement therapy (HRT)?
2. Can hormone replacement therapy (HRT) also help prevent weak-
ening of the bones (osteoporosis)?
3. Different medical fotms of HRT include tablets, skin patches, gels
and vaginal creams, pessaries or rings, don’t they?
4. Is tibolone – a medicine that is similar to combined HRT (oestrogen
and progestogen)?
5. Is clonidine – a non-hormonal medicine that may help reduce hot
flushes and night sweats in some women?
Task 2. Read and translate the following statement and say if it is
true or false
1. HRT helps to relieve most of the menopausal symptoms, such as:
hot flushes, night sweats, mood swings, vaginal dryness, reduced sex drive.
2. An obstetrician-guanacologist can explain the different types of
HRT available and help you choose one that's suitable for you..
3. HRT medicine may be taken without stopping, or used in cycles
where you take oestrogen without stopping but only take progestogen
every few weeks.
4. HRT has no any side effects include.
5. Lifestyle measures, such as exercising regularly, eating a healthy diet,
cutting down on coffee, alcohol and spicy foods, and stopping smoking can
help you reduce most of the menopausal symptoms in order not to get HRT.
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Text 17. Medicines information
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Picture 17. The different types of medicines between branded drugs and generics
This page explains the different types of medicine, the difference between branded drugs and generics, and how the medicines become available.
Which medicines can I buy without prescription?
Some medicines for minor illnesses can be bought over the counter
without a prescription, so you can treat yourself without needing to see a GP.
Simple painkillers and cough remedies, for example, can be bought
directly from supermarkets and other stores.
Other types of medicine, such as eyedrops or emergency contraception, are available without a prescription but need a pharmacist's supervision, so are only available to buy from behind the pharmacy counter.
Prescription-only medicines, such as antibiotics, must be prescribed
by a qualified health professional.
This may be a GP, hospital doctor, dentist, nurse, pharmacist, optometrist, physiotherapist or podiatrist.
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Buying medicines online
You can also buy medicines over the internet. But be very careful if
you do this, as many websites sell fake medicines.
Online medicines aren't regulated and ingredients in them can vary.
They may cause unpleasant side effects or may not be suitable for you.
It's best to see your GP before buying medicines online as they know
your medical history and can advise you whether the medicine would be
suitable.
If you choose to buy medicines online, ensure that:
• any online pharmacy is registered with the General Pharmaceuti-
cal Council (GPhC);
• any online doctor service is registered with the Care Quality
Commission (CQC) and the General Medical Council (GMC)
.
Brand names versus generics
Many medicines have at least 2 different names:
• the brand name – created by the pharmaceutical company that
made the medicine;
• the generic name – the name of the active ingredient in the medi-
cine.
For example, sildenafil is the generic name of a medicine used to
treat erectile dysfunction. But the company that makes sildenafil, Pfizer,
sells it under the brand name Viagra.
Companies take out exclusive rights called patents on each new drug
they discover. If a company has a patent on a drug, only that company can
market it under their brand name once it's been granted a licence.
Once the patent expires, other manufacturers can market generic versions. The generic versions will be the same as the branded medicine because they contain the same active ingredients.
They are used more often by the NHS because they're just as effective
but cost far less. It's similar to buying branded goods or a supermarket's
own label – the supermarket's version is usually cheaper.
If the name of your prescription medicine keeps changing, it might be
because you're being given the generic version rather than the branded
one.
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How new medicines become available
Licensed medicines
Before any new medicine can be used to treat people in the UK, it
goes through a strictly monitored development process.
This involves researching the medicine in the lab and testing it in clinical trials. After passing the clinical trials, a license will be granted before it
can be made available for wider use.
Read more about clinical trials.
Licences are only granted if strict safety and quality standards are met.
In the UK, licences are granted by the Medicines and Healthcare products
Regulatory Agency (MHRA) and the European Medicines Agency (EMA).
Licences confirm the health condition the medicine should be used
for and the recommended dosage.
This can be found in the information leaflet that comes with the medicine. The dosage instructions are usually on the label of the medicine
packet.
Unlicensed medicines
Sometimes a healthcare professional may recommend that you take
an off-label or unlicensed medicine.
Off-label use means that the medicine isn't licensed for treatment of
your condition. But the medicine will have a license to treat another condition and will have undergone clinical trials for this.
Your doctor may recommend an unlicensed medication if they think it
will treat your condition effectively and the benefits are greater than any
risks.
Safety of medicines
No medicine is completely risk free, but the MHRA and EMA try to ensure any medicine approved for treating people in the UK is as safe as possible.
Medicines continue to be carefully regulated after they've been licensed. This involves checking for problems and previously unknown side
effects.
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In rare cases, medicines may be withdrawn if there are serious safety
concerns or the risks of the medicines outweigh the benefits.
You can help the MHRA monitor the safety of medicines by reporting
any suspected side effects to the Yellow Card Scheme. Reports can also be
made on behalf of someone you're caring for.
Task 1. Answer the following questions
1. Which medicines can be bought over the counter without a pre-
scription?
2. Prescription-only medicines, such as antibiotics, must be pre-
scribed by a qualified health professional. What are those professionals?
3. Many medicines have at least 2 different names. What are they?
4. Are licences only granted if strict safety and quality standards are
met?
5. What do licences?
Task 2. Read and translate the following statement and say if it is
true or false
1. Simple painkillers and cough remedies, for example, can be
bought directly from supermarkets and other stores, without a prescription
of a doctor.
2. Many medicines have at least 2 different names: the brand name
and the generic name.
3. Sildenafil is the generic name of a medicine used to treat erectile
dysfunction. But the company Pfizer prepares it and sells it under the brand
name Viagra.
4. Before any medications can be used to treat people in the UK, they
go through a strictly monitored development process, including research in
the medicine, in the lab and testing it in clinical trials.
5. Your doctor will never recommend an unlicensed medications because they won’t treat your condition effectively and the risks are greater
than any benefits.
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Text 18. Herbal medicines
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Picture 18. Ingredients for herbal medicines
Herbal medicines are those with active ingredients made from plant
parts, such as leaves, roots or flowers. But being "natural" doesn't necessarily mean they're safe for you to take. Just like conventional medicines,
herbal medicines will have an effect on the body, and can be potentially
harmful if not used correctly. They should therefore be used with the same
care and respect as conventional medicines. If you're consulting your doctor or pharmacist about health matters, or are about to undergo surgery,
always tell them about any herbal medicines you're taking.
Potential issues with herbal medicines
If you're taking, or plan to take, any herbal medicines, be aware of the
following:
• They may cause problems if you're taking other medicines. They
could result in reduced or enhanced effects of the medicine, including potential side effects.
• You may experience a bad reaction or side effects after taking a
herbal medicine.
• Not all herbal medicines are regulated. Remedies specially pre-
pared for individuals don't need a licence, and those manufactured outside
the UK may not be subject to regulation.
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• Evidence for the effectiveness of herbal medicines is generally
very limited. Although some people find them helpful, in many cases their
use tends to be based on traditional use rather than scientific research.
Certain groups of people should be particularly wary of taking herbal
medicines.
Who should avoid herbal medicines?
Taking a herbal medicine may not be suitable for:
• people taking other medicines;
• people with serious health conditions, such as liver or kidney dis-
ease;
• people who are going to have surgery;
• pregnant or breastfeeding women;
• the elderly;
• children – as with all medicines, herbal medicines should be kept
out of the sight and reach of children.
Speak to your doctor or pharmacist for advice before trying a herbal
medicine if you fall into one of these groups.
Herbal medicines and surgery
It's important to tell your doctor if you take any herbal medicines before undergoing surgery.
This is because:
• some herbal medicines might interfere with anaesthesia and other
medicines used before, during or after procedures;
• some herbal medicines may interfere with blood clotting and
blood pressure, which may increase the risk of bleeding during or after
surgery.
Your doctor may therefore advise you to stop taking any herbal medicines during the weeks leading up to your operation.
What to look for when buying a herbal medicine
If you want to try a herbal medicine, look out for a traditional herbal
registration (THR) marking on the product packaging. This means
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