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[激素替代疗法对绝经前子宫切除术后女性卵巢功能的影响]

[The effects of hormone replacement therapy on ovarian function in premenopausal women after hysterectomy].

作者信息

Kuckatz C, Eicher W, Klinga K, Mueck A O

机构信息

Abt. Endokrinologie, Universitäts-Frauenklinik Heidelberg.

出版信息

Zentralbl Gynakol. 1999;121(5):223-7.

Abstract

OBJECTIVE

Examining the consequences of temporary postoperative hormone replacement therapy following hysterectomy for the function of the ovaries and the subjective well-being of women.

MATERIAL AND METHODS

Hormone profiles (Estradiol, FSH, LH, Testosterone, DHEA) and typical estradiol deficiency phenomena were investigated prospectively in premenopausal hysterectomized women with intact ovaries. Group 1 (n = 21) was replaced transdermally following surgery for 3 weeks with estradiol patch 0.05 mg daily. Group 2 (n = 21) got no hormones.

RESULTS

Group 1 had a remarkable decrease of estradiol after 10 days to 59% and after 6 weeks to 71% of the starting point. Gonadotropins showed an increase in this group. In group 2 without replacement there was only a small decrease of estradiol after 10 days and after 6 weeks the level was higher than before hysterectomy. Testosterone also decreased in group 1 to 64% of the level before surgery after 6 weeks, whereas in the comparing group it was 87%. On the other hand in group 1 only 2 of 21 women, but 10 of 21 in group 2 showed climacteric-like symptoms.

CONCLUSIONS

HRT over 3 weeks induces ovarian suppression, which is still seen 6 weeks after hysterectomy. But hormonally treated women have clearly less subjective complaints.

摘要

目的

研究子宫切除术后短期激素替代疗法对卵巢功能及女性主观幸福感的影响。

材料与方法

对绝经前卵巢完整的子宫切除女性进行前瞻性研究,检测其激素水平(雌二醇、促卵泡生成素、促黄体生成素、睾酮、脱氢表雄酮)及典型的雌二醇缺乏现象。第1组(n = 21)术后经皮给予每日0.05 mg雌二醇贴片,持续3周。第2组(n = 21)不给予激素治疗。

结果

第1组在术后10天时雌二醇显著下降至起始值的59%,6周时降至71%。该组促性腺激素水平升高。第2组未进行激素替代治疗,术后10天时雌二醇仅有小幅下降,6周时其水平高于子宫切除术前。第1组睾酮在术后6周时也降至术前水平的64%,而对照组为87%。另一方面,第1组21名女性中只有2人出现类似更年期症状,而第2组21人中有10人出现。

结论

3周以上的激素替代疗法会导致卵巢抑制,子宫切除术后6周仍可观察到。但接受激素治疗的女性主观不适明显较少。

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