Ansbacher R
Department of Obstetrics and Gynecology, University of Michigan Medical Center, Women's Hospital, Ann Arbor 48109-0276, USA.
Am J Obstet Gynecol. 2001 Feb;184(3):255-63. doi: 10.1067/mob.2001.109656.
In the next decade many women will turn to the medical community for advice on maintaining or improving health after menopause. Estrogen replacement therapy, with or without progestins, alleviates menopausal symptoms, prevents or manages osteoporosis, and reduces the increased cardiovascular disease risk that results from estrogen deficiency caused by ovarian decline. Although several estrogen replacement products are available, the pharmacokinetics and efficacy of these products may vary depending on either the estrogen formulation or the route of administration, or both. For example, oral estrogens, which elicit a marked hepatic response, induce greater beneficial effects on serum lipoproteins than transdermal estrogens, which circumvent first-pass liver metabolism. Oral conjugated estrogens and transdermal estradiol increase bone density and prevent bone loss. This article summarizes the studies comparing estrogen formulations and discusses the differential effects of various estrogen products that promote postmenopausal health.
在未来十年，许多女性将向医学界寻求有关绝经后保持或改善健康的建议。雌激素替代疗法，无论是否添加孕激素，都能缓解更年期症状，预防或控制骨质疏松症，并降低因卵巢功能衰退导致雌激素缺乏而增加的心血管疾病风险。尽管有几种雌激素替代产品可供选择，但这些产品的药代动力学和疗效可能因雌激素制剂或给药途径，或两者的不同而有所差异。例如，引起明显肝脏反应的口服雌激素比绕过肝脏首过代谢的经皮雌激素对血清脂蛋白具有更大的有益作用。口服结合雌激素和经皮雌二醇可增加骨密度并预防骨质流失。本文总结了比较雌激素制剂的研究，并讨论了各种促进绝经后健康的雌激素产品的不同作用。
