Landa M C
Centro de Atención a la Mujer, COFES Iturrama-San Juan, Pamplona, 31008, Spain.
An Sist Sanit Navar. 2003;26 Suppl 3:99-105.
Hormone replacement therapy has been employed for the prevention and treatment of postmenopausal osteoporosis. This paper reviews recently published trials, especially the studies Heart and estrogen/progestin replacement study (HERS) and Womeńs Health Initiative (WHI), randomized controlled trials of wide scope. The conclusion reached is that hormone replacement therapy has the effect of improving the vasomotor symptoms of menopause. It has a positive effect on the bone mass with more intensity on the trabecular bone, but this effect only persists during the hormonal treatment and the negative balance of bone exchange is recovered when treatment stops. A protective effect is found on osteoporotic fractures (vertebra, femur) during the treatment of older women (above 60 years), but this action is not found in the long term, which is why its value as a preventive therapy for osteoporosis is not supported. Finally, certain guidelines are given that can be helpful in clinical practice.
激素替代疗法已被用于预防和治疗绝经后骨质疏松症。本文回顾了近期发表的试验，特别是范围广泛的随机对照试验——心脏与雌激素/孕激素替代研究（HERS）和妇女健康倡议（WHI）。得出的结论是，激素替代疗法具有改善绝经后血管舒缩症状的作用。它对骨量有积极影响，对小梁骨的作用更强，但这种作用仅在激素治疗期间持续，治疗停止后骨转换的负平衡又会恢复。在老年女性（60岁以上）的治疗期间，发现对骨质疏松性骨折（脊椎、股骨）有保护作用，但长期来看并非如此，这就是其作为骨质疏松症预防性疗法的价值未得到支持的原因。最后，给出了一些在临床实践中可能有用的指导原则。
