Haimov-Kochman Ronit, Barak-Glantz Edyah, Arbel Revital, Leefsma Miriam, Brzezinski Amnon, Milwidsky Ariel, Hochner-Celnikier Drorith
Department of Obstetrics and Gynecology, Hadassah Medical Center, Hebrew University Hospital, Mount Scopus, Jerusalem, Israel.
Menopause. 2006 May-Jun;13(3):370-6. doi: 10.1097/01.gme.0000186663.36211.c0.
To investigate the recurrence and severity of climacteric symptoms after two methods of discontinuation of prolonged hormone therapy.
Postmenopausal women treated with hormone therapy for more than 3 years and opting to discontinue therapy were randomly assigned to two treatment groups. Hormone therapy was discontinued either abruptly (group 1) or gradually (group 2). Symptoms in both groups were monitored with the Greene climacteric scale at 1, 3, 6, 9, and 12 months.
Ninety-one women aged 48 to 73 years (mean age 56.8 +/- 4.2 years) participated in the study. The mean therapy duration was 8.8 +/- 3.8 years. No differences were noted between the two groups regarding age at menopause, body mass index, reasons to start therapy, hormone therapy duration, type of regimen, and reasons cited for hormone treatment discontinuation. After cessation of therapy, a similar percentage of patients in each group resumed hormone therapy. Climacteric syndromes, specifically vasomotor dysfunction, were more severe in group 1 than in group 2 during the first 3 months after hormone therapy withdrawal. However, by 6 months vasomotor symptoms were worse in group 2. By 9 to 12 months, no difference was noted between groups. No differences were observed in the percentage of weight gain, vaginal bleeding, and atrophy after discontinuation of therapy by either method.
Our specific regimen of gradual discontinuation of hormone therapy merely postponed, and neither prevented nor minimized, the reappearance of vasomotor symptoms, mood deterioration, and sexual dysfunction, and the resulting discomfort.
探讨两种延长激素治疗停药方法后更年期症状的复发情况及严重程度。
接受激素治疗超过3年且选择停药的绝经后女性被随机分为两个治疗组。激素治疗要么突然停药（第1组），要么逐渐停药（第2组）。在1、3、6、9和12个月时，使用格林更年期量表对两组的症状进行监测。
91名年龄在48至73岁（平均年龄56.8±4.2岁）的女性参与了该研究。平均治疗时长为8.8±3.8年。两组在绝经年龄、体重指数、开始治疗的原因、激素治疗时长、治疗方案类型以及停药原因方面均未观察到差异。治疗停止后，每组中恢复激素治疗的患者比例相似。在激素治疗停药后的前3个月，第1组的更年期综合征，尤其是血管舒缩功能障碍，比第2组更为严重。然而，到6个月时，第2组的血管舒缩症状更严重。到9至12个月时，两组之间未观察到差异。两种停药方法在停药后体重增加、阴道出血和萎缩的发生率方面均未观察到差异。
我们特定的逐渐停用激素治疗方案只是推迟了血管舒缩症状、情绪恶化和性功能障碍的再次出现以及由此产生的不适，既未预防也未最小化这些情况。
