Simon James A, Snabes Michael C
George Washington University, 1850 M. Street, NW, Suite 450, Washington, DC 20036, USA.
Expert Opin Investig Drugs. 2007 Dec;16(12):2005-20. doi: 10.1517/13543784.16.12.2005.
Estrogen therapy is the most consistently effective treatment and the only therapy approved by the FDA for menopausal vasomotor symptoms. Following the safety issues reported in the primary Women's Health Initiative publications and with continued patient requests for treatment, a challenge to clinicians has been to identify the lowest effective dose of estrogen for alleviating menopausal symptoms. A number of low-dose estrogen preparations are now available, and transdermal preparations containing an ultra-low dose (25% of the previous conventional or standard dose) of estrogen have recently been approved by the FDA. These preparations effectively relieve menopausal symptoms such as vasomotor symptoms and vaginal atrophy, and potentially protect against bone loss. Compared with standard-dose estrogen therapy, these ultra-low-dose products have an improved tolerability profile and may require reduced amounts or a lower frequency of progestogen administration, potentially mitigating the apparent long-term adverse effects of estrogen-progestogen combinations, as noted in the Women's Health Initiative.
雌激素疗法是治疗绝经后血管舒缩症状最具持续疗效的方法，也是美国食品药品监督管理局（FDA）批准的唯一疗法。继《女性健康倡议》主要出版物中报道的安全问题以及患者持续要求治疗之后，临床医生面临的一项挑战是确定缓解绝经症状的最低有效雌激素剂量。现在有多种低剂量雌激素制剂可供使用，含超低剂量（先前传统或标准剂量的25%）雌激素的透皮制剂最近已获FDA批准。这些制剂能有效缓解绝经症状，如血管舒缩症状和阴道萎缩，并可能预防骨质流失。与标准剂量雌激素疗法相比，这些超低剂量产品具有更好的耐受性，可能需要减少孕激素的给药量或给药频率，这有可能减轻如《女性健康倡议》中所述的雌激素 - 孕激素联合使用的明显长期不良反应。
