Birkhäuser M H, Reinecke I
Universitats-Frauenklinik Inselspital, Berne, Switzerland.
Climacteric. 2008 Jun;11(3):192-200. doi: 10.1080/13697130802060455.
To determine whether physicians' confidence in the use of hormone replacement therapy (HRT) for climacteric symptoms has been affected by the negative media interpretation of data from landmark studies investigating HRT usage such as the Women's Health Initiative (WHI) study.
A structured questionnaire was completed via the internet by European and US gynecologists, obstetrician/gynecologists and general practitioners - all experienced in treating women with climacteric symptoms.
Six hundred physicians completed the survey in six countries. Overall, 98% agreed that the menopause significantly affects quality of life and 97% considered that the majority/all of their patients experienced positive benefits from HRT. Most physicians (90%) believed the benefits of HRT outweigh the risks in suitable patients, and 92% would prescribe HRT for themselves/spouse/family. For treatment of atrophic vaginitis, 86% agreed that local estrogen was the most effective course of action. While 82% of participants were aware of the latest recommendations on low-dose HRT, and estrogen dose in particular, 67% cited lowering the progestogen dose as important. With regard to the recent negative media coverage on HRT, 78% of physicians felt this was unjustified.
These results provide reassurance that health-care professionals in Europe and the US, experienced in treating women with climacteric symptoms, have not lost confidence in HRT. Despite a consensus on the importance of lowering the dose of HRT and a focus on estrogen, there remains a need to heighten prescribers' awareness on the pivotal role that a lower progestogen dose plays in optimizing the risk-benefit profile.
确定医生对使用激素替代疗法（HRT）治疗更年期症状的信心是否受到媒体对诸如妇女健康倡议（WHI）研究等调查HRT使用情况的里程碑式研究数据的负面解读的影响。
欧洲和美国的妇科医生、妇产科医生和全科医生通过互联网完成了一份结构化问卷，他们都有治疗更年期症状女性的经验。
六个国家的600名医生完成了调查。总体而言，98%的人认为更年期会显著影响生活质量，97%的人认为他们的大多数/所有患者都从HRT中获得了积极益处。大多数医生（90%）认为HRT对合适的患者益处大于风险，92%的医生会为自己/配偶/家人开HRT药物。对于萎缩性阴道炎的治疗，86%的人认为局部使用雌激素是最有效的治疗方法。虽然82%的参与者了解关于低剂量HRT的最新建议，特别是雌激素剂量，但67%的人认为降低孕激素剂量很重要。关于近期媒体对HRT的负面报道，78%的医生认为这是不合理的。
这些结果表明，在欧洲和美国，有治疗更年期症状女性经验的医疗保健专业人员对HRT并没有失去信心。尽管在降低HRT剂量的重要性以及对雌激素的关注方面已达成共识，但仍有必要提高开处方者对较低孕激素剂量在优化风险效益比中所起关键作用的认识。
