Huber J
I. Univ.-Frauenklinik, A-Wien.
Geburtshilfe Frauenheilkd. 1991 Apr;51(4):257-61. doi: 10.1055/s-2007-1023715.
The replacement therapy in postmenopausal women is seen to be for transformation of the oestrogen-stimulated endometrium only, which does not apply to hysterectomised women. Because of the influence of estrane on lipids, one often advises against a replacement therapy with progestogens in hysterectomised women. With increasing knowledge of encountered extragenital functions of sexual steroids, the latter is questionable, if natural progesterone is given, which is (said to be) lipid-neutral, performing the function of the progestogens, which is quite more than reproduction only, more efficiently than estrane or gonane. Due to the competitive blocking of aldosterone the effect of progesterone is sodium-diuretic and diuretic, being as important as the therapy of climacteric complaints, as well as the consequence, which is the result of the physiological connection between progesterone and encephalics. Moreover, the effect of the progestogens is to tonicise the vascular system and is linked to a number of intestinal hormones in order to adjust their function. Therefore, progesterone seems to perform a great variety of extragenital functions. Menopausal women should not be deprived of the benefits of these functions within the framework of a replacement therapy.
绝经后女性的替代疗法仅被视为用于转化受雌激素刺激的子宫内膜，这不适用于子宫切除的女性。由于孕烷对脂质的影响，人们通常建议子宫切除的女性不要使用孕激素进行替代疗法。随着对性甾体激素所具有的非生殖功能的了解不断增加，如果给予（据说）对脂质无影响的天然孕酮来发挥孕激素的功能，而该功能远不止于生殖方面，且比孕烷或甾烷更有效，那么上述建议就值得质疑了。由于孕酮对醛固酮的竞争性阻断作用，其具有排钠利尿和利尿的效果，这与更年期症状的治疗以及孕酮与脑之间生理联系所产生的结果同样重要。此外，孕激素的作用是使血管系统保持张力，并与多种肠道激素相关联以调节其功能。因此，孕酮似乎具有多种非生殖功能。在替代疗法的框架内，不应剥夺绝经后女性这些功能所带来的益处。
