Meczekalski Błazej, Czyzyk Adam
Uniwersytet Medyczny w Poznaniu, Klinika Endokrynologii Ginekologicznej.
Pol Merkur Lekarski. 2009 Jul;27(157):77-80.
Although estrogens, are not any more the first choice therapy for osteoporosis, the are still important and promising treatment option for women after menopause. In randomized clinical trials it was shown, that they have negative influence on risk of development of particular diseases, but even though they are very efficient remedy for symptoms of climacteric syndrome and act positively on quality of life and longevity. Side effects are highly dependent on dose and route of administration and that is why the new hormonal treatment modalities are being developed. It seems, that non-oral (transdermal, nasal, sublingual or vaginal) administration of estrogens preparations has better safety profile and at least as good influence on bones, as oral estrogens. What is more, low or ultralow doses of estrogens is beneficial for skeletal system, even if their effectiveness is dose-dependent. Also polytherapy with hormonal preparations of osteoporosis is under investigation. Combinations of estrogens with parathormone and estrogens with bisphosphonates may be used in treatment-resistant osteoporosis and in individuals with severe loss of bone mass. Anyway, new, well designed clinical trials are still required, which will asses different indications for substances with estrogens activity.
尽管雌激素已不再是骨质疏松症的首选治疗方法，但对于绝经后女性而言，它们仍是重要且有前景的治疗选择。在随机临床试验中表明，雌激素对特定疾病的发生风险有负面影响，但即便如此，它们仍是治疗更年期综合征症状的高效药物，对生活质量和寿命有积极作用。副作用高度依赖剂量和给药途径，这就是新的激素治疗方式正在研发的原因。似乎雌激素制剂的非口服（经皮、鼻内、舌下或阴道）给药具有更好的安全性，并且对骨骼的影响至少与口服雌激素一样好。此外，低剂量或超低剂量的雌激素对骨骼系统有益，即使其效果依赖于剂量。骨质疏松症激素制剂的联合治疗也在研究中。雌激素与甲状旁腺激素以及雌激素与双膦酸盐的联合应用可用于治疗抵抗性骨质疏松症以及骨量严重丢失的个体。无论如何，仍需要新的、设计良好的临床试验来评估具有雌激素活性物质的不同适应证。
