Rozenberg S, Vandromme J, Antoine C
Département de Gynécologie-Obstétrique, C.H.U. Saint-Pierre, Bruxelles.
Rev Med Brux. 2011 Sep;32(4):239-42.
In this review article an update of the menopause hormone therapy is presented (MHT). MHT is the most efficient therapy for climacteric symptoms. It prevents also osteoporosis. Nevertheless, since prolonged use is associated with increased health risks, other therapies, combined with calcium and vitamin D, are preferred for women who suffer from osteoporosis without climacteric symptoms. Increased breast cancer risk has been reported, after 5 years of use, in women treated with a fixed combined regimen of oestrogen and progestin (0,625 mg conjugated estrogens (CEE) + 5 mg de medroxyprogesteron acetate (MPA) (WHI-EP), while a reduced risk has been reported in women using oestrogen only (0,625 mg conjugated estrogens) (WHI-E). In women without risk factors, the attributable risk of suffering from a stroke or thromboembolism, following using MHT, is slow in women younger than 60 years of age. While, MHT (WHI-EP), was associated with an increased risk of coronary disease, in women who started their treatment around the age of 67 years, oestrogen only treatment (WHI-E), has been associated with a reduced coronary risk in women who initiated the therapy at a younger age (between 50-60 years), suggesting that the risks vary in relation to the used regimen and the treated population.
在这篇综述文章中，对更年期激素疗法（MHT）进行了更新。MHT是治疗更年期症状最有效的疗法。它还能预防骨质疏松症。然而，由于长期使用会增加健康风险，对于没有更年期症状的骨质疏松症女性，首选其他疗法，并结合钙和维生素D。据报道，使用固定剂量的雌激素和孕激素联合方案（0.625毫克结合雌激素（CEE）+5毫克醋酸甲羟孕酮（MPA）（WHI-EP））治疗5年后的女性患乳腺癌风险增加，而仅使用雌激素（0.625毫克结合雌激素）（WHI-E）的女性患乳腺癌风险降低。在没有风险因素的女性中，60岁以下女性使用MHT后患中风或血栓栓塞的归因风险较低。虽然，MHT（WHI-EP）与冠心病风险增加有关，在67岁左右开始治疗的女性中，仅雌激素治疗（WHI-E）与较年轻（50-60岁之间）开始治疗的女性冠心病风险降低有关，这表明风险因使用的方案和治疗人群而异。
