Palacios S, Mejía Ríos A
Palacios Institute of Women's Health, Madrid, Spain.
Drugs Today (Barc). 2015 Feb;51(2):107-16. doi: 10.1358/dot.2015.51.2.2281023.
The decrease of estrogen in postmenopausal women has been associated with the presence of different symptoms such as vasomotor symptoms, vulvovaginal atrophy, bone loss, sleep disturbances, and mood and sexual activity alterations. Hormone replacement therapy with estrogen and progestins has been used to improve menopausal symptoms; however, there are still concerns regarding its safety and tolerability, as some progestins have been shown to increase breast cancer and cardiovascular risk. Bazedoxifene is a third-generation selective estrogen receptor modulator (SERM) used for osteoporosis management in postmenopausal women at fracture risk that has demonstrated a powerful antiestrogenic effect on the endometrium. Today we have a new alternative called the tissue-selective estrogen complex (TSEC), which combines bazedoxifene and conjugated estrogens and is designed not only to improve menopausal symptoms and vulvovaginal atrophy but also to prevent bone loss. Therefore, it maintains the benefits of estrogen therapy while antagonizing the stimulation effects on the endometrium and mammary gland without the effects associated with progestins.
绝经后女性雌激素水平下降与多种症状有关,如血管舒缩症状、外阴阴道萎缩、骨质流失、睡眠障碍以及情绪和性活动改变。雌激素和孕激素的激素替代疗法已被用于改善绝经症状;然而,其安全性和耐受性仍令人担忧,因为一些孕激素已被证明会增加乳腺癌和心血管疾病风险。巴多昔芬是一种第三代选择性雌激素受体调节剂(SERM),用于治疗有骨折风险的绝经后女性的骨质疏松症,已证明对子宫内膜具有强大的抗雌激素作用。如今,我们有一种新的选择,称为组织选择性雌激素复合物(TSEC),它将巴多昔芬和共轭雌激素结合在一起,不仅旨在改善绝经症状和外阴阴道萎缩,还能预防骨质流失。因此,它在维持雌激素疗法益处的同时,拮抗对子宫内膜和乳腺的刺激作用,且没有与孕激素相关的影响。