Cyganek Anna, Pietrzak Bronisława, Wielgoś Mirosław, Grzechocińska Barbara
1 Chair and Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland.
Prz Menopauzalny. 2016 Mar;15(1):1-5. doi: 10.5114/pm.2016.58765. Epub 2016 Mar 29.
Women after organ transplantation with chronic immunosuppressive therapy or after bone marrow transplantation without such therapy are a growing group of patients. Although their problems in the peri- and postmenopausal period are the same as in healthy women, due to the primary disease and treatment applied they represent a huge challenge from the point of view of their hormonal treatment of menopause. Transplanted women have no particular contraindications for hormonal therapy use. General contraindications, however, such as arterial hypertension, thrombosis in medical history, diabetes, endometriosis, myomas, or active neoplastic disease, have a higher incidence in this group of patients than in healthy women, which significantly influences the possibility of using hormonal therapy. On the other hand, taking into consideration the predisposition for premature menopause in this group, in combination with chronic immunosuppression, it predisposes these patients for higher cardiovascular disease incidence and bone density loss, so hormonal therapy would be highly advisable. Therapy management in transplanted patients requires special care and close monitoring of the transplanted organ. Saving lives with organ transplantation is one of the greatest achievements of contemporary medicine. For long-term improvement of their quality of life, emphasis should be put on regular diagnostic examinations, early detection of abnormalities, and introduction of effective treatment.
接受慢性免疫抑制治疗的器官移植女性或未接受此类治疗的骨髓移植女性患者群体正在不断扩大。尽管她们在围绝经期和绝经后期的问题与健康女性相同，但由于原发性疾病和所采用的治疗方法，从更年期激素治疗的角度来看，她们面临着巨大挑战。移植女性使用激素疗法没有特殊禁忌证。然而，一般禁忌证，如动脉高血压、病史中有血栓形成、糖尿病、子宫内膜异位症、肌瘤或活动性肿瘤疾病，在这组患者中的发生率高于健康女性，这显著影响了使用激素疗法的可能性。另一方面，考虑到这组患者有过早绝经的倾向，再加上慢性免疫抑制，使这些患者患心血管疾病的发生率更高且骨密度降低，因此激素疗法非常可取。移植患者的治疗管理需要特别小心并密切监测移植器官。器官移植挽救生命是当代医学最伟大的成就之一。为了长期改善她们的生活质量，应强调定期进行诊断检查、早期发现异常并引入有效治疗。
