Gompel A
a Unité de Gynécologie Endocrinienne , Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin , Paris , France.
Climacteric. 2018 Aug;21(4):321-325. doi: 10.1080/13697137.2018.1446932. Epub 2018 Mar 27.
It is well established that unopposed estrogen for hormone therapy in postmenopausal women (MHT) induces a dose-related stimulation of the endometrium associated with an increased risk of hyperplasia and endometrial cancer. Progesterone acts physiologically to counteract the proliferative effects of estradiol during the menstrual cycle. In MHT, progestogens protect the endometrium against the proliferative effects of estrogens in women with a uterus. Recent data suggest that, whereas micronized progesterone is apparently safer for the breast, it could be less efficient than synthetic progestin on the endometrium. An update on progestogen and endometrial safety in MHT is the subject of this review.
众所周知，绝经后女性激素治疗（MHT）中使用无对抗的雌激素会导致子宫内膜受到剂量相关的刺激，同时伴有增生和子宫内膜癌风险增加。在月经周期中，孕激素发挥生理作用以抵消雌二醇的增殖作用。在MHT中，孕激素可保护有子宫的女性子宫内膜免受雌激素的增殖影响。近期数据表明，虽然微粒化孕酮对乳腺似乎更安全，但在子宫内膜方面其效果可能不如合成孕激素。本文综述了MHT中孕激素与子宫内膜安全性的最新情况。
