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结合证据与临床判断来管理更年期。

Managing Menopause by Combining Evidence With Clinical Judgment.

作者信息

Shufelt Chrisandra, Manson Joann

机构信息

Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California.

Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

出版信息

Clin Obstet Gynecol. 2018 Sep;61(3):470-479. doi: 10.1097/GRF.0000000000000378.

Abstract

In the United States, nearly 10 million women are currently in the menopause transition and 2.25 million women are 51 years of age, which is the average age of menopause. Approximately 75% of these women will experience vasomotor symptoms such as hot flashes and night sweats. Menopause hormone therapy (HT) remains the most effective treatment for menopausal symptoms, but the decision to use HT is complex and requires balancing the benefits and risks for the individual patient. The decision also requires clinical judgment and shared decision making with the patient. In this review, we discuss the current guidelines for HT use, the benefits and risks for the individual patient and a novel algorithm and clinical decision support tool for menopausal symptom management that facilitates shared decision making between clinician and patient.

摘要

在美国,目前有近1000万女性处于绝经过渡阶段,225万女性年龄为51岁,这是绝经的平均年龄。这些女性中约75%会出现潮热和盗汗等血管舒缩症状。绝经激素治疗(HT)仍然是治疗绝经症状最有效的方法,但使用HT的决定很复杂,需要权衡个体患者的获益与风险。该决定还需要临床判断并与患者共同决策。在本综述中,我们讨论了HT使用的当前指南、个体患者的获益与风险,以及一种用于绝经症状管理的新型算法和临床决策支持工具,该工具有助于临床医生和患者之间的共同决策。

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