Llaneza Placido, Calaf Joaquim, Jurado Ana Rosa, Mendoza Nicolas, Otero Borja, Quereda Francisco, Sánchez-Borrego Rafael, Lubian Daniel
a Hospital Universitario Central de Asturias , Oviedo , Spain.
b Fundació Puigvert Barcelona , Barcelona , Spain.
Gynecol Endocrinol. 2018 Oct;34(10):826-832. doi: 10.1080/09513590.2018.1474869. Epub 2018 May 23.
Tissue-selective estrogen complex (TSEC) is projected as a progestogen-free option for the treatment of estrogen deficiency symptoms in postmenopausal, non-hysterectomized women. TSEC combines the benefits of estrogen with a selective estrogen receptor modulator (SERM), in this case bazedoxifene acetate (BZA), which has an antagonistic effect on the endometrium, thus avoiding the use of progestins. The authorized TSEC combination (conjugated estrogens [CE] 0.45 mg/BZA 20 mg) for the alleviation of vasomotor symptoms has been demonstrated in randomized clinical trials compared with placebo or menopausal hormone therapy (MHT). In addition, TSEC has shown improvements in quality of life and vaginal atrophy. In respect to MHT using progestins, the benefits of TSEC are found mainly in the bleeding pattern, amenorrhea rate, and reduction in mammary repercussion (i.e., breast tenderness and radiological density). The objective of this guide will be to analyze the efficacy and safety of TSEC consisting of CE/BZA in postmenopausal women.
组织选择性雌激素复合物（TSEC）被视为一种无孕激素的选择，用于治疗绝经后未行子宫切除术女性的雌激素缺乏症状。TSEC将雌激素的益处与选择性雌激素受体调节剂（SERM）相结合，在此情况下为醋酸巴多昔芬（BZA），其对子宫内膜具有拮抗作用，从而避免使用孕激素。与安慰剂或绝经激素治疗（MHT）相比，已在随机临床试验中证实了用于缓解血管舒缩症状的获批TSEC组合（结合雌激素[CE]0.45毫克/BZA 20毫克）。此外，TSEC已显示出生活质量和阴道萎缩方面的改善。关于使用孕激素的MHT，TSEC的益处主要体现在出血模式、闭经率以及乳腺反应（即乳房压痛和放射学密度）的降低方面。本指南的目的是分析由CE/BZA组成的TSEC在绝经后女性中的疗效和安全性。
