Pinkerton Joann V
University of Virginia Health System, Charlottesville, Virginia; The North American Menopause Society, Cleveland, Ohio.
Clin Obstet Gynecol. 2018 Sep;61(3):447-453. doi: 10.1097/GRF.0000000000000383.
The goal of the 2017 North American Menopause Society Hormone Therapy (HT) Position Statement is to remove fear about HT and encourage individualized shared decision making, using best available evidence. Systemic HT is safe and effective for symptomatic menopausal women aged younger than 60 years and within 10 years of menopause. Special populations of early menopause, high risk for fracture, risk of breast or uterine cancer, and extended duration are discussed. With longer duration of use, periodic evaluation and reassessment of health risks are needed. Lowered doses, transdermal therapies or newer options may enhance the benefit:risk ratio for HT.
2017年北美更年期协会激素治疗(HT)立场声明的目标是消除对激素治疗的恐惧,并鼓励根据现有最佳证据进行个体化的共同决策。对于60岁以下且绝经10年内出现症状的绝经后女性,全身激素治疗是安全有效的。文中还讨论了早发性绝经、骨折高风险、乳腺癌或子宫癌风险以及延长治疗时间等特殊人群。随着使用时间延长,需要定期评估和重新评估健康风险。降低剂量、经皮治疗或新的治疗选择可能会提高激素治疗的效益风险比。