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卵巢早衰——激素替代疗法及长期后果的管理

Premature ovarian insufficiency - hormone replacement therapy and management of long-term consequences.

作者信息

Machura Paulina, Grymowicz Monika, Rudnicka Ewa, Pięta Wojciech, Calik-Ksepka Anna, Skórska Jolanta, Smolarczyk Roman

机构信息

Department of Gynaecological Endocrinology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Prz Menopauzalny. 2018 Sep;17(3):135-138. doi: 10.5114/pm.2018.78559. Epub 2018 Sep 30.

Abstract

Premature ovarian insufficiency (POI) correlates with increased risk of cardiovascular diseases, osteoporosis, genitourinary syndrome, and other symptoms of prolonged oestrogen deprivation. Properly selected therapy improves the quality of women's lives and reduces the risk of mortality. There is a wide spectrum of available oestrogen and progestogen formulations restoring proper levels of serum sex steroid hormones. The treatment should be implemented at recognition of the POI and continued to at least the age of natural menopause. Transdermal oestradiol and oral or vaginal progesterone administration provide the most physiological sex steroid replacement therapy. Patients' views and individual preference according the route, dose, and regimen of hormonal treatment have to be taken into consideration in order to achieve high compliance rates. Women with POI should be managed by a multidisciplinary team, such as a gynaecologist, endocrinologist, dietitian, and psychologist.

摘要

卵巢早衰(POI)与心血管疾病、骨质疏松症、泌尿生殖综合征以及其他长期雌激素缺乏症状的风险增加相关。恰当选择的治疗可改善女性生活质量并降低死亡风险。有多种雌激素和孕激素制剂可恢复血清性激素的适当水平。治疗应在确诊POI时开始,并持续至至少自然绝经年龄。经皮雌二醇及口服或阴道用孕激素给药提供了最接近生理状态的性激素替代疗法。为了实现高依从率,必须考虑患者对激素治疗途径、剂量和方案的看法及个人偏好。POI女性应由多学科团队管理,如妇科医生、内分泌科医生、营养师和心理医生。

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