Blümel Juan Enrique, Arteaga Eugenio
Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Departamento de Endocrinología, Programa de Endocrinología Ginecológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2018 Dec;146(10):1170-1174. doi: 10.4067/S0034-98872018001001170.
The hormonal deficit of post menopause is not only linked to the classic hot flashes, but also to a higher risk of chronic diseases. Menopausal hormone therapy (MHT) adequately treats climacteric symptoms and can prevent some chronic diseases such as osteoporosis. The Women's Health Initiative (WHI) study, which indicated risks of MHT in elderly postmenopausal women, caused a massive withdrawal of this therapy. But, in recent years the results of the WHI have been challenged by methodological problems and by several studies indicating that, if MHT is initiated early and the non-oral route is preferred, the risks could be minimized and it could improve not only the quality of life but also reduce the risk of chronic diseases. However, the US Preventive Services Task Force (USPSTF) recommends against the use of MHT for the prevention of chronic diseases, a position that has been challenged by publications of the North American Menopause Society and the International Menopause Society. This controversy persists so far. We report data that suggest a preventive role of MHT in perimenopausal women.
绝经后的激素缺乏不仅与典型的潮热有关,还与患慢性病的风险增加有关。更年期激素疗法(MHT)能有效治疗更年期症状,并可预防一些慢性病,如骨质疏松症。妇女健康倡议(WHI)研究表明老年绝经后妇女使用MHT存在风险,导致这种疗法大量停用。但是,近年来,WHI的结果受到方法学问题以及多项研究的质疑,这些研究表明,如果早期开始使用MHT并优先选择非口服途径,风险可以降至最低,不仅可以改善生活质量,还能降低慢性病风险。然而,美国预防服务工作组(USPSTF)建议不要使用MHT预防慢性病,这一立场受到了北美更年期协会和国际更年期协会出版物的质疑。这一争议至今仍在持续。我们报告的数据表明MHT对围绝经期妇女有预防作用。