Department of Obstetrics and Gynecology, University Hospitals of Cleveland, MacDonald Women's Hospital, Case Western Reserve University School of Medicine, Cleveland, and Ms. Medicine, Cincinnati, Ohio.
Obstet Gynecol. 2020 Apr;135(4):853-868. doi: 10.1097/AOG.0000000000003729.
Increasing numbers of women experience early menopause due in part to surgical treatment for benign gynecologic disorders and the rise in risk-reducing bilateral salpingo-oophorectomy in women with BRCA mutations. Unfortunately, the adverse health consequences of early loss of ovarian function accelerate the menopausal state and affect multiple systems, including cardiovascular, neurologic, bone, and connective tissue, and affect quality of life owing to vasomotor symptoms, mood, sleep, and sexual function. Yet many clinicians and women remain reluctant to use hormone therapy because of the Women's Health Initiative's adverse findings, even though they are not applicable to women with early menopause. This review examines the effects of early menopause and highlights the critical role of hormone therapy in this population.
越来越多的女性经历过早绝经,部分原因是接受了良性妇科疾病的手术治疗,以及携带 BRCA 突变的女性进行风险降低的双侧输卵管卵巢切除术的增加。不幸的是,卵巢功能过早丧失的不良健康后果加速了绝经状态,并影响多个系统,包括心血管、神经、骨骼和结缔组织,并由于血管舒缩症状、情绪、睡眠和性功能而影响生活质量。然而,许多临床医生和女性仍然不愿意使用激素治疗,因为妇女健康倡议的负面发现,尽管它们不适用于早绝经的女性。本综述探讨了早绝经的影响,并强调了激素治疗在这一人群中的关键作用。