Henes M, Hübner S
Department für Frauengesundheit, Universitätsfrauenklinik Tübingen, Calwerstr. 7, 72076, Tübingen, Deutschland.
Internist (Berl). 2020 Jun;61(6):558-564. doi: 10.1007/s00108-020-00789-x.
Peri- and postmenopausal disorders can have a significant impact on quality of life. Hormone replacement therapy (HRT) might be necessary in order to decrease women's symptoms. The German S3 guideline "Peri- and Postmenopause-Diagnostics and Therapy" (2020) provides recommendations that include the most recent evidence as well as the Women's Health Initiative (WHI) study results from 2002 and 2004. These results led to reduced prescription patterns due to a high risk of cardiovascular diseases as well as an increased risk for breast cancer if HRT had been administered. Both ongoing analyses of subgroups and other studies extenuated the WHI data, since the increased risks were neither generalizable to the typical postmenopausal patient (regarding age and risk profile) nor to the medication being used today. This article summarizes all aspects of HRT in peri- and postmenopausal women (indications, contraindications, practical approaches, risks, prevention) and provides recommendations with respect to the most recent S3 guideline.
围绝经期和绝经后疾病会对生活质量产生重大影响。为减轻女性症状,可能需要进行激素替代疗法(HRT)。德国S3指南《围绝经期和绝经后——诊断与治疗》(2020年)提供了相关建议,其中包括最新证据以及2002年和2004年妇女健康倡议(WHI)研究的结果。这些结果导致HRT的处方量减少,因为使用HRT会有较高的心血管疾病风险以及患乳腺癌风险增加。对亚组的持续分析和其他研究弱化了WHI的数据,因为增加的风险既不能推广到典型的绝经后患者(在年龄和风险状况方面),也不适用于当今使用的药物。本文总结了围绝经期和绝经后女性HRT的各个方面(适应症、禁忌症、实际方法、风险、预防),并根据最新的S3指南提供了建议。