Lee Dong Yun
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Menopausal Med. 2020 Aug;26(2):99-103. doi: 10.6118/jmm.20015.
Although estrogen-progestin therapy has traditionally been standard care for postmenopausal women with an intact uterus experiencing bothersome menopausal symptoms, concerns about side effects related to menopausal hormone therapy (MHT) have led to a dramatic decrease in MHT use over recent decades. As many MHT side effects are now believed to be associated with the progestin component of MHT, efforts have been made to develop a progestin-free alternative to conventional MHT. Recently, a tissue-selective estrogen complex (TSEC), a combination of conjugated estrogen and bazedoxifene, was developed as a progestin-free MHT and is now approved and used worldwide for the relief of vasomotor symptoms and the prevention of bone loss in postmenopausal women. Replacement of synthetic progestin with bazedoxifene could allow more favorable safety profiles, such as those for pain or tenderness, mammographic density, and cancer incidence, for the breast. This review examined the effects of the TSEC on breasts and demonstrated evidence from preclinical and clinical studies supporting TSEC use in clinical practice.
尽管传统上雌激素 - 孕激素疗法一直是子宫完整且经历令人烦恼的绝经症状的绝经后女性的标准治疗方法，但近几十年来，对绝经激素治疗（MHT）相关副作用的担忧导致MHT的使用大幅下降。由于现在认为许多MHT副作用与MHT的孕激素成分有关，人们已努力开发一种不含孕激素的传统MHT替代品。最近，一种组织选择性雌激素复合物（TSEC），即结合雌激素和巴多昔芬的组合，被开发为不含孕激素的MHT，目前已在全球范围内获批用于缓解绝经后女性的血管舒缩症状和预防骨质流失。用巴多昔芬替代合成孕激素可能会使乳房具有更有利的安全性，如疼痛或压痛、乳腺X线密度和癌症发病率方面。本综述研究了TSEC对乳房的影响，并展示了临床前和临床研究的证据，支持TSEC在临床实践中的应用。
