Cheang A, Kottegoda S R, Ratnam S S
Ann Acad Med Singap. 1987 Jan;16(1):66-73.
The menopause is the physiologic cessation of normal, cyclic ovarian function. The development of vasomotor symptoms, atrophic changes in the genito-urinary system and osteoporosis are associated with oestrogen deficiency. Osteoporosis is the most important consequence of ovarian failure because it causes considerable morbidity and mortality. There is no simple screening test for detecting postmenopausal women who are at risk of developing osteoporosis. Oestrogen replacement therapy affects lipid metabolism and may be associated with the risk of developing endometrial cancer, breast cancer and thromboembolic disease. The addition of a progestogen regime have shown to reduce the risk of endometrial pathology. The most consistent and beneficial effect of oestrogen is the prevention of osteoporosis and subsequent fractures. Non-hormonal treatment regimes for postmenopausal osteoporosis include calcium, calcitonin and 1-alpha hydroxyvitamin D. It may be possible to use hormonal treatment for the optimal control of menopausal symptoms and non-hormonal treatment as long term prophylaxis.
更年期是正常周期性卵巢功能的生理性终止。血管舒缩症状的出现、泌尿生殖系统的萎缩性变化以及骨质疏松症都与雌激素缺乏有关。骨质疏松症是卵巢功能衰竭最重要的后果，因为它会导致相当高的发病率和死亡率。目前没有简单的筛查试验来检测有患骨质疏松症风险的绝经后女性。雌激素替代疗法会影响脂质代谢，可能与患子宫内膜癌、乳腺癌和血栓栓塞性疾病的风险有关。添加孕激素方案已显示可降低子宫内膜病变的风险。雌激素最一致且有益的作用是预防骨质疏松症及随后的骨折。绝经后骨质疏松症的非激素治疗方案包括钙剂、降钙素和1-α羟维生素D。或许可以采用激素治疗来最佳控制更年期症状，并采用非激素治疗进行长期预防。
