Upton G V
Obstet Gynecol Clin North Am. 1987 Mar;14(1):207-27.
All the existing data show that combination estrogen/progestogen therapy is mandatory if any replacement therapy is to be given to the woman over age 40. Sufficient evidence has indicated that estrogen alone is inadequate; progestogen must be given to prevent endometrial hyperplasia, lower the risk of breast cancer, and prevent bone loss. In the premenopausal woman, such therapy should also provide contraception. Because of the lack of minimal dose products fulfilling such criteria, many physicians will allow women to continue with their contraceptive if they do not smoke and have no other contraindications. It will remain to be seen if a product close to ideal can be found to fulfill the contraceptive and therapeutic needs of women traversing the most physiologically hazardous period of their lives.
所有现有数据表明，如果要对40岁以上的女性进行任何替代疗法，雌激素/孕激素联合治疗是必不可少的。充分的证据表明，单独使用雌激素是不够的；必须给予孕激素以预防子宫内膜增生、降低乳腺癌风险并预防骨质流失。对于绝经前女性，这种疗法还应具备避孕作用。由于缺乏符合这些标准的最低剂量产品，如果女性不吸烟且没有其他禁忌证，许多医生会允许她们继续使用现有的避孕方法。能否找到接近理想的产品来满足处于人生中生理上最危险时期的女性的避孕和治疗需求，还有待观察。
