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围绝经期疾病的管理:激素治疗。

Management of perimenopause disorders: hormonal treatment.

机构信息

Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy.

出版信息

Gynecol Endocrinol. 2021 Mar;37(3):195-200. doi: 10.1080/09513590.2020.1852544. Epub 2020 Dec 2.

Abstract

Perimenopause represents a transition period of a woman's life during which physiological, affective, psychological, and social changes mark progression from a woman's fertile life to menopause, with wide sexual hormones fluctuations until the onset of hypergonadotropic hypogonadic amenorrhea. Contraception during menopause should not only avoid unwanted pregnancies, but also improve quality of life and prevent wide range of condition affecting this population. Hormonal contraceptives confer many noncontraceptive benefits for women approaching menopause: treatment of abnormal uterine bleeding, relief from vasomotor symptoms, endometrial protection in women using estrogen therapy, musculoskeletal protection, and mood disorders protection. The main point remains selecting the most adequate contraceptive option for each woman, considering her risk factor, comorbidities, and keeping in mind the possibility of continuing contraception until reaching menopause and even further, creating a bridge between perimenopause and menopause hormonal therapy. Correct perimenopause management should rely on individualized medical therapy and multidisciplinary approach considering lifestyle and food habits as part of general good health of a woman.

摘要

围绝经期是女性生命中的一个过渡阶段,在此期间,生理、情感、心理和社会变化标志着女性从生育期向绝经的转变,广泛的性激素波动直到高促性腺激素性闭经的发生。围绝经期的避孕不仅要避免意外怀孕,还要提高生活质量,预防影响这一人群的多种疾病。激素避孕为接近绝经的女性带来了许多非避孕益处:治疗异常子宫出血、缓解血管舒缩症状、保护使用雌激素治疗的女性的子宫内膜、保护肌肉骨骼、保护情绪障碍。主要问题仍然是为每个女性选择最合适的避孕方法,考虑她的风险因素、合并症,并牢记可能继续避孕直到绝经,甚至更远,在围绝经期和绝经激素治疗之间架起一座桥梁。正确的围绝经期管理应依赖于个体化的医学治疗和多学科方法,将生活方式和饮食习惯作为女性整体健康的一部分来考虑。

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