Brzozowska Maria, Lewinski Andrzej
Department of Endocrinology and Metabolic Diseases, Medical University, Lodz, Poland Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
Prz Menopauzalny. 2021 Apr;20(1):34-39. doi: 10.5114/pm.2021.104572. Epub 2021 Mar 18.
Sudden cessation of ovary activity as a result of bilateral oophorectomy or chemo- or radiotherapy in premenopausal women is linked with more serious consequences that bear no comparison to natural menopause - to name just a few: higher rate of mortality, higher rate of colorectal and lung cancer, circulatory system diseases, cognitive disorders, Parkinson's disease, psychological disorders, osteoporosis, and sexual disorders. The prolonged period of estrogens deficit in premenopausal age is connected with worsened quality of life. The progress in oncological care means that in many malignant diseases, also in the case of gynaecological malignancies, the percentage of survivors increases. This makes improving the quality of life more and more important. The purpose of this review is to establish, based on EBM data, the answer to whether replacement hormonal therapy, being the most effective treatment of menopause symptoms, can be recommended for women who have undergone bilateral oophorectomy because of gynaecological cancer. On the basis of collected data, derived from meta-analysis, and studies which have been published within the last 20 years, it seems that the use of the appropriate type of hormonal replacement therapy (HRT) in properly selected gynaecological cancer survivors (epithelial ovarian cancer - EOC, endometrial cancer, squamous cell carcinoma of the cervix) is safe and effective. It seems that benefits connected with better quality of life that stem from the use of appropriate HRT in gynaecological cancer survivors predominate the unfounded fear of disease recurrence in selected patients' groups.
绝经前女性因双侧卵巢切除术或放化疗导致卵巢活动突然停止，会带来比自然绝经更严重的后果，仅举几例：死亡率更高、结直肠癌和肺癌发病率更高、循环系统疾病、认知障碍、帕金森病、心理障碍、骨质疏松症和性功能障碍。绝经前雌激素缺乏的延长与生活质量下降有关。肿瘤护理的进展意味着在许多恶性疾病中，包括妇科恶性肿瘤，幸存者的比例增加。这使得提高生活质量变得越来越重要。本综述的目的是基于循证医学数据，确定对于因妇科癌症接受双侧卵巢切除术的女性，作为治疗更年期症状最有效方法的激素替代疗法是否可以推荐。根据从荟萃分析以及过去20年发表的研究中收集的数据，似乎在适当选择的妇科癌症幸存者（上皮性卵巢癌-EOC、子宫内膜癌、宫颈鳞状细胞癌）中使用适当类型的激素替代疗法（HRT）是安全有效的。似乎在妇科癌症幸存者中使用适当的HRT所带来的生活质量改善的益处，在特定患者群体中超过了对疾病复发的无端恐惧。
