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激素治疗方案管理绝经和卵巢早衰。

Hormone therapy regimens for managing the menopause and premature ovarian insufficiency.

机构信息

Menopause Unit, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece; Department of Diabetes and Endocrinology, University College London Hospital, London, United Kingdom.

Menopause Unit, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece.

出版信息

Best Pract Res Clin Endocrinol Metab. 2021 Dec;35(6):101561. doi: 10.1016/j.beem.2021.101561. Epub 2021 Jun 30.

Abstract

The transition to menopause is associated with a changing hormonal milieu, leading to bothersome menopausal symptoms in the short-term and chronic health problems in the long-term. Premature ovarian insufficiency (POI) is characterized by the cessation of menses before the age of 40 years. Hormone replacement therapy (HRT) is indicated to restore sex hormones to normal premenopausal levels and prevent chronic diseases, such as osteoporosis and cardiovascular disease. Menopausal hormone therapy (MHT) is indicated in perimenopausal and postmenopausal women over 45 years of age for managing menopausal symptoms, symptoms of vulvovaginal atrophy, and reducing the risk of postmenopausal osteoporosis. Individualization is the key to management, aiming at maximizing efficacy and minimizing clinically relevant risks. This review aimed to present the hormone therapy regimens for women during the transition or after menopause and women with POI and early menopause, as well as advise on: i) the initiation of MHT, ii) steps for monitoring during follow up, iii) weaning and discontinuation of treatment.

摘要

绝经过渡期与激素环境的变化相关,导致短期出现烦扰的更年期症状,长期则出现慢性健康问题。卵巢早衰(POI)的特征是在 40 岁之前闭经。激素替代疗法(HRT)用于将性激素恢复到正常绝经前水平,并预防骨质疏松症和心血管疾病等慢性疾病。绝经激素治疗(MHT)适用于 45 岁以上的围绝经期和绝经后妇女,用于治疗更年期症状、阴道萎缩症状,并降低绝经后骨质疏松症的风险。个体化是管理的关键,旨在最大限度地提高疗效和最小化临床相关风险。本综述旨在介绍女性在过渡或绝经后以及 POI 和早绝经期间的激素治疗方案,并就以下方面提供建议:i)MHT 的启动,ii)随访期间监测的步骤,iii)治疗的减药和停药。

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