Vigneswaran Kugajeevan, Hamoda Haitham
King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
Best Pract Res Clin Obstet Gynaecol. 2022 May;81:8-21. doi: 10.1016/j.bpobgyn.2021.12.001. Epub 2021 Dec 14.
Menopause is a major life event that can affect women in several ways. Its onset marks the end of the reproductive life cycle, and its impact can be both short and long term. Menopause is often a gradual process, preceded by a transitional period known as perimenopause. The average age of menopause in the UK is 51. The clinical manifestations of menopause result from the eventual exhaustion of oocytes within the ovaries. This leads to a chronic hypo-estrogenic state, which in the short term causes menopausal symptoms and over a long term, has an impact on bone and cardiovascular health. There has been a steep drop in the prescription of hormone replacement therapy (HRT) following the publication of the Women's Health Initiative Study and the Million Women Study. It is currently estimated that approximately a million women in the UK are taking HRT for control of their menopausal symptoms. This review summarises the current recommendations for HRT use in menopausal women. The benefits of HRT in improving the symptoms of menopause are discussed as well as the potential role of HRT in managing long-term sequelae is covered. Evidence pertaining to the potential risks associated with HRT is also be reviewed.
更年期是一个重大的生活事件,会在多个方面影响女性。它的开始标志着生殖生命周期的结束,其影响既有短期的,也有长期的。更年期通常是一个渐进的过程,在此之前有一个称为围绝经期的过渡阶段。英国女性的平均绝经年龄是51岁。更年期的临床表现是由于卵巢内卵母细胞最终耗尽所致。这会导致慢性低雌激素状态,短期内会引起更年期症状,长期来看,会对骨骼和心血管健康产生影响。在《妇女健康倡议研究》和《百万女性研究》发表后,激素替代疗法(HRT)的处方量急剧下降。目前估计,英国约有100万女性正在服用HRT来控制更年期症状。本综述总结了目前关于更年期女性使用HRT的建议。讨论了HRT在改善更年期症状方面的益处,以及HRT在管理长期后遗症方面的潜在作用。还将审查与HRT相关的潜在风险的证据。