Navy Medical Readiness and Training Command (NMRTC) - U.S. Naval Hospital Rota, PSC 819 Box 18 FPO, AE 09645-0018.
FP Essent. 2023 Aug;531:15-21.
The marked decrease in estrogen levels in menopausal women can cause bothersome symptoms that affect daily life. More than 75% of women experience menopausal symptoms, which can include vaginal dryness, itching, discharge, dyspareunia, mood changes, hot flushes, and night sweats. Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms. Benefits include decreased risk of osteoporotic fractures and vaginal atrophy, improved glycemic control, and decreased vasomotor symptoms. However, recent research on risks associated with MHT has shown increased risk of venous thromboembolism and breast cancer. MHT typically is an option for patients younger than 60 years or within 10 years of menopause onset with bothersome vasomotor symptoms. The decision to start MHT should be made on an individual basis after a thorough evaluation and counseling. Oral, intramuscular, transdermal, and intravaginal formulations are available. The goal of therapy is use of the lowest dose for the shortest time that effectively manages symptoms. The patient and physician should regularly assess the risks and benefits associated with MHT and ensure that the benefits of its use continue to outweigh the risks.
绝经后女性的雌激素水平显著下降会引起困扰日常生活的症状。超过 75%的女性经历过绝经症状，这些症状包括阴道干燥、瘙痒、分泌物、性交困难、情绪变化、热潮红和盗汗。激素替代疗法（MHT）是治疗血管舒缩症状最有效的方法。其益处包括降低骨质疏松性骨折和阴道萎缩的风险、改善血糖控制和减少血管舒缩症状。然而，最近关于 MHT 相关风险的研究表明，静脉血栓栓塞和乳腺癌的风险增加。MHT 通常是 60 岁以下或绝经后 10 年内有血管舒缩症状的患者的选择。在进行全面评估和咨询后，应根据个人情况决定是否开始 MHT。口服、肌肉注射、透皮和阴道制剂均可使用。治疗的目标是使用最低剂量最短时间有效控制症状。患者和医生应定期评估 MHT 的风险和益处，并确保其使用的益处继续超过风险。
