Beginnings Assisted Conception Unit, Epsom and St Helier University Hospitals, London, UK; Comprehensive Clinical Trials Unit, Institute for Clinical Trials and Methodology, University College London, London, UK.
Reproductive Medicine Unit, University College London Hospital, London, UK.
Best Pract Res Clin Endocrinol Metab. 2024 Jan;38(1):101819. doi: 10.1016/j.beem.2023.101819. Epub 2023 Aug 25.
Women are living a significant portion of their adult lives in the post-reproductive phase, and many seek help for debilitating menopausal symptoms. Every individual's experience of menopausal transition is unique. Adopting a holistic approach to managing the menopause using a combination of lifestyle, hormonal, and non-hormonal interventions is key to maximise the quality of life of affected women. However, many opt to use non hormonal options or have contraindications to using hormonal therapy. Studies have shown that several pharmacological non-hormonal medications such as SSRIs, SSRI/SNRIs, Gabapentin, and Pregabalin are effective for managing vasomotor symptoms as well as other menopausal symptoms. Their main side effects are dry mouth, nausea, constipation, reduced libido, and loss of appetite. Clonidine is the only non-hormonal drug which is licenced for control of vasomotor symptoms in the UK, but has several side effects including dizziness and sleep disturbance. Cognitive Behavioural Therapy is recommended as a treatment for anxiety, sleep problems and vasomotor symptoms related to menopausal transition. Evidence for clinical efficacy and safety of herbal remedies and alternative therapies remains weak. Studies with neurokinin receptor 3 antagonists on women with hot flushes have shown improvement in vasomotor symptoms and results of large-scale studies are awaited.
女性在成年后的很大一部分时间都处于绝经后阶段，许多人因绝经相关的衰弱症状寻求帮助。每个人的绝经过渡体验都是独特的。采用整体方法，通过生活方式、激素和非激素干预措施相结合来管理绝经，是提高受影响女性生活质量的关键。然而，许多人选择使用非激素方法，或者对激素治疗有禁忌症。研究表明，几种药理学非激素药物，如 SSRIs、SSRIs/SNRIs、加巴喷丁和普瑞巴林，对管理血管舒缩症状以及其他绝经症状都有效。它们的主要副作用是口干、恶心、便秘、性欲降低和食欲不振。可乐定是唯一在英国获准用于控制血管舒缩症状的非激素药物，但有几个副作用，包括头晕和睡眠障碍。认知行为疗法被推荐作为治疗焦虑、睡眠问题和与绝经过渡相关的血管舒缩症状的方法。草药和替代疗法的临床疗效和安全性证据仍然薄弱。对患有热潮红的女性使用神经激肽受体 3 拮抗剂的研究表明，血管舒缩症状有所改善，正在等待大规模研究的结果。
