Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, The University of Pisa, Pisa, Italy.
Obstetrics and Gynaecology, Divakars Speciality Hospital, Bengaluru, India.
Int J Gynaecol Obstet. 2024 Feb;164(2):516-530. doi: 10.1002/ijgo.15278. Epub 2024 Jan 4.
Menopause marks the end of menstrual cyclicity and, depending on individual vulnerability, has several consequences related to gonadal steroid deprivation, especially if it is premature. Menopause may be more burdensome for some women than for others. Individual factors, such as personal history, socioeconomic status, ethnicity, and current health conditions, affect symptomatology and, thereby, the menopausal experience. In addition, some menopausal symptoms, such as severe hot flashes, sleep disorders, and depression, are markers of future health risks. Counseling is a fundamental part of health care in the peri- and postmenopause periods. It must include an assessment of the patient's symptoms, needs, desires, and risk profile to address the benefits and risks of menopausal hormone therapy (MHT) on an individual basis and promote a healthy lifestyle. Indeed, healthcare practitioners can and must protect the health and lives of mid-life women by increasing awareness of menopausal symptoms and ensuring healthcare options, especially MHT. The type and duration of MHT should be tailored based on the patient's history, menopausal age, physical characteristics, and current health status so that the benefits always outweigh the risks. This FIGO position paper focuses on the benefits and risks of MHT on health domains, target organs, and systems, and on systemic and vaginal MHT regimens, to provide indications that can be used in the clinical practice for menopausal counseling. Moreover, it offers insights into what FIGO considers the mainstay for the healthcare management of women in peri- and postmenopause, worldwide.
绝经标志着月经周期的结束，并且取决于个体的脆弱性，它会带来与性腺类固醇缺乏有关的多种后果，尤其是如果绝经过早的话。对于一些女性来说，绝经可能比其他人更具负担。个人因素，如个人病史、社会经济地位、种族和当前健康状况，会影响症状表现，从而影响绝经体验。此外，一些绝经症状，如严重的热潮红、睡眠障碍和抑郁，是未来健康风险的标志物。咨询是围绝经期和绝经后期间保健的一个基本组成部分。它必须包括评估患者的症状、需求、愿望和风险概况，以根据个体情况解决绝经激素治疗 (MHT) 的益处和风险，并促进健康的生活方式。实际上，医疗保健从业者可以而且必须通过提高对绝经症状的认识并确保医疗保健选择，特别是 MHT，来保护中年女性的健康和生命。MHT 的类型和持续时间应根据患者的病史、绝经年龄、身体特征和当前健康状况进行调整，以便始终使益处大于风险。这份 FIGO 立场文件重点关注 MHT 对健康领域、靶器官和系统以及全身和阴道 MHT 方案的益处和风险，为绝经咨询提供可以在临床实践中使用的适应症。此外，它还深入探讨了 FIGO 认为是全球围绝经期和绝经后女性保健管理的主要内容。
