Völker W, Hesch R D, Schneider H P
Geburtshilfe Frauenheilkd. 1985 May;45(5):326-32. doi: 10.1055/s-2008-1036469.
Public opinion and a large proportion of physicians believe that very often women must necessarily experience a restricted quality of life as a result of menopause, postmenopause and the senium, and that even a possible early death from the sequels of osteoporosis is quite natural and hence inevitable. However, the present state of the art rules out such fatalism, since it has been established beyond doubt that early initiation of oestrogen and progestagen substitution after the menopause is of high prophylactic value both from the viewpoint of social medicine and also in each individual case. Calculations of cost and effect in elderly women have shown that treatment results in reduced morbidity and mortality caused by carcinoma of the breast and of the endometrium, and also by cardiovascular disease, quite apart from an enhanced quality of life. Hence, all women who would like to receive such prophylactic treatment--in particular, also risk patients likely to suffer from osteoporosis-should definitely not be deprived of regular long-term administration of oestrogen that should continue until old age. The only basic condition is the sequential administration of oestrogen and progestagen at low dosage levels.
公众舆论以及很大一部分医生认为，女性常常必然会因更年期、绝经后期和老年期而经历生活质量受限的情况，甚至因骨质疏松症后遗症而早逝也相当自然，因此不可避免。然而，目前的技术水平排除了这种宿命论，因为毫无疑问，绝经后尽早开始雌激素和孕激素替代疗法，从社会医学角度以及在每个个体病例中都具有很高的预防价值。对老年女性的成本效益计算表明，这种治疗除了能提高生活质量外，还能降低乳腺癌、子宫内膜癌以及心血管疾病导致的发病率和死亡率。因此，所有希望接受这种预防性治疗的女性——尤其是那些可能患骨质疏松症的高危患者——绝对不应被剥夺持续至老年的常规长期雌激素给药。唯一的基本条件是以低剂量顺序服用雌激素和孕激素。
