Whitehead M I, McQueen J, Minardi J, Campbell S
Postgrad Med J. 1978;54 Suppl 2:69-73.
Exogenous oestrogens prescribed for the relief of menopausal symptoms are being given in pharmacological doses and the term 'hormone replacement therapy' is inappropriate. The frequent development of endometrial hyperplasia during unopposed cyclical oestrogen therapy is therefore to be expected, but no single pattern of vaginal bleeding accurately reflected the histology of the endometrium. As such doses of oestrogens are required for effective relief of symptoms, progestogens must be given to protect against endometrial hyperstimulation. Patient acceptability of sequential oestrogen/progestogen therapy is high (90%) and with such therapy breakthrough bleeding may subsequently be shown to be a reliable indicator of underlying endometrial pathology.
为缓解更年期症状而开具的外源性雌激素采用的是药理剂量，“激素替代疗法”这一术语并不恰当。因此，在无对抗的周期性雌激素治疗期间子宫内膜增生频繁发生是可以预料的，但没有一种单一的阴道出血模式能准确反映子宫内膜的组织学情况。由于需要这样的雌激素剂量来有效缓解症状，必须给予孕激素以防止子宫内膜过度刺激。序贯雌激素/孕激素疗法的患者接受度很高（90%），采用这种疗法时，突破性出血随后可能会被证明是潜在子宫内膜病变的可靠指标。
