Yang T S, Tsan S H, Chang S P, Ng H T
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1995 May;55(5):386-91.
As an estrogen derivative, estriol is rather effective in the relief of climacteric symptoms due to estrogen deficiency. When given one dose a day, it will not provoke endometrial proliferation and shedding. Thus, it is suitable for postmenopausal women who no longer want to have uterine bleeding and for those with comparatively higher risk of endometrial hyperplasia. In the aspect of postmenopausal osteoporosis, the prevention of further bone loss due to estrogen deficiency is also important and to be evaluated.
We collected 20 patients, aged 44-62 years, who had undergone either natural or surgical menopause and were treated with estriol succinate (Synapause; Organon; Holland 2 mg/tab) 2 mg/day for 2 years, with relief of climacteric symptoms evaluated after the first 3 months of treatment. Bone mineral density (BMD) of lumbar spine was measured using quantitative computed tomography (QCT) after one and two years of treatment, respectively.
Estriol was very effective in the improvement of major subjective climacteric complaints in 86% of patients, especially hot flush and insomnia within 3 months. The atrophic genital changes caused by estrogen deficiency were also improved satisfactorily. No subjective symptoms induced by the therapy were seen. The rate of uterine bleeding was low, complained by only one patient. However, our study did not show the preventive effect of estriol against osteoporosis.
Estriol can be a safe and effective alternative in the relief of climacteric symptoms for postmenopausal women, but it cannot prevent the bone loss.
作为一种雌激素衍生物，雌三醇在缓解因雌激素缺乏引起的更年期症状方面相当有效。每天服用一剂时，它不会引发子宫内膜增殖和脱落。因此，它适用于不再希望出现子宫出血的绝经后妇女以及子宫内膜增生风险相对较高的妇女。在绝经后骨质疏松方面，预防因雌激素缺乏导致的进一步骨质流失也很重要，有待评估。
我们收集了20名年龄在44 - 62岁之间的患者，她们经历了自然绝经或手术绝经，并接受了琥珀酸雌三醇（Synapause；欧加农公司；荷兰，2毫克/片）治疗，每天2毫克，持续2年，在治疗的前3个月后评估更年期症状的缓解情况。分别在治疗1年和2年后，使用定量计算机断层扫描（QCT）测量腰椎的骨密度（BMD）。
雌三醇在改善86%患者的主要主观更年期症状方面非常有效，尤其是在3个月内缓解潮热和失眠。雌激素缺乏引起的生殖器萎缩变化也得到了令人满意的改善。未观察到治疗引起的主观症状。子宫出血发生率较低，仅有一名患者抱怨。然而，我们的研究未显示雌三醇对骨质疏松的预防作用。
雌三醇可以是绝经后妇女缓解更年期症状的一种安全有效的替代药物，但它不能预防骨质流失。
