Perrone G, Capri O, Borrello M, Galoppi P
I Clinica Ostetrica e Ginecologica, Università degli Studi di Roma La Sapienza, Roma.
Minerva Ginecol. 1993 Dec;45(12):603-8.
Hormonal Replacement Therapy (HRT) is the most effective treatment of menopausal disturbances and has an established role in reducing the cardiovascular risk and in preventing the postmenopausal osteoporosis. Nevertheless several reports have evidenced that compliance with hormonal replacement therapy was not as good as expected, and that physician's and women's opinions can strongly influence the HRT choice, and the continuation of HRT use. The aim of this study was to assess the opinions and the expectations of menopausal women toward HRT. PATIENT AND METHODS. We utilized a questionnaire exploring social and affective conditions, and in particular women's opinions and experiences on menopause, hormonal therapy, the possibility of information, the reasons for accepting or refusing hormonal therapy. The questionnaires were administered to 226 menopausal clinic patients (Menopausal age: 2-10 years) in spontaneous menopause. RESULTS. 28% of the women were taking HRT at the time of the survey. Worries about menopause were reported by 27.4% of the group; this percentage was similar in both user and non-user groups. 70% received information on HRT from family doctors, and 63% from mass-media or conversations. 70% believes that the main problem of menopause is osteoporosis, and its prevention represents the most frequent aim that patients feel can be achieved by HRT. 67.5% of the group is afraid that long term treatment can be dangerous, however only 57% asked for detailed information to the doctor. To the question "Are you informed that HRT can reinduce menstrual bleeding?", 57.5% of the patients answered yes; 30% considered it to be a problem. CONCLUSIONS. Our study was carried out in a menopausal clinic and this can influence the answers of the respondents. Most women received some information on HRT, but their knowledge was only partial and did not eliminate the unrational fear of hormone therapy. Although long term use of HRT is to prevent CVD and menopausal osteoporosis, many of our patients specifically asked for treatment to be as short as possible. Women expectations's towards HRT are mainly referred to osteoporosis prevention and treatment: this may be explained by the high frequency of osteoarticular pain found in our patients; nevertheless it is possible that the more rational fear of osteoporosis hides the unconscious fear of a dramatic physical breakdown caused by the menopause. Detailed information to family doctors, to specialists, and to patients along with a further improvement of therapeutic regimens will allow a greater diffusion of HRT, bringing its short and long term benefits to an increasing number of women.
激素替代疗法（HRT）是治疗更年期紊乱最有效的方法，在降低心血管疾病风险和预防绝经后骨质疏松方面具有既定作用。然而，几份报告表明，激素替代疗法的依从性不如预期，医生和女性的意见会强烈影响HRT的选择以及HRT的持续使用。本研究的目的是评估更年期女性对HRT的意见和期望。患者与方法。我们使用了一份问卷来探究社会和情感状况，特别是女性对更年期、激素疗法、信息获取可能性、接受或拒绝激素疗法原因的意见和经历。问卷发放给了226名自然绝经的更年期门诊患者（绝经年龄：2 - 10年）。结果。调查时28%的女性正在接受HRT治疗。27.4%的受访者表示担心更年期；在使用者和非使用者群体中这一比例相似。70%的人从家庭医生那里获得了关于HRT的信息，63%的人从大众媒体或交谈中获得信息。70%的人认为更年期的主要问题是骨质疏松，其预防是患者认为HRT最常能实现的目标。67.5%的受访者担心长期治疗可能有危险，然而只有57%的人向医生询问了详细信息。对于“你是否了解HRT会再次引发月经出血？”这个问题，57.5%的患者回答是；30%的人认为这是个问题。结论。我们的研究是在更年期门诊进行的，这可能会影响受访者的回答。大多数女性获得了一些关于HRT的信息，但她们的了解并不全面，也没有消除对激素疗法的不合理恐惧。尽管长期使用HRT是为了预防心血管疾病和绝经后骨质疏松，但我们的许多患者特别要求治疗时间尽可能短。女性对HRT的期望主要涉及骨质疏松的预防和治疗：这可能是因为我们的患者中骨关节疼痛发生率较高；然而，对骨质疏松更合理的恐惧可能掩盖了对更年期导致身体剧烈变化的无意识恐惧。向家庭医生、专科医生和患者提供详细信息，并进一步改进治疗方案，将使HRT得到更广泛的应用，为越来越多的女性带来其短期和长期益处。
