Gompel A
Service du Pr P. Poitout, Hôtel-Dieu de Paris.
Rev Prat. 1993 Dec 15;43(20):2645-50.
Hormone replacement therapy is prescribed to post-menopausal women in order to correct oestrogen deficiency and its short- or long-term consequences. Progestogens are combined with oestrogens to prevent the proliferative effect of the latter on the endometrium. There are three classes of progestogens: normethyl testosterone derivatives, pregnanes and norpregnanes, and natural progesterone. The usual choice is either natural progesterone or 17-hydroxyprogesterone derivatives which do not carry metabolic or vascular risks. The endometrium is protected by simple therapeutic rules: the doses of oestradiol must be minimal to prevent osteoporosis, and this product must not be administered alone for a sequence longer than 13 days. The progestogen sequence must last for 12 days. The wide range of progestogens available in France enables individual adjustments to be made. Using progestogens alone could be interesting in women from whom oestrogenic treatments are contraindicated, in view of their effect on sudden flush and on bone.
激素替代疗法被开给绝经后女性，以纠正雌激素缺乏及其短期或长期后果。孕激素与雌激素联合使用，以防止后者对子宫内膜的增殖作用。孕激素有三类：去甲睾酮衍生物、孕烷和去甲孕烷，以及天然孕酮。通常的选择是天然孕酮或17-羟孕酮衍生物，它们没有代谢或血管风险。通过简单的治疗规则来保护子宫内膜：雌二醇的剂量必须最小化以预防骨质疏松症，并且该产品不得单独给药超过13天。孕激素疗程必须持续12天。法国有多种可用的孕激素，能够进行个体化调整。鉴于孕激素对潮热和骨骼的作用，对于雌激素治疗禁忌的女性，单独使用孕激素可能是有益的。
