Coope J
Bollington Medical Centre, Macclesfield, Cheshire, UK.
Maturitas. 1996 Mar;23(2):159-68. doi: 10.1016/0378-5122(95)00971-x.
Recent cohort studies confirm that only flushes, night sweats and vaginal dryness are provenly associated with ovarian failure. Experiments nave demonstrated that these symptoms and insomnia associated with nocturnal vasomotor symptoms are more effectively controlled by oestrogen than placebo. Hormonal interventions include a variety of oestrogen or oestrogen/progestogen regimes. Non-hormonal treatments of flushes include exercise, paced respiration and psychotherapy. After the menopause vaginal atrophy and some urinary symptoms respond to local oestrogen and vaginal dryness in also prevented by lubricants. Libido is not increased by oestrogen therapy but may be improved by testosterone. Depression is common in middle-aged women but is not specifically associated with the hormonal changes occurring at the menopause. Oestrogen therapy may improve and stabilise mood during the peri-menopause but there is no firm evidence that it is effective for depression after the menopause. Arthralgia is not a symptom specific to menopause and experimental evidence concerning the role of oestrogen in the treatment of rheumatoid arthritis is inconclusive. Cognitive function is not related to menopause and measures such as stopping smoking, exercise and maintaining body weight may be partly effective in preventing menopausal symptoms.
近期的队列研究证实，只有潮热、盗汗和阴道干燥被证实与卵巢功能衰竭有关。实验表明，与夜间血管舒缩症状相关的这些症状及失眠，雌激素治疗比安慰剂更有效地控制。激素干预包括多种雌激素或雌激素/孕激素方案。潮热的非激素治疗包括运动、有节奏的呼吸和心理治疗。绝经后，阴道萎缩和一些泌尿系统症状对局部雌激素有反应，润滑剂也可预防阴道干燥。雌激素疗法不会增加性欲，但睾酮可能会改善性欲。抑郁症在中年女性中很常见，但与绝经时发生的激素变化并无特定关联。雌激素疗法可能会在围绝经期改善并稳定情绪，但没有确凿证据表明它对绝经后抑郁症有效。关节痛并非绝经特有的症状，关于雌激素在类风湿关节炎治疗中作用的实验证据尚无定论。认知功能与绝经无关，诸如戒烟、运动和维持体重等措施在预防更年期症状方面可能部分有效。
