Smith H O, Kammerer-Doak D N, Barbo D M, Sarto G E
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine in Albuquerque, USA.
CA Cancer J Clin. 1996 Nov-Dec;46(6):343-63. doi: 10.3322/canjclin.46.6.343.
The preponderance of data support the benefits of HRT in estrogen-deprived and menopausal women to reduce the risks of osteoporosis and cardiovascular disease and to enhance quality of life and life expectancy. Controversies exist with regards to the risk-benefit ratio in women with a history of estrogen-dependent gynecologic tumors or breast cancer. Until these issues are resolved, physicians must carefully weigh, on an individual basis for each patient, the potential risks against the known benefits. Women should be counseled regarding the benefits of exercise, weight control, breast feeding, and cessation of cigarette smoking or excessive alcohol to reduce their risks of cancer, cardiac disease, and/or osteoporosis. HRT is not a panacea for an unhealthy lifestyle. When ERT is contraindicated, viable alternatives to retard bone loss and/or control vasomotor symptoms include calcium supplementation and progestin therapy. The role of tamoxifen as an alternative HRT in women at increased risk for breast cancer development is currently under investigation.
大量数据支持激素替代疗法（HRT）对雌激素缺乏和绝经后女性有益，可降低骨质疏松症和心血管疾病风险，并提高生活质量和预期寿命。对于有雌激素依赖性妇科肿瘤或乳腺癌病史的女性，其风险效益比存在争议。在这些问题得到解决之前，医生必须根据每位患者的个体情况，仔细权衡潜在风险与已知益处。应向女性提供有关运动、体重控制、母乳喂养以及戒烟或戒酒的益处的咨询，以降低她们患癌症、心脏病和/或骨质疏松症的风险。HRT并非不健康生活方式的万灵药。当雌激素替代疗法（ERT）禁忌时，延缓骨质流失和/或控制血管舒缩症状的可行替代方法包括补充钙和孕激素治疗。他莫昔芬作为乳腺癌发生风险增加的女性的替代HRT的作用目前正在研究中。
