Wren B G
Sydney Menopause Centre, Royal Hospital for Women, Randwick, New South Wales, Australia.
Drugs Aging. 1998 May;12(5):343-8. doi: 10.2165/00002512-199812050-00001.
Despite the fact that estrogen replacement therapy has been demonstrated to be of great value to postmenopausal women, many patients are still reluctant to use it. This is primarily because of fears that sex hormone therapy increases the risk of developing uterine and breast cancer. Because retrospective epidemiological studies have failed to clarify the issue for breast cancer, ambitious prospective trials have been initiated to determine the role of hormones in the development of breast cancer and cardiovascular disease. The main studies have been the Women's Health Initiative, the Postmenopausal Estrogen/Progestin Intervention (PEPI) Trial, the Heart and Estrogen-Progestin Replacement Study (HERS), the Women's International Study of long Duration Oestrogen after Menopause (WISDOM) and the Million Women Study. Only the PEPI Trial has been completed. It showed a substantial benefit for women using hormone replacement therapy, but was insufficiently powerful to determine whether such therapy affected the incidence of breast cancer. Despite the immense costs involved and the considerable time that must elapse before results are published, it is imperative that these major prospective studies are completed, analysed and published. Only then can physicians advise their patients in an appropriate manner.
尽管雌激素替代疗法已被证明对绝经后女性具有巨大价值，但许多患者仍不愿使用它。这主要是因为担心性激素疗法会增加患子宫癌和乳腺癌的风险。由于回顾性流行病学研究未能澄清乳腺癌的问题，因此已启动了雄心勃勃的前瞻性试验，以确定激素在乳腺癌和心血管疾病发展中的作用。主要研究包括妇女健康倡议、绝经后雌激素/孕激素干预（PEPI）试验、心脏与雌激素-孕激素替代研究（HERS）、绝经后长期雌激素国际妇女研究（WISDOM）和百万妇女研究。只有PEPI试验已经完成。它显示出激素替代疗法对女性有显著益处，但不足以确定这种疗法是否会影响乳腺癌的发病率。尽管涉及巨大成本且在结果发表之前必须经过相当长的时间，但这些主要的前瞻性研究必须完成、分析并发表。只有这样，医生才能以适当的方式为患者提供建议。
