Should we give up hormone treatment in menopause?
Autor: | Emine Emsal Durusoy, Mehmet Aral Atalay, Mehpare Tufekci |
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Rok vydání: | 2013 |
Předmět: |
medicine.medical_specialty
medicine.drug_class medicine.medical_treatment lcsh:Medicine Tibolone lcsh:Gynecology and obstetrics breast cancer Breast cancer Internal medicine estrogen medicine lcsh:RG1-991 Gynecology progestogen hormone therapy Progestogen business.industry lcsh:R Obstetrics and Gynecology thromboembolism medicine.disease Premature ovarian failure Menopause Endocrinology colon cancer Estrogen Selective estrogen receptor modulator endometrial cancer Hormone therapy business medicine.drug |
Zdroj: | Turkish Journal of Obstetrics and Gynecology, Vol 10, Iss 4, Pp 242-249 (2013) |
ISSN: | 1307-699X |
DOI: | 10.5505/tjod.2013.48378 |
Popis: | SUMMARY treated with HT protocols including estrogen preparations as well as estrogen/progestogen combinations have been indicated as being exposed to increased risk for breast cancer development. Moreover, HT preparations were demonstrated to be ineffective in protection from cardiovascular diseases and thromboembolic events, in contrast to the prior beliefs. Therefore, today in the light of new data, use of hormone therapy in postmenopausal women seems to lose its relevance. Nevertheless, alternative therapies have been developed to serve for the relief of menopausal disorders. Among them, tibolone, micronized testosterone, dihydroepiandrosterone, selective serotonine noradrenaline re-uptake inhibitors (SNRI), selective estrogen receptor modulators, combined oral contraceptives and fitoestrogens could be preferred. For all that, the most efficacious treatment on menopausal and genitourinary symptoms seems to be HT, yet. Furthermore, HT was indicated to be effective on osteoporosis and reducing postmenopausal bone fractures. HT should be the first choice of treatment in patients with premature ovarian failure and early onset menopause without any familial history of cancer. At the present time, it is advised to use hormone treatment choosing the appropriate preparation with the lowest effective dose with respect to above mentioned indications. If HT was introduced, there are valuable recommendations to keep the duration of therapy less than 5 years. Hormon tedavisi (HT); postmenopozal bir kad›n›n azalan hormon ya da hormonlar›n›n, overlerden salg›lanan duzeylerde olmasa da yerine konulmas› ile hormon yetmezliine bal› geliflen olumsuz durumlar›n ortadan kald›r›lmas›n› hedefleyen tedavi bicimidir. En temel endikasyon hipoostrojenemi ve ona bal› gorulen olumsuz durumlard›r. Vajinal atrofi, idrar inkontinans› gibi genitouriner semptomlar, osteoporoz ve kardiyovaskuler hastal›klar icin yuksek risk varl›¤› HT icin ongorulen dier ana endikasyonlard›r. Ancak, hem ostrojenlerin hem de ostojen/progestajen kombinasyonlar›n›n kullan›ld›¤› HT protokolleri postmenopozal kad›nlarda artm›fl meme kanseri geliflim riski ile ilifliklendirilmektedir. Ayr›ca, HT preparatlar›n›n, duflunuldu¤unun aksine kardiyovaskuler hastal›klar ve tromboembolik olaylarla iliflkili koruyucu etkilerinin bulunmad›¤› gosterilmifltir. Gunumuzde yeni verilerin ›fl›¤› alt›nda, HT'ne eskiden |
Databáze: | OpenAIRE |
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