The management of vasomotor symptoms of menopause (VMS) with menopausal hormone therapy (MHT)

Current Opinion in Endocrine and Metabolic Research Pub Date : 2022-12-01 DOI:10.1016/j.coemr.2022.100420

Tobias De Villiers

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引用次数: 1

Abstract

Vasomotor symptoms (VMS) result from menopausal hypoestrogenism with subsequent instability of central thermoregulation. VMS cause stress and decreased QOL. Menopausal hormone therapy (MHT) significantly alleviates VMS when compared to placebo or other available non-hormonal options. MHT protects the urogenital system, bone, and cardiovascular system, has beneficial effects on sleep and mood disorders, and may offer protection against colorectal cancer. Negative effects include a risk of thromboembolic disease and the promotion of breast cancer. Adverse effects can be mitigated by initiating MHT within the window of opportunity, using the transdermal route, using estrogen alone or combined with natural progesterone or dydrogesterone, and using the minimum effective dose. Initial findings from the WHI have been widely (and persistently) misinterpreted. Subsequent age-stratified analysis of WHI data indicates that MHT is safe when initiated by women younger than age 60 or within 10 years of menopause onset.

MHT remains the first choice for the treatment of VMS.

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绝经期激素治疗(MHT)对绝经期血管舒缩症状的治疗

血管舒缩症状(VMS)是由绝经期雌激素水平低下和随后的中枢体温调节不稳定引起的。VMS造成压力，降低生活质量。与安慰剂或其他可用的非激素治疗相比，绝经期激素治疗(MHT)可显著缓解VMS。MHT保护泌尿生殖系统、骨骼和心血管系统，对睡眠和情绪障碍有有益作用，并可能提供预防结直肠癌的保护。负面影响包括血栓栓塞性疾病的风险和促进乳腺癌。通过在机会窗口内启动MHT，使用透皮途径，单独使用雌激素或与天然孕酮或地屈孕酮联合使用，并使用最小有效剂量，可以减轻不良反应。世卫组织的初步调查结果被广泛(且持续)误解。随后对WHI数据的年龄分层分析表明，当年龄小于60岁或绝经10年内的妇女开始MHT时是安全的。MHT仍然是治疗VMS的首选。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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