更年期症状の治療:今,どうすればいいのか?
Martha Hickey1, Susan R Davis, David W Sturdee
1University of Western Australia, School of Women's and Infants' Health, King Edward Memorial Hospital, Subiaco, Western Australia 6008, Australia. mhickey@obsgyn.uwa.edu.au
Lancet (London, England)
|August 2, 2005
まとめ
ホルモン置換療法 (HRT) は熱中症などの更年期症状に効果的であり続けていますが,代替品の証拠は限られています. エストロゲンまたはエストロゲン-プロゲスタゲンは最も効果的であり,非ホルモンによる選択肢は最小限の利益を示します.
科学分野:
- 閉経管理の管理について
- 薬理学 薬理学とは
- 根拠に基づいた医学は,エビデンスに基づいた医療です.
背景:
- 安全性に関する懸念により,ホルモン置換療法 (HRT) の使用が減少しています.
- 更年期症状の代替治療への関心が高まりました.
- HRTの代替品のための証拠を評価する際の困難.
研究 の 目的:
- 頻繁に処方される更年期治療の有効性,リスク,および利点を見直す.
- 閉経症状の管理のための証拠に基づいた臨床ガイドラインを提供すること.
- ホルモン治療と非ホルモン治療の選択肢を比較する.
主な方法:
- 更年期症状治療に関する研究の体系的レビュー.
- 様々な治療法の安全性と有効性に関するデータの分析.
- 比較研究と臨床試験の証拠の評価.
主要な成果:
- エストロゲンまたはエストロゲンとプロゲスタゲンの組み合わせは,熱中症や陰道乾燥に対して非常に効果的です.
- ティボロンは,HRTに匹敵する有効性を示し,リビドを改善する可能性があります.
- セロトニン再吸収阻害剤を含む非ホルモンの選択肢は,短期的な利益が限られている.
- 補完療法には,血管運動症状の管理における有効性と安全性に関する十分な証拠がない.
結論:
- ホルモン療法,特にエストロゲンベースの治療とティボロンは,更年期症状管理の最も効果的な選択肢です.
- 非ホルモン治療は,特に長期使用の場合,有効性が限られています.
- 補完療法の安全性と有効性を確立するためにさらなる研究が必要である.
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