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基于证据的指导方针:过早的卵巢功能不全
, Nick Panay1, Richard A Anderson2
1Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK.
Climacteric : the journal of the International Menopause Society
|December 8, 2024
概括
本指南为诊断和管理早产/初级卵巢衰竭 (POI) 提供了最新的建议,强调了有关妇女健康和生育能力的当前证据. 它涉及诊断,后果和治疗,包括激素治疗 (HT).
科学领域:
- 生殖内分泌学 生殖内分泌学
- 妇女健康 妇女健康
- 临床指南 临床指南
背景情况:
- 过早/初级卵巢衰竭 (POI) 显著影响女性的身体和情感健康,影响生活质量,生育能力和长期健康 (骨,心血管,认知).
- 优化POI的管理仍然是一个挑战,尽管激素疗法 (HT) 提供了一些减轻不良影响.
研究的目的:
- 提供基于证据的建议,用于诊断和管理早产/初级卵巢衰竭 (POI).
- 更新医疗保健专业人员照顾POI妇女的临床实践指南,纳入新的证据和扩展的临床问题.
主要方法:
- 该指南的制定遵循了欧洲人类生殖和胚胎学会 (ESHRE) 的方法,包括专家共识和文献审查,直到2024年1月.
- 主要问题是通过对妇女和医疗保健专业人员的调查得到了解的;建议是通过共识制定和完善的,来自有POI生活经验的妇女的投入.
主要成果:
- 更新后的指导方针涉及40个临床问题,涉及POI诊断,后果 (骨,心血管,神经,性功能,生育能力,幸福感) 和治疗,包括HT.
- 关键的变化包括要求POI诊断只需要一个升高的卵泡刺激激素 (FSH) >25 IU/L,对抗Müllerian激素 (AMH) 测试的指导,以及对遗传测试,雌激素/避孕药的使用和治疗的更新建议.
- 新的主题包括生育保护,肌肉健康,阳性POI管理,以及扩大补充/非激素治疗和生活方式管理.
结论:
- 本指南为POI护理的最佳实践提供了明确的,基于证据的建议,旨在改善受影响妇女的结果.
- 它强调了证据有限的领域,并提供了研究建议,以指导POI管理的未来研究.
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