更年期荷尔蒙疗法:30年的进步和争议
Arielle M Schwartz1, Mary Ellen Sweeney1, Mary Dolan2
1Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
概括
更年期激素治疗 (MHT) 建议因新研究而发展. 目前的指导方针平衡了症状缓解与女性更新的安全概况.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 妇女健康 妇女健康
- 预防心血管疾病 预防心血管疾病
背景情况:
- 更年期激素治疗 (MHT) 曾经被认为为女性提供广泛的健康益处.
- 早期的观察性研究表明,MHT改善了更年期症状,生殖尿道健康,骨密度和心血管结果.
- 随后的随机对照试验引入了新的证据,改变了医学社会的建议和MHT使用.
研究的目的:
- 审查了30年来关于更年期激素治疗 (MHT) 的研究.
- 突出围绕MHT的关键进展和持续的争议.
- 讨论主要医学协会目前的MHT建议.
主要方法:
- 对跨越30年的研究研究的文献综述.
- 分析MHT研究中的关键进展.
- 检查MHT中正在进行的争议和辩论.
主要成果:
- 在过去的30年中,MHT建议发生了重大变化.
- 从随机对照试验中出现新的证据.
- 根据最新的指导方针,MHT处方急剧下降.
结论:
- 讨论了心脏病学,产科/妇科和内分泌学学会目前的MHT建议.
- 介绍了MHT使用的临床观点.
- 总结了MHT不断变化的景观.
相关概念视频
01:28Menopause
3.5K
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
3.5K
01:22Hormonal Regulation of the Menstrual Cycle
1.4K
The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
1.4K
01:30Hormonal Control of the Ovarian Cycle
6.4K
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
6.4K
01:33Hormonal Regulation
35.7K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
35.7K
01:40Hormonal Regulation
47.7K
Hormones regulate a significant portion of digestion through activation of the neuroendocrine system. The neuroendocrine system of digestion contains many different hormones all with multiple functions that are both, directly and indirectly, involved in digestion.
47.7K
01:26Aging
580
Aging is a complex biological phenomenon influenced by various processes that affect cellular and systemic functions. Several prominent theories attempt to explain its mechanisms, highlighting cellular limitations, oxidative damage, and hormonal changes as central factors in aging.
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
580