更年期荷尔蒙疗法风险,益处和新兴选择:叙述性审查
Ana Maria Arnautu1, Vanda Roxana Nimigean2, Claudia Alexandra Nacea-Radu1
1Endocrinology Department, Bucharest University Emergency Hospital, 050098 Bucharest, Romania.
International journal of molecular sciences
|November 27, 2025
概括
更年期激素治疗 (MHT) 有效治疗热和阴道干燥,并预防骨质损失. 风险和益处因MHT类型,剂量和途径而异,需要个性化治疗计划.
科学领域:
- 生殖内分泌学和妇女健康
- 药理学和治疗学 药理学和治疗学
- 证据综合和临床指导方针
背景情况:
- 更年期激素治疗 (MHT) 仍然是治疗更年期症状的主要治疗方法.
- 当代证据综合对于优化MHT使用至关重要.
- 了解不断变化的风险和益处为临床决策提供了信息.
研究的目的:
- 审查当前关于更年期激素治疗 (MHT) 益处和风险的证据.
- 探索新兴的MHT选项及其安全概况.
- 为个人MHT处方提供指导.
主要方法:
- 对同行评审的研究和指导方针进行叙述性审查,截至2025年9月.
- 专注于最近的文学 (过去五年) 和定性综合.
- 包括主要的生物医学数据库 (MEDLINE/PubMed,Embase,Cochrane) 在内.
主要成果:
- 对于血管运动和泌尿生殖系统症状以及预防骨质损失,MHT非常有效.
- 心血管益处尚未确立;风险 (VTE,中风) 取决于路线,剂量和孕激素类型.
- 乳腺癌风险是特定于治疗方案的;埃斯特醇 (E4) 是有前途的,但需要进一步的安全数据.
结论:
- 基于患者因素,时间,路线,剂量和孕激素的个性化MHT选择是必不可少的.
- 应使用最低有效剂量,并定期重新评估.
- 像Estetrol (E4) 这样的新兴疗法需要继续研究长期的安全性和有效性.
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