对更年期荷尔蒙治疗中使用的雌激素的综述
Amythis Soltani1, Amy J Voedisch
1Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA.
Current opinion in obstetrics & gynecology
|February 1, 2026
概括
更年期激素治疗 (MHT) 的选择取决于雌激素的类型,时间和分娩. 新的雌激素和雌激醇提供了更好的安全性和有效性,特别是当更年期早期开始时.
科学领域:
- 雌激素信号通路的内分泌学和药理学.
- 生殖健康和更年期医学.
- 药物基因组学和个性化激素治疗.
背景情况:
- 雌激素在生理过程中起着至关重要的作用,具有多种不同的受体相互作用.
- 更年期激素治疗 (MHT) 是广泛使用的,但需要仔细考虑影响因素.
- 了解雌激素受体 (ER) 亚型 (ERα,ERβ,GPER) 是治疗开发的关键.
研究的目的:
- 审查内源性和治疗性雌激素,它们的受体生物学和临床应用.
- 强调雌激素类型,时间和施用途径如何影响MHT结果.
- 讨论雌激素治疗中不断变化的安全考虑因素.
主要方法:
- 关于雌激素受体信号传导的新兴研究的综述.
- 对MHT启动中的时间假设进行最新研究的分析.
- 对不同雌激素配方及其配置的比较研究.
主要成果:
- 雌激素受体 (ERα,ERβ,GPER) 介导着不同的生理效应.
- 在更年期接近时开始MHT可能会为心血管和神经系统带来好处.
- 雌激醇显示出比结合的马类雌激素更有利的血栓和代谢特征.
- 像埃斯特这样的新药显示有选择性的ERα激活,具有潜在的益处.
- 雌醇对更年期的生殖泌尿综合征有效.
结论:
- 雌激素治疗需要考虑受体选择性,药物多样性和启动时间的细微方法.
- 以雌激醇为基础的和透皮的MHT是系统治疗的首选.
- 低剂量的阴道雌激素是泌尿器官症状的第一线治疗方法.
- 新型雌激素和机械学的洞察力正在改进MHT,使其更安全,更有针对性的使用.
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