homonereplacementtherapy(hrt)：激素替代療法hrt-文庫吧在線文庫
【正文】 e premature menopause HOMONE REPLACEMENT THERAPY (HRT) ? RISKS OF VTE HRT (bined or oestrogenalone) increases the risk of a deep vein thrombosis or pulmonary embolism, especially in the first year of treatment. The risk is more pronounced in women with preexisting risk factors. A recent metaanalysis suggests that transdermal oestrogens may be a safer option than oral oestrogens for HRT. HOMONE REPLACEMENT THERAPY (HRT) ? RISKS OF BREAST CANCER ? The increased breast cancer risk is proportional to the duration of HRT. HRT increases this risk by about times after 5 years of use and times after 10 years of use. Risk decreases within a few years of stopping HRT. ? Women considering HRT should be counselled that the absolute risk for breast cancer for any individual remains relatively low* Her actual risk increases % (ACOG) HOMONE REPLACEMENT THERAPY (HRT) ? RISKS OF ENDOMETRIAL CANCER Endometrial cancer: increased risk only with unopposed oestrogen. There is no increased risk with bined (oestrogen and progestogen) HRT. RISKS OF OVARIAN CANCER longterm use of oestrogenonly HRT and bined HRT may slightly increase the risk. Risk decreases after stopping HRT. HOMONE REPLACEMENT THERAPY (HRT) ? RISKS OF CARDIOVASCULAR DISEASE There is not the same evidence of cardioprotection from HRT as was originally thought. Assess all women39。 and is marked by the ending of menstruation. WHAT? ? It be defined with certainty after twelve months39。s risk of CHD prior to starting HRT. HRT E+P E HOMONE REPLACEMENT THERAPY (HRT) E+P E For hysterectomized pts HOMONE REPLACEMENT THERAPY (HRT) s Sequentially bined HRT ? E(continuously D1D21) ? P(sequentially D11D21) Continuous bined HRT ? E amp。change of life39。P (continuous: D1D28) HOMONE REPLACEMENT THERAPY (HRT) ? Women with an intact uterus Vasomotor symptoms ? Perimenopausal: systemic cyclical bined HRT . ? Postmenopausal: systemic continuous bined HRT or tibolone. Urogenital symptoms ? Perimenopausal: low
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