homonereplacementtherapy(hrt)：激素替代療法(hrt)(完整版)
【正文】 lood. 第九頁(yè)，共五十四頁(yè)。 SYMPTOMS! 第十七頁(yè)，共五十四頁(yè)。 HOMONE REPLACEMENT THERAPY (HRT) ? For the treatment of menopausal symptoms where the riskbenefit ratio* is favorable, in fully informed women, in the lowest possible dose to control symptoms and for the shortest duration possible. 第二十五頁(yè)，共五十四頁(yè)。 HOMONE REPLACEMENT THERAPY (HRT) s Sequentially bined HRT ? E(continuously D1D21) ? P(sequentially D11D21) Continuous bined HRT ? E P (continuous: D1D28) 第三十二頁(yè)，共五十四頁(yè)。 ALTERNATIVE TO HRT! “ Tibolone〞 is a synthetic hormone that acts in the same way as HRT (SERM) Useful for postmenopausal women who want to end their periods. Which has oestrogenic, progestogenic and androgenic properties. (estrogenic activity in bone, CNS vasomotor suppression of hot flushes and helpful in improving sexual function . 第四十頁(yè)，共五十四頁(yè)。 . 第四十七頁(yè)，共五十四頁(yè)。 Perimenopause “ Climacteric〞。 Renal Profile Baseline。 NON HRT ? For psychological symptoms Selfhelp groups Psychotherapy Other forms of counselling Antidepressants. 第四十九頁(yè)，共五十四頁(yè)。 FOLLOW UP OF TAKING HRT! ? Review the woman 3 months after starting HRT and once each year thereafter. ? At 3months: – Enquire about bleeding patterns, check blood pressure, and body weight. – Assess the effectiveness of treatment and adjust to achieve symptom control. – Enquire about adverse effects and manage appropriately. 第四十二頁(yè)，共五十四頁(yè)。 HOMONE REPLACEMENT THERAPY (HRT) ? Women who have had a hysterectomy Vasomotor symptoms: systemic oestrogenonly HRT. Urogenital symptoms: lowdose vaginal oestrogen or systemic oestrogenonly HRT. 第三十四頁(yè)，共五十四頁(yè)。 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. 第二十七頁(yè)，共五十四頁(yè)。 TREATMENT ? Only 1 in 10 women seek medical advice when they go through the menopause and many do not need any treatment. ? If menopausal symptoms are severe enough
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