20xx年醫(yī)學(xué)專題—homonereplacementtherapy(hrt)：激素替代療法(hrt)(編輯修改稿)
2024-10-31 17:01 本頁面
【文章內(nèi)容簡(jiǎn)介】 ,第二十五頁，共五十四頁。,HOMONE REPLACEMENT THERAPY (HRT),BENEFITS Relieve menopausal symptoms Maintenance of quality of life Prevention of osteoporosis Note: HRT should not be used as a firstline treatment in osteoparosis except in women who have premature menopause,第二十六頁，共五十四頁。,HOMONE REPLACEMENT THERAPY (HRT),RISKS OF VTE HRT (combined 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，共五十四頁。,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 1.6 times after 5 years of use and 2.3 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 0.08% (ACOG),第二十八頁，共五十四頁。,HOMONE REPLACEMENT THERAPY (HRT),RISKS OF ENDOMETRIAL CANCER Endometrial cancer: increased risk only with unopposed oestrogen. There is no increased risk with combined (oestrogen and progestogen) HRT. RISKS OF OVARIAN CANCER longterm use of oestrogenonly HRT and combined HRT may slightly increase the risk. Risk decreases after stopping HRT.,第二十九頁，共五十四頁。,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。s risk of CHD prior to starting HRT.,第三十頁，共五十四頁。,HOMONE REPLACEMENT THERAPY (HRT),第三十一頁，共五十四頁。,HOMONE REPLACEMENT THERAPY (HRT),s,Sequentially combined HRT E(continuously D1D21) P(sequentially D11D21),Continuous combined HRT E amp。P (continuous: D1D28),第三十二頁，共五十四頁。,HOMONE REPLACEMENT THERAPY (HRT),Women with an intact uterus Vasomotor symptoms Perimenopausal: systemic cyclical combined HRT . Postmenopausal: systemic cont
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