A Review of Hormone and Non-Hormonal Therapy Options for the Treatment of Menopause.
A Review of Hormone and Non-Hormonal Therapy Options for the Treatment of Menopause.
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DOI：
10.2147/ijwh.s379808
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发表时间：
2023
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了解绝经期激素治疗（MHT）沿着非激素治疗对绝经后血管扩张症状、睡眠中断和泌尿生殖系统症状的作用对妇女中晚期的健康至关重要。最近更新的激素和非激素疗法治疗更年期症状的证据以及专业协会的最新指南可以帮助指导临床医生治疗自然绝经或由于原发性卵巢功能不全或手术或药物诱导绝经而导致雌激素缺乏的女性。本叙述性综述的目的是为临床医生提供MHT用于女性更年期症状的概述，纳入风险与获益特征的最新主要证据，最近的专业协会建议以及替代性非激素选择。在这篇综述中，我们总结了关于使用MHT治疗绝经相关疾病的文献，包括MHT的配方和剂量选择，非激素治疗选择，以及MHT的风险-受益特征，包括长期健康后果（例如，心血管疾病，认知能力下降，静脉血栓栓塞和骨折风险）。最后，我们强调了未来需要研究的领域，以促进绝经后妇女的护理。总之，激素（MHT）和非激素的选择都存在治疗更年期症状。有强有力的证据表明，MHT用于治疗年龄小于60岁、绝经后不到10年且无显著心脏代谢合并症的女性血管痉挛症状的安全性和有效性。对于其他人，可以根据个人风险状况以及其他因素（如药物配方，治疗目标和症状严重程度）考虑激素与非激素治疗。
Understanding the role of both menopausal hormone therapy (MHT) along with non-hormonal options for the treatment of vasomotor symptoms, sleep disruption, and genitourinary symptoms after menopause is critical to the health of women during middle and later life. Recent updates to the evidence for the treatment of menopausal symptoms pertaining to both hormonal and non-hormonal therapies as well as updated guidance from specialty societies can help guide clinicians in their treatment of women going through natural menopause or with estrogen deficiencies due to primary ovarian insufficiency or induced menopause from surgery or medications. The objective of this narrative review is to provide clinicians with an overview of MHT for the use of menopausal symptoms in women, incorporating updated primary evidence for risk versus benefit profiles, recent specialty society recommendations, and alternative, non-hormonal options. In this review, we summarize literature on the use of MHT for menopause-related symptomatology including options for formulations and dosages of MHT, non-hormonal treatment options, and the risk–benefit profile of MHT including long-term health consequences (eg, cardiovascular disease, cognitive decline, venous thromboembolism, and fracture risk). Finally, we highlight areas in which future research is needed to advance care of women after menopause. In summary, both hormonal (MHT) and non-hormonal options exist to treat symptoms of menopause. There is strong evidence for safety and effectiveness of MHT for the treatment of vasomotor symptoms among women who are less than 60 years of age, less than 10 years since menopause, and without significant cardiometabolic comorbidities. For others, treatment with hormonal versus non-hormonal therapies can be considered based on individual risk profiles, as well as other factors such as drug formulation, therapeutic goals, and symptom severity.