The 2012 Hormone Therapy Position Statement of The North American Menopause Society
The 2012 Hormone Therapy Position Statement of The North American Menopause Society
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DOI：
10.1097/gme.0b013e31824b970a
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发表时间：
2012-03-01
影响因子：
2.7
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中科院分区：
文献类型：
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目的：本立场声明旨在更新北美更年期协会 (NAMS) 于 2010 年发布的关于绝经后女性激素治疗 (HT) 建议的循证立场声明。本更新的立场声明进一步区分了雌激素疗法 (ET) 和雌激素-孕激素联合疗法 (EPT) 在绝经开始后不同年龄和时间间隔的治疗获益风险比方面出现的差异。方法：邀请了一个由妇女健康领域的临床专家和研究人员组成的咨询小组来审查 2010 年 NAMS 立场声明，评估新证据，并就建议达成共识。该小组的建议经过 NAMS 董事会的审查并批准为 NAMS 的官方立场声明。结果：当前证据支持，当潜在利益和风险的平衡对女性个体有利时，可以对围绝经期和绝经后女性使用 HT。本立场声明回顾了 ET 和 EPT 对女性健康许多方面的影响，并认识到与 ET 相关的更高的安全性。结论：最近的数据支持在绝经期前后开始 HT，以治疗绝经相关症状并预防骨折高风险女性的骨质疏松症。与 EPT 相比，ET 的获益风险比更有利，可以更灵活地延长使用时间，而 EPT 较早出现乳腺癌风险增加，因此建议使用时间超过 3 至 5 年。
Objective: This position statement aimed to update the evidence-based position statement published by The North American Menopause Society (NAMS) in 2010 regarding recommendations for hormone therapy (HT) for postmenopausal women. This updated position statement further distinguishes the emerging differences in the therapeutic benefit-risk ratio between estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) at various ages and time intervals since menopause onset.Methods: An Advisory Panel of expert clinicians and researchers in the field of women's health was enlisted to review the 2010 NAMS position statement, evaluate new evidence, and reach consensus on recommendations. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement.Results: Current evidence supports the use of HT for perimenopausal and postmenopausal women when the balance of potential benefits and risks is favorable for the individual woman. This position statement reviews the effects of ET and EPT on many aspects of women's health and recognizes the greater safety profile associated with ET.Conclusions: Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms and to prevent osteoporosis in women at high risk of fracture. The more favorable benefit-risk ratio for ET allows more flexibility in extending the duration of use compared with EPT, where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years.