A Comprehensive Approach to the Menopause: So Far, One Size Should Fit All
A Comprehensive Approach to the Menopause: So Far, One Size Should Fit All
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治疗更年期的综合方法：到目前为止，一种方法应该适合所有人
DOI：
10.1097/00006254-200110000-00023
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发表时间：
2001
影响因子：
6.2
通讯作者：
A. Ewies
中科院分区：
文献类型：
--
作者：
A. Ewies
尽管大量研究表明激素替代疗法的益处大于风险，但许多女性和医疗保健提供者仍对安全性和副作用感到担忧。许多替代疗法深受患者欢迎，仅 1999 年美国更年期妇女就花费了 6 亿多美元购买这些疗法。本文对几种更常用的更年期替代疗法进行了批判性评价。对于选择不服用雌激素的女性和服用雌激素的女性来说，钙、维生素 D、锻炼、减轻压力以及不同饮食和生活方式的适应等额外益处可能会提高她们随着年龄增长的生活质量。尽管它们有可能成为有效且安全的选择，但其他替代疗法的临床研究有限。妇科医生和其他医疗保健提供者在解决患者的问题和担忧时应该意识到，大多数这些疗法的有效性缺乏证据。我们关于替代疗法的信息在未来几年将会增加。最终，越来越多的可用治疗选择将允许治疗的个体化。尽管如此，在进行长期随访的前瞻性研究来评估不同替代疗法的风险和益处之前，经过更好研究的激素替代疗法仍将是首选治疗方法，并且至少在不久的将来，“一刀切”将继续成为大多数围绝经期和绝经后妇女的治疗计划。目标受众：妇产科医生、家庭医生 学习目标：读完本文后，读者将能够总结针对更年期症状的激素疗法的各种替代方案，描述植物雌激素在治疗更年期症状中的作用，并解释更常见草药疗法的起源和临床用途。
Although extensive studies have indicated that the benefits of hormone replacement therapy outweigh the risks, many women and health care providers have concerns about safety and side effects. Many alternative therapies are popular with patients, and menopausal women in the United States spent more than $600 million in 1999 alone purchasing these therapies. Several of the more commonly used alternative therapies for the menopause are critically appraised in this article. For women who choose not to take estrogen, and for those who do, the additional benefits of calcium, vitamin D, exercise, stress reduction, and different dietary and lifestyle adaptations may enhance the quality of life as they age. Although they have the potential for being effective and safe options, there has been limited clinical research for the other alternative therapies. Gynecologists and other health care providers should be aware of the lack of evidence for the effectiveness of most of these therapies when they address patient’s questions and concerns. Our information about alternative therapies will increase in the coming years. Ultimately, the growing number of available treatment choices will allow individualization of the treatment. Nevertheless, until prospective studies with prolonged follow-up are conducted to evaluate the risks and benefits of different alternative therapies, hormone replacement therapy, which is better studied, will remain the treatment of first choice, and “one size fits all” will continue to describe the management plan for most peri- and postmenopausal women at least in the near future. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be able to summarize the various alternatives to hormonal therapy for menopausal symptoms, describe the effects of phytoestrogens in the management of menopausal symptoms, and explain the origin and clinical use of the more common herbal therapies.
影响因子：
158.5
作者：
DawsonHughes, B;Harris, SS;Dallal, GE
通讯作者：
Dallal, GE