再析绝经妇女激素替代治疗

Hormone therapy for postmenopausal women

近60年来HT（Hormone therapy）的应用已在很多国家展开,并已成为当前研究绝经后妇女生活质量和健康状态的热点,对HT的安全性,医患双方都极为关注,在临床医生中仍有不同观点,甚至仍然是个争论的焦点。我们今天讨论的重点不再是绝经后妇女该不该用HT,而是HT可以预防什么病,谁需要用HT、谁能用HT以及如何有效、安全地使用HT。理想的HT应该是能有效缓解绝经前后出现的症状,预防泌尿生殖器官萎缩、预防骨丢失加速、保护心血管、促进心理健康,提高社会交往能力;无不规则的阴道出血;不增加癌的危险。对所有需要用又没有禁忌证的妇女给予规范化、个体化、系统化的HT治疗以及定期监测,可以保证所有使用HT的妇女冒最小的风险得到最大的利益。

Hormone therapy（HT） has been used in many countries for 60 years and become the focus of living quality and health status in postmenopausal women. The safety of HT is still a subject of debate. Now what we discuss is who need HT,who can use HT as well as how to use HT. The ideal HT can relieve the symptoms of menopause effectively,including prevention the atrophy of uropoiesis and reproduction organs,prevention bone loss,promotion mental health,improvement social skills,as well as no vaginal bleeding,and no increased cancer risk. If those who need HT with no contraindications can be given standardized,individualized and systematized treatment of HT and monitored regularly,they can get the biggest benefit with minimal risk.