激素治疗预防绝经后妇女骨质疏松症WHI后精析

Perspectives of hormone treatment for postmenopausal osteoporosis after the WHI study

雌激素应用可以预防和治疗绝经后妇女骨质疏松症。在许多雌激素应用的大型临床试验中人们对雌激素治疗利益与风险有了更进一步的认识。妇女健康倡议(WHI)后对雌激素应用引发了争议;中华医学会妇产科学分会绝经学组发表了激素补充治疗临床应用指南;国际绝经协会指南肯定雌激素治疗在预防绝经后妇女骨量丢失与减少骨折危险性;本文也阐述了许多国家骨质疏松指南中雌激素应用的地位;雌激素治疗骨质疏松症与绝经相关症状处方量的变化。

Estrogen therapy has been used for prevention and treatment of postmenopausal osteoporosis. Estrogen therapy has been evaluated in many large clinical trials, in which the benefit and risk of the therapy has been further understood. The use of estrogen has raised to a controversy after the publish of Women＇s Health Initiative （WHI）. The Menopause Study Group of Obstetrics and Gynecology Society of CMA has published a clinical guideline of hormone replacement therapy. The Guideline of International Menopause Society has confirmed that estrogen therapy could be effective in both preventing hone loss and reducing fracture risk in postmenopausal women. In this article, we explain the role of estrogen therapy according to the osteoporosis guidelines in many countries, and the alteration of estrogen dose prescription in the treatment of osteoporosis and menopausal symptoms.