早发性卵巢功能不全激素补充治疗

Hormone replacement therapy for premature ovarian insufficiency

早发性卵巢功能不全(POI)对女性最大的危害是生殖功能提前衰退和过早出现的低雌激素状态。临床上多数POI患者的生育愿望难以顺利实现,常常需要借助供卵体外受精-胚胎移植(IVF-ET)治疗完成。但是POI患者除生殖以外的卵巢内分泌功能完全可以通过激素补充治疗(HRT)实现,从而有效改善低雌激素状态,预防远期并发症,提高患者生活质量。尤其是对于青春期女性诱发第二性征,维护正常性心理、促进性健康和骨健康等尤为重要。POI患者只要排除了禁忌证,应尽早开始HRT,并坚持长期使用,直至妇女平均绝经年龄(50岁),再按绝经激素治疗(MHT)流程判断是否可以继续采用绝经激素治疗。

The greatest harm to women with premature ovarian insufficiency(POI)is reproductive function decline and premature hypoestrogenic state.Clinically,the fertility desire of most patients is not satisfied,and often needs to be completed with egg donation-IVF-ET treatment.However,ovarian endocrine functions other than reproduction in POI patients can be fully realized through hormone replacement therapy,which can effectively improve the hypoestrogenic status,prevent long-term complications,and improve the quality of life of patients.Especially for.adolescent women,it is very important to induce secondary sexual characteristics,maintain sexual psychology,and promote sexual health and bone health.As long as the contraindications are excluded,POI patients should start HRT as soon as possible and insist on long-term use until the average age of menopause(50 years old),and then judge whether menopausal hormone therapy can be continued according to the MHT treatment process.