Effects of hormone replacement therapy on mood and sleep quality in menopausal women

BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women.However,some patients report experiencing adverse effects.AIM To analyze the effects of hormone replacement therapy in menopausal female patients.METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group(n=76,conventional treatment+hormone replacement therapy)and the control group(n=76,conventional treatment only)via random casting.The improvement observed in the following items were compared between the groups:Kupperman menopausal index(KMI),emotional state[The Positive and Negative Affect Scale(PANAS)],sleep quality[Self-Rating Scale of Sleep(SRSS)],treatment effectiveness,and treatment safety.RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment.The improvement in the PANAS score observed in the observation group was greater than that observed in the control group(P<0.05).The total treatment effectivity rate in the observation group was higher than that in the control group(86.84%vs 96.05%,χ2=4.121,P=0.042).The incidence rate of adverse reactions in the two groups was comparable(6.58%vs 9.21%,χ2=0.361,P=0.547).CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms,actively channeled negative emotions,and improved the quality of sleep in menopausal patients,indicating its effectiveness and safety.

Research status of hormone replacement therapy on mood and sleep quality in menopausal women

Menopausal syndrome is a common disease of clinical women,which refers to a series of physical and mental symptoms caused by the fluctuation or reduction of sex hormones before and after menopause.Many of these patients have sleep and mood abnormalities that affect their health and quality of life.At present,the understanding of it is gradually improving.This paper mainly analyzes its back-ground and current treatment.

Hormone replacement therapy for menopausal mood swings and sleep quality:The current evidence

Marked alterations in the normal female hormonal milieu in the perimenopausal period significantly affect women’s health,leading to decreased well-being,psychological distress,and impaired quality of life.Common menopausal symp-toms include hot flashes,sleep and mood changes,fatigue,weight gain,and urogenital disturbances.Clinicians often neglect mood swings and disrupted sleep,although those can significantly limit the productivity of women and impair their cognitive function and mental health.Evidence-based management should include a personalized,holistic approach to alleviate symptoms and careful consideration of the risks vs benefits of hormone replacement therapy(HRT),with due consideration of personal preferences.A research paper in the recent issue of the World Journal of Psychiatry by Liu et al investigated the role of HRT in altering mood changes and impaired sleep quality in menopausal women,which helps us to understand the benefits of this treatment approach.

Effects of hormone replacement therapy on endothelial function in menopausal women

Objective To observe the effects of hormone replacement therapy (HRT) on endothelial function in menopausal women. Methods A total of 30 menopausal women were treated with 2.5 mg of Tibolone (Livial) daily. At the same time,30 women with natural menopause without any treatment served as the control group. Endothelium-dependent (EDD),endothelium-independent (NID) vasodilatation function,and estradiol (E2) were examined by the non-invasive high-resolution ultrasonography before the treatment and at 12th,24th,36th and 48th week of treatment,respectively. Results After hormone treatment,E2 increased significantly and EDD was improved significantly (P<0.05),and E2 was positively related with EDD (r=0.8092,P<0.001). No change of EDD was observed in the control group whereas a significant increase was observed in the treatment group. Conclusion Endothelium-dependent vasodilatation dysfunction is prominent in menopausal women. Tibolone can help improve the condition.

Optimizing menopausal hormone therapy:for treatment and prevention,menstrual regulation,and reduction of possible risks

Menopausal hormone therapy(MHT)is used to treat menopausal complaints including the genitourinary syndrome of menopause,to prevent osteoporosis,and to treat bleeding problems.Since these can be the indications also in young women,especially with POI(premature ovarian insufficiency)or with surgical menopause(bilateral oophorectomy),also the old term"Hormone Replacement Therapy(HRT)”is still used.The effective component is the estrogen component without relevant difference in the efficacy of the various MHT-preparations.Additional preventive benefits are reduction of cardiovascular disease(including prevention of diabetes mellitus and metabolic syndrome),reduction of colon cancer,and perhaps also Alzheimer's disease,if started within a Kwindow of opportunity",i.e.in perimenopause or within 6-10 years after menopause.Primary indication for progestogen addition is to avoid the development of estrogen-dependent endometrial cancer,i.e.addition not recommended in hysterectomized women.Two main schedules,sequential-or continuous-combined estrogen/progestogen regimens,are used for treatment of bleeding problems.For this and for optimizing menstrual regulation detailed recommendations are given including proposed dosages for the available different progestogens if added to oral or transdermal estradiol in different estrogen dosages.The WHI-study demonstrated the main risks using MHT within a“worst-case scenario",i.e.start of MHT in old women with high risk for breast cancer and cardiovascular diseases,whereby only^conjugated equine estro-gens”and^medroxprogesterone acetate”have been tested.One main result was that the progestogen component is decisive for the risk of breast cancer,which according to own experimental research and observational studies may be reduced using the physiological progesterone or its isomer dydrogesterone.In addition we propose to push forward research for screening patients with increased breast cancer risk like we have done in the past decade demonstrating that certain membrane-bound receptors in breast cancer tissue or blood can increase this risk.To reduce the risk of venous thromboembolism and stroke,transdermal estradiol(gels,patches,)should be used,in free combination with progesterone or dydrogesterone as"golden standard"in patients with increased risk.To increase the compliance in our patients without special risks we mostly use the available fix-combinations of estradiol/dydrogesterone getting strong efficacy,good menstrual regulation or amenorrhea,respectively,but also other combinations may be indicated to take advantage of for example androgenic or antiandrogenic progestogens.

Shifts in endocrine homeostasis and preventive hormone replacement therapy:extending the Women’s Health Initiative globally

Background:Reducing disease risk for women after menopause is global health issue.A major portion of the Women’s Health Initiative(WHI)consisted of two clinical trials involving 161,809 post-menopausal women aged 50–79 that tested the effect of hormone replacement therapy(HRT)on reducing cardiovascular disease and other secondary outcomes.Previous analyses of the data reveal that HRT should not be recommended for postmenopausal women,but show potential benefits for younger women.Thus,there may be a critical period just prior to or during the early stages of menopause where HRT could be both safe and beneficial.Main body:Menopause marks the beginning of a process of non-reversible reduction in estrogen by which estrogen levels decline progressively,followed by a reduction in estrogen receptors.This results in periods of hormone-receptor imbalances,exacerbating the effects of lower serum estrogen and is considered the primarily endocrinal source of menopause symptoms.Eventually a hormone-receptor balance is achieved at a lower level.Here,we purport that the negative outcomes from WHI trials were primarily due to the fact preventive HRT was initiated in women who had already achieved hormone-receptor equilibrium at lower hormonal levels.Conclusion:We argue for further HRT clinical trials in women at varying stages of menopause,including premenopause and early menopause,and in women from different countries.Variation across countries and subgroups in how women experience menopause and perceive menopause symptoms suggest that biocultural differences should be considered in both study design and measurement approaches to test the effectiveness of HRT.Particularly,we recommend longitudinal studies to assess changes in hormonal level over time,and to detect the“most effective period”for HRT to reduce health risk for women going through the whole menopause period.

Effect of Menopausal Hormone Replacement Therapy on Cytokine Patterns in a Perimenopausal Mouse Model Established by the Ovarian Castration Method

Objective: To investigate the effect of perimenopausal hormone replacement therapy(HRT) on cytokine patterns in a perimenopausal mouse model established by ovarian castration. Methods: The mice were divided into natural menopause group,ovariectomy group and HRT group, with 15 mice in each group, and the estrous cycle, estrous frequency and menopausal time of the mice were determined by vaginal cytology,and the estrous cycle, estrous frequency and menopausal time were compared among the three groups. The serum levels of estradiol(E2) and progesterone(P4) in each group were detected by double-antibody sandwich ELISA, and the levels of interferon gamma(IFN-γ), interleukin-2(IL-2), IL-4 and IL-10 in the spleen γ tissues of mice were detected by ELISA. Results: The time of menopause(53.07±3.99) d in the HRT group was between that of the natural menopause group(80.80±3.26) d and that of the ovariectomy group(16.27±4.35) d, with a statistically significant difference in the two-by-two comparison of the three groups(P<0.05). The levels of serum E2(694.4±128.3) ng/L and P4(14.2 ±6.0) ng/L in the HRT therapy group are between those of the ovariectomy group and the natural menopause group, with statistically significant differences between the groups(P<0.05). The levels of IL-2(30.9±5.3) pg/ml, IL-4(9.4±1.6) pg/ml, IL-10(19.7±3.1) pg/ml, IFN-γ(22.0±3.7) pg/ml in the HRT group were all between those of natural menopause group and ovariectomy group. The Th1/Th2 ratio in the ovariectomy group was 7.55±1.57, higher than that in the natural menopause group(1.53±0.48) and HRT group(2.38 ±0.44), with statistically significant differences(P<0.05). Conclusion:Menopausal HRT can partially correct the imbalance of Th1/Th2 cytokines, which is able to provide an experimental basis for the regulation of menopause-related immune imbalance by HRT.

Patterns of medication use for the treatment of menopausal symptoms before and after the women’s health initiative;implications for decision-making practices of women and women’s health professionals

Background: The Women’s Health Initiative (WHI) published findings in 2002 that changed the perception of the use of hormone replacement therapy (HRT) for the reduction of cardiovascular risks. Menopausal women using HRT for the relief of vasomotor symptoms were advised to use the lowest possible dose of HRT over the shortest possible duration. Objective: This study sought to examine patterns of HRT use for the treatment of menopausal symptoms before and after the WHI among women at least 40 years of age. Methods: A retrospective analysis was performed on a total of 1367 women in the pre-WHI group and 6467 women in the post-WHI group using the U.S. General Electric (GE) Centricity electronic medical record database. Menopause diagnosis was assessed using ICD-9 codes. Clinical characteristics and medication use were assessed for women with at least 3 years of enrollment (1 year baseline, 2 years follow-up). Results: The proportion of women in the post-WHI group that initiated HRT was significantly less than that of women in the pre-WHI group (31.3% vs. 56.9%, respectively;p < 0.001). Combination HRT use declined significantly (21.9% pre-WHI cohort vs. 7.2% post- WHI cohort, p < 0.001) among increases in non-HRT use, namely SSRIs (15.2% pre-WHI cohort v. 22.3% post-WHI cohort, p < 0.001) and tranquilizers (9.5% pre-WHI cohort v. 15.8% post-WHI cohort, p < 0.001). Conclusion: The results of the WHI 2002 publication made an impression on the perception of HRT’s role in the relief of menopausal symptoms. Decision-making on the part of women seeking treatment for vasomotor symptoms and women’s health professionals demonstrates that despite HRT precautions, women continue to exhibit a need for HRT use. This study’s findings suggest that women seeking treatment for menopausal symptom relief and women’s health professionals continue to work together to find the appropriate balance between therapy use and adherence to therapy use guidelines.

Effects of hormone replacement therapy on platelet activation in postmenopausal women

Objective To assess the effects of hormone replacement therapy (HRT) on platelet activation in postmenopausal women compared with premenopausal women. Methods The expressions of CD41 and CD62P in fifteen postmenopausal women before and after HRT were detected using flow cytometry (FCM),with fifteen premenopausal women with a mean age of 47 years as controls.Results The expressions of CD41 and CD62P in postmenopausal women were higher than those in the control group. CD62P(%),CD62P(I) and CD41 were reduced from 36.40±5.9,37.75±5.8,and 470.11±74.0 to 27.97±5.6,26.64±4.9,and 303.23±72.8 after six months of HRT ( P <0.05). Conclusions Platelet activation in postmenopausal women was higher than in premenopausal women and was reduced significantly after six months of HRT. HRT may have a favorable effect on reduction of platelet activity.

Risk of venous thromboembolic disease in postmenopausal women taking oral or transdermal hormone replacement therapy

Objective: The influence of hormone replacement therapy (HRT) on hemostasis processes depends on the type of hormone,the combination of doses,the time of taking HRT,and the route of administration (oral,transdermal,implanted).The aim of the current study was to assess some parameters of coagulation,especially tissue factor pathway inhibitor (TFPI) and tissue factor (TF) in postmenopausal women using oral or transdermal HRT.Methods: The study was conducted on 76 healthy women,including 46 women aged 44–58 years who were taking oral (26) or transdermal (20) HRT,and 30 women aged 44–54 years who did not take HRT as the control group.Plasma concentrations of TF,TFPI,thrombin-antithrombin complex (TAT),and D-dimer were performed by enzyme-linked immunosorbent assay (ELISA).Moreover,the concentration of fibrinogen and activity of protein C were measured by chromogenic and chronometric methods.Results: We observed a significantly higher concentration of TF and a significantly lower concentration of TFPI in women taking oral and transdermal HRT in comparison with the control group.We also found a significantly lower concentration of fibrinogen in women taking oral HRT vs.the control group.Moreover,no statistically significant changes in concentrations of TAT and D-dimer,or activity of protein C were noted.Conclusions: In this study,the occurrence of an increased TF concentration simultaneously with a decreased concentration of TFPI in women taking HRT indicates hypercoagulability.No significant modification of TAT or D-dimer occurred,and thus there may not be increased risk of thrombosis.

女性绝经相关症状特点及绝经激素治疗认知状况的调查分析

目的 调查更年期女性绝经相关症状的特点及对绝经激素治疗(MHT)的认知状况。方法 选择就诊于西安交通大学第一附属医院有绝经相关症状的619例更年期女性为研究对象,采用调查问卷的方式收集资料,分析绝经相关症状的特点,探讨更年期女性对MHT的认知状况及疗效。结果 371例围绝经期女性中绝经相关症状发生率位于前3位的分别是:疲乏(69.81%)、失眠(66.85%)、潮热出汗(58.22%),248例绝经后女性中绝经相关症状发生率位于前3位的分别是:潮热出汗(64.11%)、骨关节痛(60.89%)、疲乏(56.85%)。绝经后女性的失眠、疲乏发生率显著低于围绝经期女性(P<0.01),而骨关节痛、泌尿系感染、阴道干涩性交痛的发生率显著高于围绝经期女性(P<0.01)。围绝经期和绝经后女性的Kupperman评分比较无统计学差异(P>0.05),但评分程度分布比较有统计学差异(P<0.05);围绝经期女性轻度占比最高,绝经后女性中度占比最高。绝经后女性的不同绝经年龄、绝经年限、绝经方式之间Kupperman评分比较有统计学差异(P<0.05);绝经年龄越早、绝经年限越短Kupperman评分越高;手术绝经者Kupperman评分显著高于自然绝经者(P<0.05)。多因素Logistic回归分析结果显示,年龄45~54岁、退休或无业、配偶疾病或去世、性生活不正常、文化程度高是绝经相关症状发生的危险因素(P<0.05),家庭收入高、>3次/周的运动是绝经相关症状发生的保护因素(P<0.05)。更年期女性对MHT了解途径占比最高为网络(39.92%),对MHT的担忧占比最高为肿瘤(33.67%)。465例(89.77%)无MHT禁忌证的更年期女性,治疗后症状显著改善(P<0.05)。结论 更年期女性绝经相关症状显著,年龄越早、绝经年限越短及手术绝经者症状更为严重,应关注绝经对更年期女性健康的影响并增加专业医师指导,提高MHT使用率以改善更年期女性的生活质量。

激素替代疗法联合气道正压通气治疗绝经后女性阻塞性睡眠呼吸暂停疗效观察

目的 观察激素替代疗法(HRT)联合气道正压通气(CPAP)治疗绝经后女性阻塞性睡眠呼吸暂停(OSA)的临床效果。方法 选择2022年2月至2023年5月在上海市第八人民医院治疗的100例绝经期女性OSA患者作为研究对象,按随机数表法分为观察组和对照组各50例。对照组患者给予CPAP治疗,观察组患者给予HRT+CPAP治疗。一个疗程为28 d,治疗28 d后常规开展门诊随访。治疗前及治疗28 d后,比较两组患者的睡眠图(PSG)、性激素指标[雌二醇(E2)、孕激素(P)]及生存质量测定简表(WHOQOL-BREF)变化,并比较两组患者对诊疗效果的满意率。结果 治疗后,两组患者的低通气指数、呼吸暂停次数、呼吸紊乱指数、最长呼吸暂停次数均降低,且观察组患者的上述指标分别为(10.27±2.10)次/h、(6.21±1.02)次/h、(26.10±3.28)次/h、(24.28±4.18) s,明显低于对照组的(14.28±2.17)次/h、(9.73±2.10)次/h、(31.29±4.12)次/h、(35.19±3.95) s,而两组患者治疗后的睡眠最低SaO2均升高,且观察组患者的睡眠最低SaO2为(91.31±8.21)%,明显高于对照组的(79.26±7.31)%,差异均有统计学意义(P<0.05);治疗后,两组患者的E2、P水平均升高,且观察组患者的E2、P分别为(35.13±2.25) pmol/L、(2.01±0.31)μmol/L,明显高于对照组的(18.93±2.10) pmol/L、(1.66±0.42)μmol/L,差异均有统计学意义(P<0.05);治疗后,两组患者的生理领域、心理领域、社会关系、环境领域评分均升高,且观察组患者的上述评分分别为(16.10±2.31)分、(15.31±2.04)分、(16.28±3.31)分、(16.29±2.12)分,明显高于对照组的(12.28±2.01)分、(12.01±1.94)分、(13.28±2.74)分、(12.88±1.89)分,差异均有统计学意义(P<0.05);观察组患者对诊疗效果的满意率为96.00%,明显高于对照组的82.00%,差异有统计学意义(P<0.05)。结论 HRT联合CPAP治疗绝经期女性OSA可有效改善睡眠质量、呼吸功能及激素水平,提高患者生存质量及对诊疗效果的满意度。

A comparison of two different dosages of conjugated equine estrogen in continuous combined hormone replacement therapy with progestin

To investigate the effects of two different dosages of conjugated equine estrogen (CEE) on preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause Methods A total of 236 postmenopausal women were randomly allocated to one of the following groups: Group A: 0 625 mg CEE+2 mg medroxyprogesterone acetate (MPA)+1 tab Caltrate-D per day; Group B: 0 3 mg CEE+2 mg MPA+1 tab Caltrate-D per day; Group C: 1 tab Caltrate-D per day as the control group The study was continued for 2 years The following parameters were monitored: ① L2-4 bone mineral density (BMD) (measured with dual energy X-ray absorptiometry (DEX)), ② menopausal syndr ome improvement (assessed by comparing Kupperman scores), ③ vaginal bleeding rate, and the thickness of the endometrium and breast in each group Results Overall, 213 cases (90%) completed the 1-year study and 176 cases (75%) completed the 2-year study The percentage changes in L2-4 BMD at the 12th and 24th month in Group A were +2 3% and +3 7%, respectively, with the posttreatment values being significantly higher than pretreatment values (P<0 001) The percentage changes were +2 7% at 12th month (P<0 05) and +0 7% at 24th month (P>0 05) in Group B And that of Group C were -0 4% at 12t h month and -1 6% at 24th month (P>0 05) L2-4 BMD in both Group A and B w as significantly higher than that in Group C at 12th and 24th month (A vs C, P<0 001; B vs C, P<0 05) Kupperman Sco res were significantly reduced after 1, 3, 6 ,12 and 24 months in all 3 groups when compared with baseline (P<0 001) Scores in Group A and Group B were significantly lower than that in Group C (P<0 001) However, the vaginal bleeding rates in Group A were significantly higher than that in Group B or in Group C There was no atypical hyperplasia of endometrium in the 3 groups by the end of the study One p atient in Group A developed superficial thrombophlebitis by the end of 12th month Conclusion Continuous combination of CEE and MPA is effective in preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause The vaginal bleeding rates in the Group treated with 0 625 mg/d CEE were significantly higher than those treated with 0 3 mg/d CEE

Study on drug retention in menopausal women with sequential hormone therapy and tibolone

In the present study, we aimed to retrospectively analyze the medication prescriptions of menopausal women diagnosed with menopausal syndrome in our hospital from 2015 to 2018, and compare the retention rate of estrogen and progesterone sequential therapy and hormone continuous therapy in menopausal women. The rational drug management system of Ningbo Women and Children’s hospital was used to screen the prescriptions of menopausal syndrome in 4 years. After the age, year included in the study, and prescription cost were adjusted, Kaplan-Meier regression analysis was performed to compare the prescription retention rates of the two drug regimens. The distribution of the two HRT regimens in the 4 years showed an increasing trend year by year, and the age groups of the two HRT regimens were mainly distributed between 41 and 60 years old, accounting for 97.1% and 87.06%, respectively. The cost distribution for the other two HRT regimens was approximately the same. Compared with the two HRT regimens, the drug retention rate of hormone continuous regimens was higher than that of hormone sequential regimens within 4 years. Kaplan-Meier regression analysis showed that the trend was significant(Tarone-Ware, Chi-square value = 3.857, P = 0.050). This study found that the median retention time of HRT therapy in menopausal women in our hospital was about half a year, which was significantly lower than that reported in previous studies of 1 year or longer. In addition, the present study found that compared with Femoston, the tibolone regimen significantly increased retention time in the treatment of menopausal syndrome.

上海市中老年女性绝经相关症状及绝经相关知识认知现状调查

目的了解上海市40岁以上中老年女性绝经相关症状的发生情况及对绝经相关知识的认知现状,为加强绝经过渡期及绝经后期女性健康保健及管理工作提供参考。方法2021年1月—2021年12月,随机选择上海市年龄≥40岁的女性进行问卷调查,并以改良Kupperman评分量表评估其绝经相关症状发生情况。结果共收调查问卷5441份,其中有效问卷5200份,有效率95.57%。受调查人群平均年龄为(51.7±7.0)岁,平均身高(160.42±5.07)cm,平均体质量(58.94±8.01)kg,平均BMI(22.55±2.75)kg/m^(2)。出现绝经综合征者达77%,其中重度占10.15%,中度占34.37%,绝经综合征的主要症状报告率居前五位的依次为疲乏,易激动,肌肉、骨关节痛,失眠和头痛。23.03%~36.55%对绝经相关知识认识不清或存在错误认知,41.63%的调查对象不知道绝经激素治疗;46.31%调查对象不接受绝经激素治疗;48.23%不会推荐身边的适龄女性或者亲友进行绝经激素治疗;影响受调查人群接受激素治疗的主要原因中依次是不了解安全性和有效性(66.60%)与激素治疗的风险(45.94%)等。结论40岁以上女性中绝经综合征的报告率较高,但在一定程度上存在认知缺乏,尤其是对激素补充治疗;不了解安全性和有效性与激素治疗的风险是影响接受激素治疗的主要原因,加强科普宣教和健康管理非常重要。

对500名广州妇女关于激素替代疗法态度的调查

【目的】了解广州妇女对激素替代疗法 (HRT)的态度。【方法】对 5 0 0名妇女进行面对面的问卷调查 ,记录她们对绝经症状以及激素替代疗法的认识和态度。【结果】 5 9%的妇女认为对绝经症状应该求医 ,41%妇女采取消极忍耐的态度 ,76 2 %的人选择妇科就诊 ,19 8%的妇女选择内外科或精神科 ;仅有 2 2 1%的妇女听说过HRT。绝经后妇女应用HRT的有5 9% ,2 4 4%的人不知道HRT的益处 ,知道可以预防骨质疏松和心血管疾病的分别有 17 8%和 10 8% ,5 9 8%的人不知道HRT的副作用 ,13 6 %的人不知道在哪科医生的指导下应用HRT ,40 4%的人不知道何时开始应用HRT。【结论】我们认为广州妇女的围绝经期保健意识不强 ,对HRT的了解很少 ,对HRT的利弊认识不足 ,有必要开展这方面的科普教育工作。

激素治疗对更年期综合征患者生存质量的影响

目的综合评价激素补充治疗对更年期综合征患者生理、心理的生存质量的影响。方法观察性研究125例更年期综合征患者,按有无经过激素治疗分为2组:A组65例患者未经任何激素类药物治疗,B组60例经过了6个月的激素补充治疗;测量基本参数,并填写改良Kupperman评分、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、绝经期生存质量量表(menopause-specific quality of life questionnaire,MENQOL)。结果 60例实施激素补充治疗的更年期女性的Kupperman指数,SAS、SDS、MENQOL的结果均显著低于未经治疗者;35例患者治疗前后4项量表评分差异也有统计学意义。结论激素补充治疗不仅可以显著缓解患者围绝经期出现的躯体不适,还能够改善焦虑、抑郁程度,提高更年期综合征患者的生存质量。

雌激素替代疗法对绝经期骨质疏松伴牙周病患者系统治疗的影响

目的研究雌激素替代疗法对绝经期雌激素降低伴骨质疏松女性牙周病患者进行牙周系统治疗的临床疗效。方法观察38名绝经期女性雌激素、骨密度测量水平及牙周各项指标,根据身体状况随机分为两组,对照组采取牙周系统治疗,实验组补充雌激素结合牙周系统治疗。术后3个月、6个月记录各项指标进行对比研究。结果 38名绝经期女性患者雌激素水平及骨密度存在不同程度降低,实验组12例患者补充雌激素3个月后雌激素恢复或接近正常(P<0.05),统计学上有显著性差异;6个月骨密度测量出现不同程度改善(P>0.05),但统计学上无显著性差异;附着丧失水平较未补充雌激素组降低(P>0.05),但统计学上无显著性差异。结论雌激素替代疗法可以有效提高绝经期女性雌激素、骨密度水平及牙周病患者牙周系统治疗的疗效。

成都市围绝经期和绝经后妇女对激素替代治疗的认知和接受程度

目的 :调查成都市中老年妇女绝经状况和激素替代治疗 (HRT)的使用和认知状况 ,为有针对性地开展生殖健康服务提供依据。方法 :经调查表对成都市市区和郊县的190 6名 4 4岁以上妇女进行横断面研究。结果 :成都市妇女平均绝经年龄为 4 8岁 ,2 5 .4 %的妇女应用过HRT。近 1/3的妇女了解HRT。 5 0 %的妇女希望得到这方面的教育。获得信息的主要途径是医生、亲友、医学书籍和传媒。结论 :成都市中老年妇女的生殖健康知识较为贫乏 ,应将宣传教育和医学服务相结合 。

应用小剂量利维爱对绝经后妇女的防治效果和意义

对绝经后妇女应用小剂量利维爱为期 3年的前瞻性研究。服药剂量每日 1 .2 5mg (1 / 2量组 ) 3 9例和每日 0 .62 5 mg (1 / 4量组 ) 1 2例。于用药前及用药后每 6个月随诊 ,分别观察骨密度、尿 Ca/ Cr比值、血脂 ,子宫大小、子宫内膜厚度 ,体重及副反应等。结果 :两组经 SPA、DXA和 QCT测量骨密度均有上升。以 QCT更为明显 ,其中 1 / 2量组治疗后上升 1 5 .4% ,与治疗前相比有显著差异 (P<0 .0 0 1 ) ,1 / 4量组治疗后上升 9.0 % ,与治疗前相比无显著差异 (P>0 .0 5 ) ;两组尿 Ca/ Cr比值相应的下降率分别为 1 1 .8%与8.6%。两组甘油三脂相应下降 1 6.5 %和 2 6.7% ;两组子宫内膜厚度虽有所增加 ,但平均厚度均未超过 0 .5 cm。以上各项两组相比均无显著差异 (P>0 .0 5 )。阴道出血率 2 6%(1 3 / 5 1 ) ,其中 77% (1 0 / 1 3 )为绝经 3年内开始服药 ,63 % (8/ 1 3 )为服药 1年内开始出血。体重在 1 / 2量组增加约 5 %而 1 / 4量组无明显增加 ,但两组相比也无明显差异 (P>0 .0 5 )。结论 :绝经后妇女应用 1 / 2量利维爱可提高骨密度 ,1 / 4量利维爱可维持骨量 ;甘油三脂均下降 ,参与保护心血管的作用 ,对子宫内膜无明显刺激作用。结果显示利维爱能有效地用于绝经后妇女激素替代治疗 ,但例数较少 ,年龄段有?