Hormone replacement therapy and prevention of chronic conditions

Abstract

Nowadays, postmenopausal women are largely undertreated. Analysis of conflicting results among different studies suggests that hormone replacement therapy (HRT) can prevent osteoporosis and cardiovascular disease in symptomatic, early postmenopausal women. In fact, climacteric symptoms are related to an increased risk of chronic conditions, including hypertension and cardiovascular disease. Different scientific societies have pointed out that patient selection, timing of initiation, and the choice of the type and dose of HRT used are the major determinants of the ultimate effect of HRT on women’s health and quality of life in selected women. HRT may prevent chronic conditions when started in symptomatic women before the age of 60 years or within 10 years of the onset of the menopause, taking into consideration the characteristics and risk profiles of each given woman. The bulk of scientific evidence from preclinical, clinical, epidemiological, and also randomized studies indicates that wisely selected HRT is generally useful and rarely dangerous. Following simple and well-established rules, HRT benefits outweigh all of the possible risks. Progestogen choice can make the difference in terms of cardiovascular disease benefits.

摘要

如今, 绝经后妇女很大程度上没有得到全面的治疗。通过对不同研究结果的分析表明, 激素替代疗法(HRT)可以预防有症状的早期绝经妇女的骨质疏松症和心血管疾病。事实上, 更年期综合征与高血压和心血管疾病等慢性疾病的风险增加有关。不同的研究团队均指出, 病人的筛选标准、开始治疗的时间、用激素替代疗法的类型和剂量是激素替代疗法对妇女的健康和生活质量最终影响的主要决定因素。考虑到每位妇女的特点和风险特征, HRT可在60岁前有更年期症状的绝经妇女或绝经后10年内的女性中预防慢性疾病。大量来自临床前、临床、流行病学和随机研究的科学证据表明, 明智地选择HRT通常是有意义而且几乎没有用药风险的。HRT的好处大于所有可能的风险。孕激素的选择会对心血管疾病的益处产生影响。

Keywords:

• Menopause
• hormone replacement therapy
• osteoporosis
• cardiovascular disease
• hypertension

Conflict of interest

M. Gambacciani is a Speaker and Advisory Board member for Bayer, Fotona, Gedeon Richter, MSD, and Teva. A. Cagnacci is a Speaker and Advisory Board member for MSD, Bayer Italia, Gedeon-Richter, and Teva Italia. S. Lello reported no potential conflict of interest.

Additional information

Funding

Nil.