人工绝经的激素替代治疗.ppt

* 人工绝经与激素替代 效果如何？ 方案选择？ 知情选择 激素治疗的风险、益处？ 医生的作用？ * 人工绝经与激素替代 效果如何？一级预防或二级预防 方案选择？个体化 激素治疗的风险、益处：知情选择 医生的作用: 利弊权衡，方案优化 * 总结 人工绝经者绝经综合征症状更为严重 切除子宫的情况下，可单一应用雌激素 口腹途径不是唯一和可能最好的途径 采用优化后的低剂量复合用药改善泌尿生殖道症状 治疗个体化：Not a “one-size fits all” approach 告知患者风险，获益及可能副作用 * THANKS FOR YOUR ATTENTION * Menopause, whether it occurs naturally or surgically, is characterized by the loss of hormones cyclically produced by ovarian follicles, including estradiol, a potent estrogen known to influence brain function, and progesterone * Hysterectomies remain one of the most common operations in the US. Within the last 10 years, there have been an average of about 600,000 hysterectomies a year. The most common age is 40-44, followed by age 35 to 39. By the age of 40 in the US, half of the women who are having a hysterectomy are having their ovaries removed. * The ovaries are the main source of estrogen, progesterone, and androgens in the body. When they are gone, the hormone levels fall and changes associated with menopause occur. These changes are different in each woman, but can include: In addition, Women with surgical menopause are also at increased risk for cardiovascular disease and osteoporosis. -90% of surgically induced menopausal women experience hot flashes compared to the 40% of natural menopause. -Reports also suggest they are more frequent and/or severe. * This slide shows ovaries in the premenopause, postmenopause, and then the blank space for the surgical menopausal woman. This slide emphasizes that menopause marks the time in a woman’s life when there is a change in ovarian function. With natural menopause there is actually a level of continuing ovarian function, even after the last menstual flow. But for women who have a surgical menopause, that is completely absent. The blank space emphasizes the finality of ovarian function and the absence of the transitional phase. * As you can see, the main difference between natural and surgical menopause is the rapid rate of d