هورمون درمانی بعد از یائسگی: مزایا و معایب

نوع مقاله: مروری

نویسندگان

1 استاد گروه زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 دکترای بهداشت باروری، دانشکده پزشکی، دانشگاه آزاد اسلامی واحد تنکابن، تنکابن، ایران.

3 دکترای بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

چکیده

مقدمه: هورمون درمانی به طور گسترده ای جهت کنترل علائم یائسگی، پیشگیری و درمان بیماری قلبی عروقی، استئوپروز و زوال عقل در زنان مسن استفاده می شود. مطالعه حاضر با هدف شناسایی اثرات طولانی مدت هورمون درمانی بر مشکلات یائسگی انجام شد.
روش کار: این مطالعه به صورت مروری با جستجوی 25 مقاله مرتبط در مورد هورمون درمانی بعد از یائسگی طی سال های 1999 تا 2010 صورت گرفت. جستجو در پایگاه‌های اطلاعاتی ISI Web of Science، Up to date و Scopus با استفاده از کلیدواژه هایی نظیر یائسگی، هورمون درمانی، عوارض هورمون درمانی، استروژن و پروژسترون انجام گرفت. معیارهای ورود مقالات به مطالعه شامل درج واژه های مورد جستجو در بخش عنوان یا کلیدواژه های مقالات بود. مقالات با داده های ناقص و مقالاتی که تنها چکیده آن ها در دسترس بود از مطالعه خارج شدند.
یافته ها: در زنان نسبتاً سالم، هورمون درمانی ترکیبی مداوم به میزان قابل توجهی خطر ترومبوآمبولیسم وریدی یا حوادث کرونری، سکته، سرطان پستان و بیماری کیسه صفرا را افزایش می دهد. هورمون درمانی طولانی مدت با استروژن تنها به میزان قابل توجهی خطر سکته و بیماری کیسه صفرا را افزایش می دهد. به طور کلی، تنها فواید مهم هورمون درمانی، کاهش بروز شکستگی ها و سرطان کولون با مصرف طولانی مدت می باشد.
نتیجه گیری: هورمون درمانی برای درمان معمول بیماری مزمن اندیکاسیون ندارد. نیاز به شواهد بیشتر در زمینه بی خطر بودن هورمون درمانی جهت کنترل علائم یائسگی وجود دارد. تصور بر این است که مصرف کوتاه مدت هورمون برای زنان سالم جوان تر، نسبتاً بی خطر باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Hormone therapy after menopause: Advantages and Disadvantages

نویسندگان [English]

  • Farideh Akhlaghi 1
  • Maryam Zakeri Hamidi 2
  • Zohreh Khakbazan 3
1 Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 PhD of Reproductive Health, School of Medicine, Islamic Azad University of Tonekabon, Tonekabon, Iran.
3 PhD of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Hormone therapy is widely used to control the menopause symptoms, prevention and treatment of cardiovascular disease, osteoporosis and dementia in old women. This study was performed with aim to identify the long-term effects of hormone therapy on menopausal problems.
Methods: This study was performed as a review of 25 articles related to hormone therapy after menopause between 1999 and 2010.  Searching was performed in databases including ISI web of Science, Up to date, and Scopus using keywords of menopause, hormone therapy, complications of hormone therapy, estrogen and progesterone. Inclusion criteria included the insertion of search terms in the title or keywords of the article. Articles with incomplete data and articles which only their abstracts are available were excluded.
Results: In relatively healthy women, continuous combined hormone therapy significantly increases the risk of venous thromboembolism or coronary events, stroke, breast cancer and gallbladder disease. Long-term hormone therapy with estrogen alone significantly increases the risk of stroke and gallbladder disease. In general, the only benefits of hormone therapy are reducing the incidence of fractures and colon cancer with long-term use.
Conclusions: Hormone therapy is not an indication for routine management of chronic disease. There is a need for more evidence on the safety of hormone therapy to control the menopausal symptoms. It is believed that short-term use of hormones is relatively safe for healthy younger women.

کلیدواژه‌ها [English]

  • Estrogen
  • Estrogen and Progesterone
  • Hormone Therapy
  • Menopause
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