Aia ʻo Hormone replacement therapy, e like me ka inoa e hōʻike nei, i ka lanakila ʻana i kahi lawa ʻole o nā huna hormonal. Hiki ke kuhikuhi ʻia kēia ʻano lapaʻau i ka manawa o ka peri-menopause a me ka menopause, e uku ai i ka pani ʻana i ka hana ʻana o nā hormoni ovarian. No laila kona inoa ʻē aʻe, menopause hormone therapy (THM).

Ma ke ʻano he hoʻomanaʻo, hele pinepine ka menopause ma kahi o ka makahiki 50. Ma hope o ka pau ʻana o ka waihona follicular, kū ka hana ʻana o nā homone ovarian (estrogen a me progesterone), e hoʻopau ana i ka menstruation. Manaʻo ʻia ua hele kekahi wahine ma waena o ka menopause ma hope o 12 mau mahina o ka hoʻōki ʻana i ka menstruating.

ʻO ka kū ʻana o ka hana hormonal hiki ke kumu i nā ʻōuli like ʻole, i ʻike ʻia ʻo "climacteric disorders": nā uila wela, ka wela o ka pō, ka maloʻo a me nā pilikia urinary. Hoʻololi ka ikaika a me ka lōʻihi o kēia mau maʻi ma waena o nā wahine.

Hoʻolālā ʻo HRT e kaupalena i kēia mau hōʻailona ma o ka uku ʻana no ka hemahema estrogen ma ke kumu o kēia mau maʻi climacteric. I nā wahine hysterectomized non-hysterectomized (ke loaʻa nei kā lākou kōpū), hoʻohui pinepine ʻia ka estrogen me kahi progestogen waha e pale ai i ka hoʻomaka ʻana o ka maʻi ʻaʻai endometrial-pili i ka estrogen.

Maikaʻi kēia hana a hoʻoliʻiliʻi i ke alapine a me ke koʻikoʻi o nā wela wela, hoʻomaikaʻi i ka maloʻo a me nā pilikia moekolohe. He hopena pale pū kekahi ia ma nā haʻi āpau (vertebrae, nā pulima, nā pūhaka) i nā wahine postmenopausal, hoʻopau i ka hōʻike 2004 HAS ma HRT (1).

Ua kuhikuhi ākea ʻo HRT a hiki i ka 2000 mau mua. Eia nō naʻe, ma waena o 2000 a me 2002 mau noiʻi ʻAmelika, e like me ka Women Health Initiative ʻoi aku ka maikaʻi i ʻike ʻia ma lalo o ka inoa ʻo WHI (2), i hōʻike i ka hoʻonui ʻia o ka makaʻu o ka umauma maʻi ʻaʻai a me ka maʻi ʻaʻai umauma. maʻi maʻi maʻi i loko o nā wahine e lawe ana i ka HRT.

Ua alakaʻi kēia hana i nā luna olakino e hōʻike hou i nā makaʻu o ka HRT a hoʻololi i kā lākou mau manaʻo e like me kēia i ka hōʻike 2004 like. Hoʻomanaʻo ka hana i nā pilikia ʻē aʻe i ʻike ʻia i ka hanana o HRT.

• ka māhuahua o ka maʻi ʻaʻai o ka umauma: hoʻohui ʻia nā estrogen-progestogen lapaʻau i alakaʻi ʻia i ka hoʻonui ʻana i ka maʻi kanesa o ka umauma e pili ana i ka lōʻihi o ke kauka, keu hoʻi ma hope o 5 mau makahiki o ka hoʻohana (3). Ma waena o 2000 a me 2002, 3% a i 6% o nā maʻi ʻaʻai umauma i nā wahine ma waena o nā makahiki 40 a me 65 i manaʻo ʻia e pili ana i ka hormone therapy no ka menopause (4);
• hoʻonui i ka makaʻu o ka thrombosis venous me ka embolism pulmonary;
• hoʻonui i ka makaʻu o ka hahau. Ma waena o 2000 a me 2002, 6,5% a hiki i ka 13,5% o nā hihia hahau e pili ana i nā wahine 40 a 65 (5) mau makahiki.
• ka piʻi nui o ka maʻi ʻaʻai endometrial i ka hanana o ka estrogen therapy, ʻo ia ke kumu e pili mau ai kahi progestogen me ia i nā wahine me ka ʻole o ka hysterectomy.

Ma ka ʻaoʻao ʻē aʻe, he kuleana pale ko ka estrogen-progestogen HRT i ka maʻi ʻaʻai kala.

ʻAʻole pono e kuhikuhi pinepine ʻia ʻo HRT a puni ka menopause. Paipai ʻo HAI iā ʻoe e nānā pākahi i ka lakio pōmaikaʻi / pilikia ma mua o ke kuhikuhi ʻana iā HRT. Pono e aʻo ʻia ka ʻikepili o kēlā me kēia wahine e pili ana i nā pilikia (nā pilikia o ka maʻi maʻi, ka ʻeha haki, ka mōʻaukala o ka umauma umauma) a me nā pōmaikaʻi (e kūʻē i nā maʻi climacteric a me ka pale ʻana i ka osteoporosis) i mea e koho ai i ka lapaʻau, ke ʻano o ka lawelawe ʻana (waha. a i ʻole ke ala transdermal) a me kona lōʻihi.

Ma 2014, ua hōʻano hou ka HAS i kāna mau ʻōlelo aʻoaʻo (6) a hoʻomanaʻo i nā hōʻike aʻe no ka HRT:

• ke ʻike ʻia nā maʻi climacteric e like me ka hilahila e hōʻino ai i ke ʻano o ke ola;
• no ka pale ʻana i ka osteoporosis postmenopausal i nā wahine i ka nui o ka maka o ka haʻi osteoporotic a i hoʻomanawanui a i ʻole cont conticated i nā lāʻau ʻē aʻe i hōʻike ʻia no ka pale ʻana i ka osteoporosis.

Paipai pū kekahi i ke kau ʻana i ka lāʻau ma ka lāʻau liʻiliʻi a no ka palena o ka lōʻihi, a me ka hoʻoponopono hou ʻana i ka lāʻau ma hoʻokahi manawa i ka makahiki. Ma ka awelika, ʻo ka manawa kuhikuhi i kēia manawa ʻo 2 a 3 mau makahiki e pili ana i ka hoʻomaikaʻi ʻana i nā ʻōuli.

Ma muli o nā ʻano pilikia like ʻole i ʻōlelo ʻia, ua hoʻopiʻi ʻia ka HRT i nā hihia aʻe:

• moʻolelo pilikino o ka umauma maʻi 'aʻai;
• ka mōʻaukala o ka myocardial infarction, coronary heart disease, stroke a venous thromboembolic maʻi;
• ka pilikia kiʻekiʻe o ka maʻi puʻuwai (hypertension, hypercholesterolemia, puhipaka, kaona kaumaha) (7).