停經後婦女之低劑量荷爾蒙療法與乳房癌症

在2002年以前的數十年，荷爾蒙治療被認爲是處理停經症狀時最有效的主流方法。但是2002年以後報告顯示，不管是單補充動情素或是共同補充動情素和黃體素的荷爾蒙補充療法都可能會造成罹患乳癌的風險上升，或是其他的不良影響。也許就是因爲關於荷爾蒙補充的好處結果仍不明確，而這些相對明顯的壞處存在，所以在2002年以後，臨床醫師治療這些更年期婦女時對於荷爾蒙的使用相對得保守許多。但是有些停經後的婦女，的確身受嚴重的更年期症狀所困擾。所以面對一個有嚴重停經症狀的婦女其實有時仍需要使用荷爾蒙來治療，對於荷爾蒙來治療嚴重停經症狀的婦女，目前的看法認爲可以給予低劑量的荷爾蒙或短時間的荷爾蒙的治療來改善症狀。但是長期的影響仍不清楚。因此，爲了了解低劑量的荷爾蒙在停經後婦女造成乳癌所扮演的角色，較適當的方法是去回顧利用低劑量荷爾蒙來改善停經後婦女之停經後症侯群所造成乳癌上升的相關資料。本篇文章將針對以低劑量的荷爾蒙對乳房的影響，從研究結果作一整理。

關鍵字

乳癌；荷爾蒙治療；停經

並列摘要

Menopause is a hypoestrogenic state, which may adversely affect estrogen target tissues, such as the brain, skeleton, and skin, as well as the cardiovascular and genitourinary systems, with resultant frequency and severity of climacteric symptoms. The climacteric symptoms, however, vary significantly among women. For decades, hormone therapy (HT) has been the mainstay and is considered the most effective for managing menopausal symptoms. The prolonged use of either single estrogen therapy (UT) or a combination therapy of estrogen and progestogen (EPT) might be associated with a slightly increased risk of breast cancer. Perhaps because the clear benefits are limited to these end points of HT in treating menopausal women, the relatively significant adverse event profiles of these women may not be enough to trigger primary care physicians to be more aggressive than they have been to date in treating climacteric symptoms of postmenopausal women. However, severe climacteric symptoms really disturb the woman's life. Low-dose oral EPT appears to be effective for the alleviation of climacteric symptoms; (ii) it has a good tolerability profile with a low incidence of the most common and problematic side effects such as breast tenderness and an increased mammographic density. Taken together, compared to the standard dose HT, physicians may prefer to use low-dose HT initially in managing the climacteric symptoms of postmenopausal women.

並列關鍵字

estrogen ； hormone therapy ； low-dose ； menopause ； postmenopausal women ； progestins

國際替代計量

停經後婦女之低劑量荷爾蒙療法與乳房癌症

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