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Endokrinopathien in der Postmenopause

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Zusammenfassung

Der Ausfall der Sexualsteroide in der Postmenopause führt zu Veränderungen mehrerer endokrinologischer Regelkreise, teils mit Krankheitswert. Dies betrifft v. a. Volkskrankheiten, deren Verläufe aggraviert werden. Der Glukosestoffwechsel wird bereits bei jüngeren Patientinnen durch Übergewicht oder Erkrankungen wie das PCO-Syndrom vorgeschädigt. In der Peri- oder Postmenopause kommt es dann zur Ausbildung eines Diabetes mellitus Typ II. Durch Verschiebungen der Steroidbalance überwiegen bei korpulenten Frauen in der Postmenopause Androgene, die durch negative Veränderungen des Lipidstoffwechsels das Risiko für Gefäßerkrankungen erhöhen. Auch ein veränderter Leberstoffwechsel verstärkt die biologische Verfügbarkeit von Androgenen. Schilddrüsenerkrankungen werden in den Wechseljahren oftmals klinisch manifest und beeinflussen Lipid- und Glukosestoffwechsel, die Hyperandrogenämie wird verstärkt.

Es empfiehlt sich daher, bei Patientinnen in der Peri- und Postmenopause auf krankhafte Veränderungen dieser Stoffwechselwege und des Steroidmetabolismus zu achten.

Abstract

The postmenopausal loss of estrogens and progestins alters many endocrine systems. These changes are often so profound that serious conditions arise. Some very common diseases are aggravated by postmenopausal status. Many young women already suffer from obesity and endocrine conditions, such as PCO-syndrome, which are related to a disturbed glucose metabolism. There is a high risk that these women will develop a NIDDM during menopause. A disturbed steroid balance in these patients leads to hyperandrogenemia resulting in a compromised lipid metabolism. Vascular diseases may follow. Thyroid dysfunction adds to metabolic disorders and worsens hyperandrogenemia.

Patients during peri- and postmenopause should be checked for conditions related to glucose metabolism, hyperandrogenemia and thyroid dysfunction.

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  1. Klinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum, RWTH Aachen

    J. Neulen

  2. Klinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum der RWTH Aachen, Pauwelsstraße 30, 52074 Aachen

    J. Neulen

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Neulen, J. Endokrinopathien in der Postmenopause. Gynäkologe 36, 216–219 (2003). https://doi.org/10.1007/s00129-003-1333-6

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  • DOI: https://doi.org/10.1007/s00129-003-1333-6

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