Zusammenfassung
Mit steigender Lebenserwartung verbringen heute Frauen ein Drittel ihres Lebens und darüber hinaus in der Menopause. Die überwiegende Mehrheit leidet unter Symptomen, die sich negativ auf ihre Lebensqualität auswirken. Systemische vasomotorische Symptome (VMS) wie Hitzewallungen und Schweißausbrüche sind die klassische Symptomgruppe, die 80 % der peri- und postmenopausalen Frauen betrifft. Lokale vulvovaginale und harnableitende Symptome, die heute als genitourinäres Syndrom der Menopause (GSM) bezeichnet werden, treten bei etwa der Hälfte der postmenopausalen Frauen auf. Östrogen ist nach wie vor die wirksamste Behandlung für diverse klimakterische Beschwerden. Bei Frauen mit erhöhtem Frakturrisiko kann es zur Osteoporoseprävention verwendet werden. Für Frauen, die eine vorzeitige Menopause erleben, sei es aufgrund einer primären Ovarialinsuffizienz (POI) oder anderer Ätiologien, ist Östrogen die natürlichste Substanz zur Linderung von Beschwerden und kann auch zur Prävention chronischer Krankheiten eingesetzt werden. Die seit der WHI-Studie in Verruf geratene menopausale Hormontherapie (MHT) ist heute in einem völlig neuen Licht zu sehen, nicht nur aufgrund neuer Studiendaten und Erkenntnisse, sondern auch aufgrund verbesserter Anwendungsformen der hormonellen Komponenten. Die für viele Frauen im Klimakterium so wichtige Hormontherapie wurde in den letzten Jahren sträflich vernachlässigt und soll hier aus der Sicht eines langjährigen Praktikers beleuchtet werden.
Abstract
Today, with increasing life expectancy, women spend a third of their lives or more in menopause. The vast majority have symptoms that negatively impact their quality of life. Systemic vasomotor symptoms (VMSs) like hot flushes and attacks of sweating are the classic group of symptoms that affect 80% of peri- and postmenopausal women. Local vulvovaginal and urinary tract symptoms, now known as genitourinary syndrome of menopause (GSM), occur in half of postmenopausal women. Estrogen is still the most effective treatment for various menopausal symptoms. It can be used to prevent osteoporosis in women with high fracture risk. For women who experience premature menopause, be it due to primary ovarian insufficiency (POI) or iatrogenic aetiologies, estrogen is the most natural substance for relief of symptoms and prevention of chronic diseases. Menopausal hormone therapy (MHT), which has fallen into disrepute since the WHI study, can now be seen in a completely new light, not only because of new study data and findings but also because of the different ways in which the hormonal components are used. Hormonal treatment during menopause, which is so important for many women, has been criminally neglected in recent years and is to be examined in the following article from the perspective of a long-term practitioner.
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Svejda, B. Praxisnahe menopausale Hormontherapie. J. Miner. Stoffwechs. Muskuloskelet. Erkrank. 28, 47–55 (2021). https://doi.org/10.1007/s41970-021-00153-x
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DOI: https://doi.org/10.1007/s41970-021-00153-x
Schlüsselwörter
- Vasomotorische Symptome
- Osteoporose
- Transdermales Östrogen
- Mikronisiertes Progesteron
- Women’s-Health-Initiative-Studie