| spelling |
Fernando Marcos dos Reishttp://lattes.cnpq.br/3201214049358628Cristina Laguna Benetti PintoAndrea Prestes Náculhttp://lattes.cnpq.br/0735263312769501Caroline Reis Gonçalves2023-05-12T12:16:08Z2023-05-12T12:16:08Z2021-12-16http://hdl.handle.net/1843/531760000-0003-0556-1934The aim of this systematic review and meta-analysis was to evaluate the effects of different hormone therapies (HT) on clinical outcomes in women with premature ovarian insufficiency (POI). We included 31 studies totalizing 4142 participants with POI from diverse etiologies, of whom 2619 received HT and 201 received calcium supplementation, vitamin D, placebo, or no treatment. HT was superior to non-treatment, placebo, calcitriol or calcium to preserve bone mineral density (BMD) in women with POI. HT was associated with up to 80% reduction in the prevalence of hot flushes and with stability or improvement in the quality of life scores. HT induced significant increases in uterine volume and endometrial thickness in women with POI. Overall, the studies had good quality, although some lacked blinding of participants and personnel or had incomplete outcome data. We found moderate to high quality evidence that HT with estrogen and progesterone or progestin is beneficial to women with POI, not only to mitigate menopausal symptoms but also to preserve BMD and avoid uterine atrophy. More studies are needed to reassure the long-term safety of this therapy and to assess its possible impact on the risk of hard outcomes such as bone fractures and cardiovascular events.Esta revisão sistemática e meta-análise buscou avaliar os efeitos de diferentes terapias hormonais (HT) sobre os resultados clínicos em mulheres com insuficiência ovariana prematura (POI). Foram incluídos 31 estudos, totalizando 4.142 participantes com POI de diversas etiologias, dos quais 2.619 receberam HT e 201 receberam suplementação de cálcio, vitamina D, placebo ou nenhum tratamento. HT foi superior ao não tratamento, placebo, calcitriol ou cálcio para preservar a densidade mineral óssea (DMO) em mulheres com POI. A TH foi associada a uma redução de até 80% na prevalência de fogachos e à estabilidade ou melhora nos escores de qualidade de vida. HT induziu aumentos significativos no volume uterino e espessura endometrial em mulheres com POI. No geral, os estudos tiveram boa qualidade, embora alguns não tivessem cegamento dos participantes e do pessoal ou tivessem dados de resultados incompletos. Encontramos evidências de qualidade moderada a alta de que a TH com estrogênio e progesterona ou progesterona é benéfica para mulheres com POI, não apenas para mitigar os sintomas da menopausa, mas também para preservar a DMO e evitar a atrofia uterina. Mais estudos são necessários para assegurar a segurança em longo prazo dessa terapia e para avaliar seu possível impacto sobre o risco de outros desfechos clínicos, como fraturas ósseas e eventos cardiovasculares.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoengUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Saúde da MulherUFMGBrasilMEDICINA - FACULDADE DE MEDICINAhttp://creativecommons.org/licenses/by-nd/3.0/pt/info:eu-repo/semantics/openAccessPrimary Ovarian InsufficiencyInsuficiência Ovariana PrimáriaHormone Replacement TherapyTerapia de Reposição HormonalEstrogensEstrogêniosProgesteroneProgesteronaBone DensityDensidade ÓsseaMeta-AnalysisMetanálisepremature ovarian insufficiencyhormone therapyestrogenprogesteronebone mineral densitymeta-analysisHormone therapy in women with premature ovarian insufficiency: a systematic review and meta-analysisTerapia hormonal em mulheres com insuficiência ovariana prematura: uma revisão sistemática e meta-análiseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINAL10-05-2021 DISSERTAÇÃO MESTRADO CAROL OFICIAL FINAL.pdf10-05-2021 DISSERTAÇÃO MESTRADO CAROL OFICIAL FINAL.pdfDissertação de Mestrado : Hormone Therapy in women with premature ovarian insufficiency: a systematic review and meta-analysisapplication/pdf2358858https://repositorio.ufmg.br/bitstream/1843/53176/1/10-05-2021%20DISSERTA%c3%87%c3%83O%20MESTRADO%20CAROL%20OFICIAL%20FINAL.pdf6f34910f29cb1c0a0eee1bb7c76ad50fMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805https://repositorio.ufmg.br/bitstream/1843/53176/2/license_rdf00e5e6a57d5512d202d12cb48704dfd6MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/53176/3/license.txtcda590c95a0b51b4d15f60c9642ca272MD531843/531762023-05-12 09:16:08.733oai:repositorio.ufmg.br:1843/53176TElDRU7Dh0EgREUgRElTVFJJQlVJw4fDg08gTsODTy1FWENMVVNJVkEgRE8gUkVQT1NJVMOTUklPIElOU1RJVFVDSU9OQUwgREEgVUZNRwoKQ29tIGEgYXByZXNlbnRhw6fDo28gZGVzdGEgbGljZW7Dp2EsIHZvY8OqIChvIGF1dG9yIChlcykgb3UgbyB0aXR1bGFyIGRvcyBkaXJlaXRvcyBkZSBhdXRvcikgY29uY2VkZSBhbyBSZXBvc2l0w7NyaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIChSSS1VRk1HKSBvIGRpcmVpdG8gbsOjbyBleGNsdXNpdm8gZSBpcnJldm9nw6F2ZWwgZGUgcmVwcm9kdXppciBlL291IGRpc3RyaWJ1aXIgYSBzdWEgcHVibGljYcOnw6NvIChpbmNsdWluZG8gbyByZXN1bW8pIHBvciB0b2RvIG8gbXVuZG8gbm8gZm9ybWF0byBpbXByZXNzbyBlIGVsZXRyw7RuaWNvIGUgZW0gcXVhbHF1ZXIgbWVpbywgaW5jbHVpbmRvIG9zIGZvcm1hdG9zIMOhdWRpbyBvdSB2w61kZW8uCgpWb2PDqiBkZWNsYXJhIHF1ZSBjb25oZWNlIGEgcG9sw610aWNhIGRlIGNvcHlyaWdodCBkYSBlZGl0b3JhIGRvIHNldSBkb2N1bWVudG8gZSBxdWUgY29uaGVjZSBlIGFjZWl0YSBhcyBEaXJldHJpemVzIGRvIFJJLVVGTUcuCgpWb2PDqiBjb25jb3JkYSBxdWUgbyBSZXBvc2l0w7NyaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIHBvZGUsIHNlbSBhbHRlcmFyIG8gY29udGXDumRvLCB0cmFuc3BvciBhIHN1YSBwdWJsaWNhw6fDo28gcGFyYSBxdWFscXVlciBtZWlvIG91IGZvcm1hdG8gcGFyYSBmaW5zIGRlIHByZXNlcnZhw6fDo28uCgpWb2PDqiB0YW1iw6ltIGNvbmNvcmRhIHF1ZSBvIFJlcG9zaXTDs3JpbyBJbnN0aXR1Y2lvbmFsIGRhIFVGTUcgcG9kZSBtYW50ZXIgbWFpcyBkZSB1bWEgY8OzcGlhIGRlIHN1YSBwdWJsaWNhw6fDo28gcGFyYSBmaW5zIGRlIHNlZ3VyYW7Dp2EsIGJhY2stdXAgZSBwcmVzZXJ2YcOnw6NvLgoKVm9jw6ogZGVjbGFyYSBxdWUgYSBzdWEgcHVibGljYcOnw6NvIMOpIG9yaWdpbmFsIGUgcXVlIHZvY8OqIHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIG5lc3RhIGxpY2Vuw6dhLiBWb2PDqiB0YW1iw6ltIGRlY2xhcmEgcXVlIG8gZGVww7NzaXRvIGRlIHN1YSBwdWJsaWNhw6fDo28gbsOjbywgcXVlIHNlamEgZGUgc2V1IGNvbmhlY2ltZW50bywgaW5mcmluZ2UgZGlyZWl0b3MgYXV0b3JhaXMgZGUgbmluZ3XDqW0uCgpDYXNvIGEgc3VhIHB1YmxpY2HDp8OjbyBjb250ZW5oYSBtYXRlcmlhbCBxdWUgdm9jw6ogbsOjbyBwb3NzdWkgYSB0aXR1bGFyaWRhZGUgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCB2b2PDqiBkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgYW8gUmVwb3NpdMOzcmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgaWRlbnRpZmljYWRvIGUgcmVjb25oZWNpZG8gbm8gdGV4dG8gb3Ugbm8gY29udGXDumRvIGRhIHB1YmxpY2HDp8OjbyBvcmEgZGVwb3NpdGFkYS4KCkNBU08gQSBQVUJMSUNBw4fDg08gT1JBIERFUE9TSVRBREEgVEVOSEEgU0lETyBSRVNVTFRBRE8gREUgVU0gUEFUUk9Dw41OSU8gT1UgQVBPSU8gREUgVU1BIEFHw4pOQ0lBIERFIEZPTUVOVE8gT1UgT1VUUk8gT1JHQU5JU01PLCBWT0PDiiBERUNMQVJBIFFVRSBSRVNQRUlUT1UgVE9ET1MgRSBRVUFJU1FVRVIgRElSRUlUT1MgREUgUkVWSVPDg08gQ09NTyBUQU1Cw4lNIEFTIERFTUFJUyBPQlJJR0HDh8OVRVMgRVhJR0lEQVMgUE9SIENPTlRSQVRPIE9VIEFDT1JETy4KCk8gUmVwb3NpdMOzcmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lKHMpIG91IG8ocykgbm9tZXMocykgZG8ocykgZGV0ZW50b3IoZXMpIGRvcyBkaXJlaXRvcyBhdXRvcmFpcyBkYSBwdWJsaWNhw6fDo28sIGUgbsOjbyBmYXLDoSBxdWFscXVlciBhbHRlcmHDp8OjbywgYWzDqW0gZGFxdWVsYXMgY29uY2VkaWRhcyBwb3IgZXN0YSBsaWNlbsOnYS4KRepositório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-05-12T12:16:08Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
|