Terapia hormonal da menopausa
Autor(a) principal: | |
---|---|
Data de Publicação: | 2007 |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0004-27302007000600007 http://repositorio.unifesp.br/handle/11600/3851 |
Resumo: | Although estrogen has been clinically available for more than 6 decades, women have been confused by different opinions regarding the risks and benefits of menopausal hormone therapy (HT), estrogen therapy (ET), and estrogen-progestin therapy (EPT). The main indication for HT use in postmenopausal women remains the relief of vasomotor symptoms and vulvovaginal atrophy, and is effective in the prevention of osteoporosis. In other areas of research, notably in cardiovascular and central nervous system effects, the recent literature has produced conflicting results. Treatment for up to 5 years does not add significantly to lifetime risk of breast cancer, but significantly decreases bone loss and risk of osteoporotic fractures. Some women may be susceptible to early thrombotic risk, but when appropriate HT is given after individual clinical evaluation, the benefits will far outweigh any potential risks and the treatment should be recommended. Clinical research continues into genetic factors influencing the response to ET/HT, different estrogen formulations, different modes of delivery and lower-dose options. Patients and clinicians should make treatment decisions on the basis of an individual s needs and risks, and should enhance a woman s ability to undergo the menopausal transition with minimal disruption to her quality of life. In women experiencing distressing climacteric symptoms during the peri and postmenopause there is conclusive evidence from abundant randomized controlled trials that systemic hormone therapy (HT) of any type affords symptom relief, with no alternative treatment producing similar effect. Future research is needed to identify new indications for HRT and to diminish or abolish its potential risks. |
id |
UFSP_60db0a0469e2f6615a80caf869c0798e |
---|---|
oai_identifier_str |
oai:repositorio.unifesp.br/:11600/3851 |
network_acronym_str |
UFSP |
network_name_str |
Repositório Institucional da UNIFESP |
repository_id_str |
3465 |
spelling |
Terapia hormonal da menopausaMenopausal hormone therapyMenopauseHormone therapyClimacteriumMenopausaTerapia hormonalClimatérioAlthough estrogen has been clinically available for more than 6 decades, women have been confused by different opinions regarding the risks and benefits of menopausal hormone therapy (HT), estrogen therapy (ET), and estrogen-progestin therapy (EPT). The main indication for HT use in postmenopausal women remains the relief of vasomotor symptoms and vulvovaginal atrophy, and is effective in the prevention of osteoporosis. In other areas of research, notably in cardiovascular and central nervous system effects, the recent literature has produced conflicting results. Treatment for up to 5 years does not add significantly to lifetime risk of breast cancer, but significantly decreases bone loss and risk of osteoporotic fractures. Some women may be susceptible to early thrombotic risk, but when appropriate HT is given after individual clinical evaluation, the benefits will far outweigh any potential risks and the treatment should be recommended. Clinical research continues into genetic factors influencing the response to ET/HT, different estrogen formulations, different modes of delivery and lower-dose options. Patients and clinicians should make treatment decisions on the basis of an individual s needs and risks, and should enhance a woman s ability to undergo the menopausal transition with minimal disruption to her quality of life. In women experiencing distressing climacteric symptoms during the peri and postmenopause there is conclusive evidence from abundant randomized controlled trials that systemic hormone therapy (HT) of any type affords symptom relief, with no alternative treatment producing similar effect. Future research is needed to identify new indications for HRT and to diminish or abolish its potential risks.Embora a reposição estrogênica esteja disponível há mais de 6 décadas, as mulheres e mesmo os profissionais da saúde estão confusos pelas opiniões divergentes em relação aos riscos e benefícios da terapia hormonal na menopausa (THM), estrogênica (TE) ou estro-progestagênica (TEP). A principal indicação para terapêutica hormonal na menopausa é o alívio dos sintomas menopausais, tais como sintomas vasomotores, alterações gênito-urinárias e a prevenção de osteoporose nas pacientes de risco. Em outras áreas de pesquisa, principalmente ao que se refere aos efeitos nos sistemas cardiovasculares e nervoso central, os resultados atuais na literatura são conflitivos. O tratamento por mais de 5 anos não adiciona risco significativo para câncer de mama, mas diminui significativamente o risco de fratura osteoporótica. Algumas mulheres podem ser susceptíveis a risco tromboembólico precoce, mas quando a TH for adequada após avaliação individualizada, os benefícios superam os riscos e o tratamento deve ser recomendado. Estudos futuros são necessários para identificar novas indicações para TH e diminuir ou abolir seus riscos. A pesquisa clínica continua na identificação de fatores genéticos que possam influenciar a resposta individual à TH, diferentes formulações estrogênicas, diferentes vias de administração e liberação, além das opções de dose. Nas mulheres que apresentam os sintomas da síndrome climatérica de forma severa durante a peri e pós-menopausa já existem evidências conclusivas oriundas de vários estudos randomizados controlados de que a TH é a única terapia com resultados satisfatórios. Os médicos devem sempre fazer suas decisões terapêuticas com base nos riscos e benefícios individuais de cada paciente, tendo a responsabilidade e o dever de promover as condições para a mulher atravessar a transição menopáusica com qualidade de vida.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciELOSociedade Brasileira de Endocrinologia e MetabologiaUniversidade Federal de São Paulo (UNIFESP)Pardini, Dolores [UNIFESP]2015-06-14T13:37:02Z2015-06-14T13:37:02Z2007-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion938-942application/pdfhttp://dx.doi.org/10.1590/S0004-27302007000600007Arquivos Brasileiros de Endocrinologia & Metabologia. Sociedade Brasileira de Endocrinologia e Metabologia, v. 51, n. 6, p. 938-942, 2007.10.1590/S0004-27302007000600007S0004-27302007000600007.pdf0004-2730S0004-27302007000600007http://repositorio.unifesp.br/handle/11600/3851porArquivos Brasileiros de Endocrinologia & Metabologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-04T18:19:31Zoai:repositorio.unifesp.br/:11600/3851Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-04T18:19:31Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Terapia hormonal da menopausa Menopausal hormone therapy |
title |
Terapia hormonal da menopausa |
spellingShingle |
Terapia hormonal da menopausa Pardini, Dolores [UNIFESP] Menopause Hormone therapy Climacterium Menopausa Terapia hormonal Climatério |
title_short |
Terapia hormonal da menopausa |
title_full |
Terapia hormonal da menopausa |
title_fullStr |
Terapia hormonal da menopausa |
title_full_unstemmed |
Terapia hormonal da menopausa |
title_sort |
Terapia hormonal da menopausa |
author |
Pardini, Dolores [UNIFESP] |
author_facet |
Pardini, Dolores [UNIFESP] |
author_role |
author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Pardini, Dolores [UNIFESP] |
dc.subject.por.fl_str_mv |
Menopause Hormone therapy Climacterium Menopausa Terapia hormonal Climatério |
topic |
Menopause Hormone therapy Climacterium Menopausa Terapia hormonal Climatério |
description |
Although estrogen has been clinically available for more than 6 decades, women have been confused by different opinions regarding the risks and benefits of menopausal hormone therapy (HT), estrogen therapy (ET), and estrogen-progestin therapy (EPT). The main indication for HT use in postmenopausal women remains the relief of vasomotor symptoms and vulvovaginal atrophy, and is effective in the prevention of osteoporosis. In other areas of research, notably in cardiovascular and central nervous system effects, the recent literature has produced conflicting results. Treatment for up to 5 years does not add significantly to lifetime risk of breast cancer, but significantly decreases bone loss and risk of osteoporotic fractures. Some women may be susceptible to early thrombotic risk, but when appropriate HT is given after individual clinical evaluation, the benefits will far outweigh any potential risks and the treatment should be recommended. Clinical research continues into genetic factors influencing the response to ET/HT, different estrogen formulations, different modes of delivery and lower-dose options. Patients and clinicians should make treatment decisions on the basis of an individual s needs and risks, and should enhance a woman s ability to undergo the menopausal transition with minimal disruption to her quality of life. In women experiencing distressing climacteric symptoms during the peri and postmenopause there is conclusive evidence from abundant randomized controlled trials that systemic hormone therapy (HT) of any type affords symptom relief, with no alternative treatment producing similar effect. Future research is needed to identify new indications for HRT and to diminish or abolish its potential risks. |
publishDate |
2007 |
dc.date.none.fl_str_mv |
2007-08-01 2015-06-14T13:37:02Z 2015-06-14T13:37:02Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0004-27302007000600007 Arquivos Brasileiros de Endocrinologia & Metabologia. Sociedade Brasileira de Endocrinologia e Metabologia, v. 51, n. 6, p. 938-942, 2007. 10.1590/S0004-27302007000600007 S0004-27302007000600007.pdf 0004-2730 S0004-27302007000600007 http://repositorio.unifesp.br/handle/11600/3851 |
url |
http://dx.doi.org/10.1590/S0004-27302007000600007 http://repositorio.unifesp.br/handle/11600/3851 |
identifier_str_mv |
Arquivos Brasileiros de Endocrinologia & Metabologia. Sociedade Brasileira de Endocrinologia e Metabologia, v. 51, n. 6, p. 938-942, 2007. 10.1590/S0004-27302007000600007 S0004-27302007000600007.pdf 0004-2730 S0004-27302007000600007 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Arquivos Brasileiros de Endocrinologia & Metabologia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
938-942 application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Endocrinologia e Metabologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Endocrinologia e Metabologia |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
_version_ |
1814268415495372800 |