HOMONEREPLACEMENTTHERAPY(HRT)：激素替代疗法(HRT)VIP免费

MENOPAUSE第一页，共五十四页。WHAT?MenopauseisadeviationoftheancientGreekwordsmenos(month)andpauses(ending).Themenopauseissometimesknownasthe'changeoflife'andismarkedbytheendingofmenstruation.第二页，共五十四页。WHAT?Itbedefinedwithcertaintyaftertwelvemonths'spontaneousamenorrhoea.Endofreproductivelife.第三页，共五十四页。Age(years)Pre-menopausePost-menopauseMENOPAUSE1YEARPeri-menopause“Climacteric〞RELATEDTERMINOLOGY第四页，共五十四页。WHEN?Menopausalage:45-55years(mean:50.7years)Ifthemenopauseoccursinawomanwhoisunder45yearsofage,itisknownasprematuremenopause.Latemenopause:>55yearsold第五页，共五十四页。WHEN?Otherfactorsthatcanaffecttheageatwhichwomenhavetheirfinalperiodincludeageatmenarche,parity,previousoralcontraceptivehistoryethnicityandfamilyhistory.第六页，共五十四页。WHY?RELATIVEACTIVITYOFESTROGEN第七页，共五十四页。WHY?Themenopauseistheendofeggproduction(ovulation).Thisoccursasaresultoffallinglevelsofthefemalesexhormoneoestrogen,whichregulatesawoman'speriods.第八页，共五十四页。WHY?Themenopauseresultsfromafallinthelevelofthefemalehormoneoestrogenintheblood.第九页，共五十四页。WHY?Atahormonallevel-asovarianfollicularactivitybeginstofail,oestrogenandprogesteronelevelsfallandthereducednegativefeedbacktothepituitarycausesariseinluteinisinghormone(LH)andfolliclestimulatinghormone(FSH).第十页，共五十四页。HOW?Oestrogenreductioneventuallyresultsinmenstrualcycledisruptionandothermenopausalsymptoms.第十一页，共五十四页。HOW?Oestrogenreductioneventuallyresultsinmenstrualcycledisruptionandothermenopausalsymptoms.*FSHhigh(30–170mU/ml)*LHhigh(20–80mU/ml)*Estradiollow(<110pmol/L)第十二页，共五十四页。VasomotorSymptomsSleepDisordersMenstrualDisordersMoodChangesVaginalAtrophyDyspareuniaSkinAtrophyOsteoporosisAtherosclerosisCoronaryHeartDiseaseCerebrovascularDisease40yrs50yrsMenopause60yrsSYMPTOMS!ONSETOFSYMPTOMSINRELATIONTOAGEOFMENOPAUSE第十三页，共五十四页。SYMPTOMS!Changesinyourperiod—timebetweenperiodsorflowmaybedifferent.Hotflashes(“hotflushes〞)—gettingwarmintheface,neckandchest.Nightsweatsandsleepingproblemsthatmayleadtofeelingtired,stressedortense.Vaginalchanges—thevaginamaybecomedryandthin,andsexmaybepainful.Thinningofyourbones,whichmayleadtolossofheightandbonebreaks(osteoporosis).第十四页，共五十四页。SYMPTOMS!Itisestimatedthat8outof10womenintheUKexperiencesymptomsleadinguptothemenopause.Ofthese,45%findtheirsymptomsdifficulttodealwith.第十五页，共五十四页。SYMPTOMS!Withouttreatment,mostmenopausalsymptomsgraduallystopnaturally.Thisusuallyhappenstwotofiveyearsafterthesymptomsstart.Althoughsomewomenexperiencesymptomsformanymoreyears.第十六页，共五十四页。SYMPTOMS!第十七页，共五十四页。SYMPTOMS!NORMALTRABECULARBONEOSTEROPEROTICBONE第十八页，共五十四页。TREATMENTOnly1in10womenseekmedicaladvicewhentheygothroughthemenopauseandmanydonotneedanytreatment.Ifmenopausalsymptomsaresevereenoughtointerferewithdailylife,therearetreatmentsthatcanhelp.第十九页，共五十四页。TREATMENTThekindoftreatmentyoucantakedependsontheseverityofthesymptoms,medicalhistoryandpatient’sownpreferences.第二十页，共五十四页。TREATMENTHRTNON-HRT第二十一页，共五十四页。HOMONEREPLACEMENTTHERAPY(HRT)Asthenamesuggests,HRTworksbyreplacingoestrogen.Hormonereplacementtherapy(HRT)canbeaneffectivetreatmentforthetypicalmenopause-relatedsymptoms.第二十二...