Hormone replacement therapy inosanganisira, sezvinoreva zita rayo, mukukunda kusakwana kwehomoni secretions. Mhando iyi yekurapa inogona kurongerwa panguva yeperi-menopause uye menopause, kubhadhara kumisa mukugadzirwa kwehomoni ye ovarian. Saka rimwe zita rayo, menopause hormone therapy (THM).

Sechiyeuchidzo, kuenda kumwedzi kunowanzoitika kumativi ezera remakore 50. Kutevera kupera kwefollicular stock, kugadzirwa kwehomoni ye ovarian (estrogen uye progesterone) inomira, zvichiita kuti kupera kwekuenda kumwedzi. Mukadzi anonzi aenda kumwedzi mushure memwedzi inokwana gumi nemiviri ambomira kuenda kumwedzi.

Kumisa kugadzirwa kwehomoni kunogona kukonzera zviratidzo zvakasiyana-siyana, zvinozivikanwa se "climacteric disorders": kupisa kunopisa, kudikitira usiku, kuoma kwechikadzi uye matambudziko eweti. Kusimba uye nguva yezvirwere izvi zvinosiyana pakati pevakadzi.

HRT ine chinangwa chekudzikamisa zviratidzo izvi nekubhadhara kushomeka kweesrogen pamavambo ezvirwere zveclimacteric. Muvakadzi vasina-hysterectomy (vachiri nechibereko chavo), estrogen inogara ichisanganiswa nemuromo progestogen kudzivirira kutanga kweesrogen-inoenderana nekenza yeendometrial.

Kurapa uku kunoshanda uye kunoderedza kuwanda uye kuomarara kwekupisa kunopisa, kunovandudza kuoma kwemukadzi uye matambudziko epabonde. Iyo inewo inodzivirira pane zvese zvakaputsika (vertebrae, wrists, mahudyu) muvakadzi postmenopausal, yakagumisa iyo 2004 HAS mushumo weHRT (1).

HRT yakatemerwa zvakanyanya kusvika kutanga kwema2000s. Zvakadaro, pakati pa2000 na2002 zvidzidzo zvakawanda zvekuAmerica, kusanganisira Women’s Health Initiative inozivikanwa zviri nani pasi pezita reWHI (2), yakashuma kuwedzera kwenjodzi yegomarara rezamu negomarara rezamu. chirwere chemwoyo muvakadzi vanotora HRT.

Iri basa raita kuti vakuru vehutano vatarise zvakare njodzi dzeHRT uye kugadzirisa kurudziro yavo zvinoenderana nemushumo iwoyo wa2004. Basa racho rinorangarira njodzi dzakasiyana-siyana dzinoonekwa pachiitiko chekutora HRT:

• kuwedzera kwengozi yekenza yemazamu: kurapa kwakasanganiswa kweestrogen-progestogen kunotungamirira kune ngozi yakawedzerwa yekenza yemazamu yakabatanidzwa nehurefu hwemishonga, kunyanya mushure memakore mashanu ekushandiswa (5). Pakati pe3 ne2000, 2002% kusvika 3% yekenza yemazamu muvakadzi pakati pemakore e6 ne40 vaifungidzirwa kuti inokonzerwa nehomoni yekurapa kwekuenda kumwedzi (65);
• kuwedzera kwengozi yevenous thrombosis kusanganisira pulmonary embolism;
• kuwedzera kwengozi yesitiroko. Pakati pe2000 ne2002, 6,5% kusvika 13,5% yezviitiko zvesitiroko zvingave zvichikonzerwa nevakadzi vane makore 40 uye 65 (5);
• kuwedzera kwengozi yekenza ye endometrial muchiitiko cheesrogen therapy, ndicho chikonzero progestogen inogara ichibatanidzwa nayo kune vakadzi vasina hysterectomy.

Kune rimwe divi, estrogen-progestogen HRT ine basa rekudzivirira kubva kune colorectal cancer.

HRT haifanirwe kurongerwa nguva nenguva panguva yekuenda kumwedzi. HAS inokurudzira kuti iwe pachako uongorore chiyero chekubatsira / njodzi usati waraira HRT. Chimiro chemukadzi wega wega chinofanira kudzidzwa maererano nenjodzi (njodzi dzemoyo, njodzi yekuputsika, nhoroondo yekenza yemazamu) uye mabhenefiti (anopesana neclimacteric kusagadzikana uye nekudzivirira osteoporosis) kuti asarudze kurapwa, nzira yekutonga (yemuromo. kana transdermal nzira) uye nguva yayo.

Muna 2014, iyo HAS yakavandudza kurudziro yayo (6) uye yakarangarira zvinotevera zviratidzo zveHRT:

• apo zvirwere zveclimacteric zvinoonekwa sezvinonyadzisa zvakakwana kukanganisa mararamiro ehupenyu;
• nokuda kwekudzivirira postmenopausal osteoporosis muvakadzi vari pangozi yakawanda ye osteoporotic fracture uye avo vasingashiviriri kana kuti zvinopesana kune mamwe marapirwo anoratidzwa nokuda kwekudzivirira osteoporosis.

Inokurudzirawo kurongerwa kurapwa padiki shoma uye kwenguva shoma, uye kuongororazve kurapwa kanenge kamwe pagore. Paavhareji, nguva yazvino yekuraira ndeye 2 kana 3 makore zvichienderana nekuvandudzwa kwezviratidzo.

Nekuda kwenjodzi dzakasiyana siyana dzakataurwa, HRT inopesana muzviitiko zvinotevera:

• nhoroondo yega yega kenza yemazamu;
• nhoroondo yemyocardial infarction, coronary heart disease, sitiroko kana venous thromboembolic chirwere;
• njodzi yepamusoro yemwoyo (hypertension, hypercholesterolemia, kusvuta, kuwandisa) (7).