事件记录
Dr. 琼斯: 更年期症状的治疗有什么新进展? 这是博士. Kirtly Jones from obstetrics and gynecology at University of Utah Health Care, and this is 范围.
播音员: Covering all aspects of Women's Health, this is the seven domains of women's health with Dr. Kirtly Jones在Scope上报道.
Dr. 琼斯: Before the 1960's there wasn't much for the treatment of menopausal symptoms. 在20世纪70年代，大发娱乐发现只服用雌激素的女性, had a greater risk of uterine cancer and women and physicians were hesitant to prescribe. In the 1980's and 90's we learned about all the benefits of estrogen and added progestin to protect the uterus, 很多女性服用激素治疗更年期症状. In 2000, the results of the women's health initiative suggested that women over 60 who took hormones had a higher risk of breast cancer and heart disease. 你应该问问自己“更高”是什么意思? 对于作用域侦听器，和处方掉落.
The North American Menopause Society's older guidelines suggested that the lowest dose of hormones for the shortest period of time, 应该大发娱乐提供. And many clinicians only offered for hormonal therapy for five years, but now we have new guidelines informed by research from the past ten years. 那么现在有什么新的呢?
What's new isn't really new to those of us who've practiced menopausal medicine. What's new is that the decision to take hormonal therapy for menopausal symptoms or non-hormonal therapy for menopausal symptoms is a conversation that takes more than just a few minutes in your clinicians office. The clinician must be informed about the real numbers involving risks and benefits of hormone therapy and they must have the time to talk to the patient about her symptoms, 她在治疗中的选择, 她的利益和风险. And because menopause symptoms change over time, the conversation should happen every year. Most women can safely use hormones if they want and hormones shouldn't be discontinued just because of a women's age. 这是个人的风险/收益分析.
这就是经常发生的事情. “我的月经停止了，而且潮热得厉害。”. 医生说：“等一下，它们很快就会消失的.“嗯, that's not necessarily true, hot flashes persist for an average of 7.4年. Some women will feel better in several months but the majority of women with troublesome hot flashes will have them for years.
Another, "I'm only 55 and my bone density shows that I have thin bones. 我该怎么办？?“嗯 here's a prescription for a medicine that will block bone thinning. 不，这不是荷尔蒙.“嗯, drugs like bisphosphonates do decrease bone thinning but they have their own risks and benefits and for young women, 也就是绝经后的十年内, 雌激素可能是一个不错的选择. And estrogens are FDA approved for the prevention of bone thinning. 雌激素有保护骨骼的功效, treating hot flashes and vaginal thinning that causes pain with intercourse.
对于更年期的两个主要症状, 潮热和阴道干燥, 雌激素是最好的治疗方法. The new "North American Menopause Society's Guidelines" outline the importance of individualizing therapy for each woman. Looking at the options, discussing the symptoms and the patient's own biology. There are few if any absolute contraindications to hormonal therapy. 这都是风险/收益的讨论. If the risks are small and the benefits for the woman is great, than the options should be open. 绝经后的第一个十年, 最后一个时期, are the years when the benefits are the greatest and women who had early menopause for whatever reason might have significant benefits of taking hormones for longer.
Dr. 乔安妮·平克顿, who's the executive director of the North American Menopause Society and is the lead author of the new guidelines said, 在一次采访中, "We want to remove the fear of using menopausal hormone therapy for healthy women under 60 and within ten years of menopause and make sure the benefits and the risks are discussed with women in an appropriate way."
What should you do if you're significantly troubled by menopausal symptoms? 对于那些刚刚入门的人, 如果你是更年期的婴儿, there is a lot of not very scientific information out there on the web. 要小心，如果你需要更年期的基本知识，就去更年期.org/forwomen. 对于那些数据驱动的范围侦听器, you can go the website for the North American Menopause Society which is menopause.org and look at their treatment guidelines and clinical care recommendations. 它们对非会员免费, 更年期治疗也有指导方针, treatment of vaginal thinning and non-hormonal treatments for menopause that actually work and which ones don't work.
If your clinician isn't a specialist in menopause, these guidelines are available to them too. 准备好去看医生. 你有什么症状？? 他们有多烦你? 你的病史是什么? 你的恐惧，担心和希望是什么? 临床医生的时间可能有限, 但是如果你的问题没有得到回答或者你需要更多的时间, 再来一次. But coming prepared will help you and your clinician focus on your needs. 对于更年期的许多主要症状, 有很多选择, 有一种方法对每个人都有效. You can feel better, and being informed is a really great start.
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