Hormone Therapy Reimagined2.pdf

Over 1 million U.S. women enter menopause each year and yet few are offered evidence-based hormonal support for long-term brain, bone, and cardiovascular health. Despite emerging evidence, most guidelines continue to group all estrogens and progestogens into the same risk category. But not all hormones are created equal. Much of the caution surrounding menopausal hormone therapy (MHT) stems from early interpretations of the Women’s Health Initiative (WHI) studies. But as science evolves, so should our treatment guidelines. This article provides a comprehensive analysis of the reasoning behind current entrenched guidelines, an update of evidence on the systemic benefits and minimal risks of bioidentical hormone formulations. <br>

每年有超过100万美国女性进入更年期，但极少有人能获得基于循证医学的激素支持方案，以维护长期的大脑、骨骼与心血管健康。尽管已有新兴研究证据涌现，多数临床指南仍将所有雌激素与孕激素归为同一风险类别。但各类激素并非完全等效。围绕更年期激素治疗（menopausal hormone therapy, MHT）的诸多审慎态度，大多源于早期对女性健康倡议（Women’s Health Initiative, WHI）研究的解读。但随着科学研究的发展，临床治疗指南也应与时俱进。本文全面剖析了当前根深蒂固的临床指南背后的逻辑依据，并更新了关于生物同源激素制剂的全身获益与极低风险的相关研究证据。