par L'Hermite, Marc 
Référence Reference Module in Biomedical Research, Elsevier Inc.
Publication Publié, 2014-12
Référence Reference Module in Biomedical Research, Elsevier Inc.
Publication Publié, 2014-12
Partie d'ouvrage collectif
| Résumé : | Peri- and postmenopause are stages of reproductive aging in women characterized first by ovarian hormone imbalance, and later by deprivation of these hormones. Associated with these stages are a variety of symptoms called the climacteric, including a risk of bone loss with increased susceptibility to fractures. Hormone treatment (HT) is the gold standard for the control of moderate to severe climacteric symptoms; it can greatly improve the quality of life, prevent 40-70 bone fractures per 10 000 women per year, and may also exert some cardioprotective effects. HT must be initiated fairly soon after menopause (not after 60 years of age or more than 10 years since menopause). Estrogen-only treatment is adequate for hysterectomized women, and does not entail a significantly increased breast cancer risk. Estrogen administration transdermally rather than orally may help to avoid increased risk of stroke, thromboembolic events, and gallbladder disease. For endometrial protection, women with an intact uterus must be given a progestin in combination with estrogen. This combined HT involves an increased breast cancer risk when using androgenic progestins, but there is some evidence that this increased risk may be suppressed with the use of natural micronized progesterone. |
