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Влияние терапии тестостероном на состояние молочных желез у пациенток с дефицитом андрогенов, получающих заместительную эстроген-гестагенную терапию
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Аннотация
Андрогендефицитные состояния у женщин в период перименопаузы по-прежнему остаются одной из противоречивых проблем в гинекологии и эндокринологии. Одним из ограничивающих факторов применения не только андрогензаместительной, но и эстроген-гестагенной терапии у женщин в перименопаузе является безопасность в отношении молочных желез. В данной работе оценивается влияние терапии трансдермальным тестостероном на ткань молочных желез и течение доброкачественных заболеваний молочных желез.
Ключевые слова: перименопауза, дефицит андрогенов у женщин, андрогензаместительная терапия, заместительная гормональная терапия, доброкачественные заболевания молочных желез.
Ключевые слова: перименопауза, дефицит андрогенов у женщин, андрогензаместительная терапия, заместительная гормональная терапия, доброкачественные заболевания молочных желез.
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Androgen deficiency in women during menopausal still remain one of the controversial issues in gynecology and endocrinology. One of the limiting factors of not only androgen-replacement, and estrogen-progestogen therapy in perimenopausal women in a safety in respect of the mammary glands. In this work we evaluated the influence of transdermal testosterone therapy on breast tissue, and for benign breast diseases.
Key words: perimenopause, androgen deficiency in women, androgen replacement therapy, HRT, benign breast disease.
Полный текст
Список литературы
1. Сметник В.П. Красота зрелого возраста. Status Praesents, 2011.
2. Harvie M, Hooper L, Howell AH. Central obesity and breast cancer risk: a systematic review. Obes Rev 2003; 4 (3): 157–73.
3. Hulca BS, Moorman PG. Reprint of Breast cancer: hormones and other risk factors. Maturitas 2008; 61: 203–13.
4. Fournier F. Clavel-Chapelon. Unicual risks for breast cancer associated with different hormone replacement therapies results from the E3N cohort study. Breast Cancer Res Treat 2008; 107 (1): 103–11.
5. Fabre A, Fournier A, Mesrine S et al. Oral progestagens before menopause and breast cancer risk. Br J Cancer 2007; 96 (5): 841–4.
6. Alfred O, Muecka, Seegera H, Kai-J. Use of dydrogesterone in hormone replacement therapy. Maturitas 2009: 65S, S51–S60.
7. Радзинский В.Е., Калинченко С.Ю., Апетов С.С. Терапия андрогенами в гинекологической практике. Вестн. РУДН. 2010; 6: 196–204.
8. Braunstein GD, Sundwall DA, Kate M et al. Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: randomized placebo-controlled trial. Arch Intern Med 2005; 165: 1582–9.
9. Buster JE, Kingsberg SA, Brown C et al. Testosterone patch for low sexual desire in surgically menopausal women: A randomized trial. Obstet Gynecol 2005; 105: 944–52.
10. Davis SR, Bouchard C, Kroll R et al. The effect of a testosterone transdermal system on hypoactive sexual desire disorder in postmenopausal women not receiving systemic estrogen therapy, the aphrodite study. 82nd Annual Meeting of the Endocrine Society; Boston USA, 2006.
11. Somboonporn W, Davis SR. Postmenopausal testosterone therapy and breast cancer risk. Maturitas 2004; 49: 267–75.
12. Labrie F, Luu-The V, Labrie C et al. Endocrine and intracrine sources of androgens in women: Inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev 2003; 24: 152–82.
13. Gammon MD, Thompson WD. Polycystic ovaries and the risk of breast cancer. Am J Epidemiol 1991; 134: 818–24.
14. Burgess HE, Shousha S. An immunohistochemical study of the long-term effects of androgen administration on female-to-male transsexual breast: A comparison with normal female breast and male breast showing gynaecomastia. J Pathol 1993; 170: 37–43.
15. Dimitrakakis C, Jones RA, Liu A, Bondy CA. Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy. Menopause 2004; 11: 531–5.
16. Сотникова Л.С. Мастопатия. Новые аспекты в лечении. 2011; с. 6–14.
17. Радзинский В.Е, Калинченко С.Ю., Апетов С.С. Синдром дефицита андрогенов у женщин. Вестн. РУДН. 2010; 6: 266–76.
18. Bachmann GA, Bancroft J, Braunstein G et al. Female androgen insufficiency: the Princeton consensus statement on definition, classification and assessment. Fertil Steril 2002; 77: 660–5.
19. Guay A, Munarriz R, Jacobson J et al. Serum androgen levels in healthy premenopausal women with and without sexual dysfunction: Part A. Serum androgen levels in women aged 20-49 years with no complaints of sexual dysfunction, kit. J Impot Res 2004; 16: 112–20.
20. Davison SL, Bell R, Donath S et al. Androgen levels in adult females: Changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab 2005; 90: 3847–53.
21. Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80: 1429–30.
22. Singh AB, Lee ML, Sinha-Hikim I et al. Pharmacokinetics of a testosterone gel in healthy postmenopausal women. J Clin Endocrinol Metab 2006; 91: 136–44.
23. Braunstein GD. The Endocrine Society Clinical Practice Guideline and The North American Menopause Society position statement on androgen therapy in women: Another one of Yogi's forks. J Clin Endocrinol Metab 2007; 92: 4091–3.
24. Hofling M, Carlstrom K, Svane G et al. Different effects 'of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels an association with mammographic density. Gynecol Endocrinol 2005; 20: 110–5.
25. Hofling M, Hirschberg AL, Skoog L et al. Testosterone inhibits estrogen/progestogen-induced breast cell proliferation in postmenopausal women. Menopause 2007; 14: 183–90.
26. Burger HG. Should testosterone be added to estrogen-progestin therapy for breast protection? Menopause 2007; 14: 159–62.
2. Harvie M, Hooper L, Howell AH. Central obesity and breast cancer risk: a systematic review. Obes Rev 2003; 4 (3): 157–73.
3. Hulca BS, Moorman PG. Reprint of Breast cancer: hormones and other risk factors. Maturitas 2008; 61: 203–13.
4. Fournier F. Clavel-Chapelon. Unicual risks for breast cancer associated with different hormone replacement therapies results from the E3N cohort study. Breast Cancer Res Treat 2008; 107 (1): 103–11.
5. Fabre A, Fournier A, Mesrine S et al. Oral progestagens before menopause and breast cancer risk. Br J Cancer 2007; 96 (5): 841–4.
6. Alfred O, Muecka, Seegera H, Kai-J. Use of dydrogesterone in hormone replacement therapy. Maturitas 2009: 65S, S51–S60.
7. Радзинский В.Е., Калинченко С.Ю., Апетов С.С. Терапия андрогенами в гинекологической практике. Вестн. РУДН. 2010; 6: 196–204.
8. Braunstein GD, Sundwall DA, Kate M et al. Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: randomized placebo-controlled trial. Arch Intern Med 2005; 165: 1582–9.
9. Buster JE, Kingsberg SA, Brown C et al. Testosterone patch for low sexual desire in surgically menopausal women: A randomized trial. Obstet Gynecol 2005; 105: 944–52.
10. Davis SR, Bouchard C, Kroll R et al. The effect of a testosterone transdermal system on hypoactive sexual desire disorder in postmenopausal women not receiving systemic estrogen therapy, the aphrodite study. 82nd Annual Meeting of the Endocrine Society; Boston USA, 2006.
11. Somboonporn W, Davis SR. Postmenopausal testosterone therapy and breast cancer risk. Maturitas 2004; 49: 267–75.
12. Labrie F, Luu-The V, Labrie C et al. Endocrine and intracrine sources of androgens in women: Inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev 2003; 24: 152–82.
13. Gammon MD, Thompson WD. Polycystic ovaries and the risk of breast cancer. Am J Epidemiol 1991; 134: 818–24.
14. Burgess HE, Shousha S. An immunohistochemical study of the long-term effects of androgen administration on female-to-male transsexual breast: A comparison with normal female breast and male breast showing gynaecomastia. J Pathol 1993; 170: 37–43.
15. Dimitrakakis C, Jones RA, Liu A, Bondy CA. Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy. Menopause 2004; 11: 531–5.
16. Сотникова Л.С. Мастопатия. Новые аспекты в лечении. 2011; с. 6–14.
17. Радзинский В.Е, Калинченко С.Ю., Апетов С.С. Синдром дефицита андрогенов у женщин. Вестн. РУДН. 2010; 6: 266–76.
18. Bachmann GA, Bancroft J, Braunstein G et al. Female androgen insufficiency: the Princeton consensus statement on definition, classification and assessment. Fertil Steril 2002; 77: 660–5.
19. Guay A, Munarriz R, Jacobson J et al. Serum androgen levels in healthy premenopausal women with and without sexual dysfunction: Part A. Serum androgen levels in women aged 20-49 years with no complaints of sexual dysfunction, kit. J Impot Res 2004; 16: 112–20.
20. Davison SL, Bell R, Donath S et al. Androgen levels in adult females: Changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab 2005; 90: 3847–53.
21. Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80: 1429–30.
22. Singh AB, Lee ML, Sinha-Hikim I et al. Pharmacokinetics of a testosterone gel in healthy postmenopausal women. J Clin Endocrinol Metab 2006; 91: 136–44.
23. Braunstein GD. The Endocrine Society Clinical Practice Guideline and The North American Menopause Society position statement on androgen therapy in women: Another one of Yogi's forks. J Clin Endocrinol Metab 2007; 92: 4091–3.
24. Hofling M, Carlstrom K, Svane G et al. Different effects 'of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels an association with mammographic density. Gynecol Endocrinol 2005; 20: 110–5.
25. Hofling M, Hirschberg AL, Skoog L et al. Testosterone inhibits estrogen/progestogen-induced breast cell proliferation in postmenopausal women. Menopause 2007; 14: 183–90.
26. Burger HG. Should testosterone be added to estrogen-progestin therapy for breast protection? Menopause 2007; 14: 159–62.
________________________________________________
1. Сметник В.П. Красота зрелого возраста. Status Praesents, 2011.
2. Harvie M, Hooper L, Howell AH. Central obesity and breast cancer risk: a systematic review. Obes Rev 2003; 4 (3): 157–73.
3. Hulca BS, Moorman PG. Reprint of Breast cancer: hormones and other risk factors. Maturitas 2008; 61: 203–13.
4. Fournier F. Clavel-Chapelon. Unicual risks for breast cancer associated with different hormone replacement therapies results from the E3N cohort study. Breast Cancer Res Treat 2008; 107 (1): 103–11.
5. Fabre A, Fournier A, Mesrine S et al. Oral progestagens before menopause and breast cancer risk. Br J Cancer 2007; 96 (5): 841–4.
6. Alfred O, Muecka, Seegera H, Kai-J. Use of dydrogesterone in hormone replacement therapy. Maturitas 2009: 65S, S51–S60.
7. Радзинский В.Е., Калинченко С.Ю., Апетов С.С. Терапия андрогенами в гинекологической практике. Вестн. РУДН. 2010; 6: 196–204.
8. Braunstein GD, Sundwall DA, Kate M et al. Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: randomized placebo-controlled trial. Arch Intern Med 2005; 165: 1582–9.
9. Buster JE, Kingsberg SA, Brown C et al. Testosterone patch for low sexual desire in surgically menopausal women: A randomized trial. Obstet Gynecol 2005; 105: 944–52.
10. Davis SR, Bouchard C, Kroll R et al. The effect of a testosterone transdermal system on hypoactive sexual desire disorder in postmenopausal women not receiving systemic estrogen therapy, the aphrodite study. 82nd Annual Meeting of the Endocrine Society; Boston USA, 2006.
11. Somboonporn W, Davis SR. Postmenopausal testosterone therapy and breast cancer risk. Maturitas 2004; 49: 267–75.
12. Labrie F, Luu-The V, Labrie C et al. Endocrine and intracrine sources of androgens in women: Inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev 2003; 24: 152–82.
13. Gammon MD, Thompson WD. Polycystic ovaries and the risk of breast cancer. Am J Epidemiol 1991; 134: 818–24.
14. Burgess HE, Shousha S. An immunohistochemical study of the long-term effects of androgen administration on female-to-male transsexual breast: A comparison with normal female breast and male breast showing gynaecomastia. J Pathol 1993; 170: 37–43.
15. Dimitrakakis C, Jones RA, Liu A, Bondy CA. Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy. Menopause 2004; 11: 531–5.
16. Сотникова Л.С. Мастопатия. Новые аспекты в лечении. 2011; с. 6–14.
17. Радзинский В.Е, Калинченко С.Ю., Апетов С.С. Синдром дефицита андрогенов у женщин. Вестн. РУДН. 2010; 6: 266–76.
18. Bachmann GA, Bancroft J, Braunstein G et al. Female androgen insufficiency: the Princeton consensus statement on definition, classification and assessment. Fertil Steril 2002; 77: 660–5.
19. Guay A, Munarriz R, Jacobson J et al. Serum androgen levels in healthy premenopausal women with and without sexual dysfunction: Part A. Serum androgen levels in women aged 20-49 years with no complaints of sexual dysfunction, kit. J Impot Res 2004; 16: 112–20.
20. Davison SL, Bell R, Donath S et al. Androgen levels in adult females: Changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab 2005; 90: 3847–53.
21. Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80: 1429–30.
22. Singh AB, Lee ML, Sinha-Hikim I et al. Pharmacokinetics of a testosterone gel in healthy postmenopausal women. J Clin Endocrinol Metab 2006; 91: 136–44.
23. Braunstein GD. The Endocrine Society Clinical Practice Guideline and The North American Menopause Society position statement on androgen therapy in women: Another one of Yogi's forks. J Clin Endocrinol Metab 2007; 92: 4091–3.
24. Hofling M, Carlstrom K, Svane G et al. Different effects 'of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels an association with mammographic density. Gynecol Endocrinol 2005; 20: 110–5.
25. Hofling M, Hirschberg AL, Skoog L et al. Testosterone inhibits estrogen/progestogen-induced breast cell proliferation in postmenopausal women. Menopause 2007; 14: 183–90.
26. Burger HG. Should testosterone be added to estrogen-progestin therapy for breast protection? Menopause 2007; 14: 159–62.
Авторы
С.С.Апетов1, С.Ю.Калинченко1, А.В.Агафонова2, Л.С.Сотникова2
1. Сибирский государственный медицинский университет, Томск;
2. Российский университет дружбы народов, Москва
1. Сибирский государственный медицинский университет, Томск;
2. Российский университет дружбы народов, Москва
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