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Влияние терапии тестостероном на состояние молочных желез у пациенток с дефицитом андрогенов, получающих заместительную эстроген-гестагенную терапию
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.
Key words: perimenopause, androgen deficiency in women, androgen replacement therapy, HRT, benign breast disease.
Ключевые слова: перименопауза, дефицит андрогенов у женщин, андрогензаместительная терапия, заместительная гормональная терапия, доброкачественные заболевания молочных желез.
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Key words: perimenopause, androgen deficiency in women, androgen replacement therapy, HRT, benign breast disease.
Полный текст
Список литературы
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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.
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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.
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.
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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