В обзорной статье отражены современные взгляды на проблему менопаузальной гормональной терапии с учетом обновленных рекомендаций Международного общества по менопаузе 2013 г. Сформулированы основные принципы назначения гормонотерапии в пери- и постменопаузе, ее преимущества и возможные риски. Сделан важный акцент на неодинаковых нежелательных последствиях от применения комбинированных гормональных препаратов в зависимости от их состава и прежде всего гестагенного компонента.
Modern views on the issue of menopausal hormone therapy based on updated recommendations of the International Menopause Society 2013 are reviewed in the following article as well as the basic principles of hormone therapy in peri- and postmenopausal women, its benefits and possible risks. An important emphasis is made on unequal undesirable consequences from the use of combined hormonal preparations, depending on their composition and, above all, progestin component.
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3. Seeger H., Mueck A.O. Effects of dydrogesterone on the vascular system. Gynecol Endocrinol 2007; 23 (Suppl. 1): 2–8.
4. Collins JA, Blake JM. Breast cancer risk with postmenopausal hormone treatment 2005; 111: 545–60.
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6. Fournier A, Berrino F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat 2008; 362: 419–27.
7. Kanda N, Watanabe S. 17b-Estradiol stimulates the growth of human keratinocytes by inducing cyclin D2 expression. J Invest Dermatol 2004; 123: 319–28.
8. Sumino H, Ichikawa S, Abe M. Effects of aging, menopause, and hormone replacement therapy on forearm skin elasticity in women. J Am Geriatr Soc 2004; 52: 945–9.
9. Raine-Fenning NJ, Brincat MP. Skin aging and menopause: implication for treatment. Am J Clin Dermatol 2003; 4: 371–8.
10. Kwok S, Charlton-Menys V, Pemberton P et al. Effects of dydrogesterone and norethisterone, in combination with oestradiol, on lipoproteins and inflammatory markers in postmenopausal women. Maturitas 2006; 53: 439–46.
11. Brincat MP, Muscut Baron, Galea R. Climacteric 2005; 8: 110–23.
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1. Byyny RL. A Clinical Guide for the Care of Older Women, 2001.
2. Серов В.Н., Прилепская В.Н., Овсянникова Т.В. Гинекологическая эндокринология. М., 2006.
3. Seeger H., Mueck A.O. Effects of dydrogesterone on the vascular system. Gynecol Endocrinol 2007; 23 (Suppl. 1): 2–8.
4. Collins JA, Blake JM. Breast cancer risk with postmenopausal hormone treatment 2005; 111: 545–60.
5. Prentice RL, Chlebowski RT. Estrogen plus progestin therapy and breast cancer in recently postmenopausal women. Am J Epidemiol 2008; 167: 1207–16.
6. Fournier A, Berrino F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat 2008; 362: 419–27.
7. Kanda N, Watanabe S. 17b-Estradiol stimulates the growth of human keratinocytes by inducing cyclin D2 expression. J Invest Dermatol 2004; 123: 319–28.
8. Sumino H, Ichikawa S, Abe M. Effects of aging, menopause, and hormone replacement therapy on forearm skin elasticity in women. J Am Geriatr Soc 2004; 52: 945–9.
9. Raine-Fenning NJ, Brincat MP. Skin aging and menopause: implication for treatment. Am J Clin Dermatol 2003; 4: 371–8.
10. Kwok S, Charlton-Menys V, Pemberton P et al. Effects of dydrogesterone and norethisterone, in combination with oestradiol, on lipoproteins and inflammatory markers in postmenopausal women. Maturitas 2006; 53: 439–46.
11. Brincat MP, Muscut Baron, Galea R. Climacteric 2005; 8: 110–23.
Авторы
Н.А.Шешукова, О.В.Большакова
ИПО ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России; ГБУЗ ГКБ №5, Москва