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首页> 外文期刊>Reviews in gynaecological practice >Treatment of vasomotor symptoms: Is there an alternative to hormone replacement therapy?
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Treatment of vasomotor symptoms: Is there an alternative to hormone replacement therapy?

机译：血管舒缩症状的治疗：激素替代疗法有替代方法吗？

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Menopause is associated with vasomotor symptoms, which can affect the quality of life of some women. Although oestrogen replacement therapy is an effective treatment yet many women declines its use especially with the highly publicised findings of Women Health Initiative trials. Although oestrogen withdrawal is the main cause of hot flushes, neurotransmitter modulators are involved in its pathophysiology. Selective serotonin reuptake inhibitors as venlafaxine, flouxetine and paroxetine have been shown to reduce hot flushes by nearly 60% and are generally well tolerated. Trials on gabapentin, another group of neurotransmitter modulators, yielded similar results. Clonidine is a central a-adrenergic agonist, which is only modestly effective in reducing hot flushes. Their side effects may preclude their use but may be a suitable option for hypertensive patients with hot flushes. Non-prescription medications are widely popular as natural alternatives to hormone replacement therapy despite the lack of enough data regarding their safety. The current available evidence suggests that phytoestrogens are ineffective in treating hot flushes. Trials of black cohosh lack methodological quality and yielded conflicting results. Other herbal medicines are only included in isolated trials. Systemic progestogens can be effective in treating hot flushes but their long-term effect in breast cancer survivors is uncertain. There is little evidence to support progesterone cream for treatment of vasomotor symptoms. Many women might benefit of life style modifications and regular physical exercise.
机译：更年期与血管舒缩症状有关，会影响某些女性的生活质量。尽管雌激素替代疗法是一种有效的治疗方法，但是许多妇女特别是在妇女健康倡议试验得到高度宣传的发现后，拒绝使用它。尽管雌激素戒断是潮热的主要原因，但神经递质调节剂参与了其病理生理过程。选择性5-羟色胺再摄取抑制剂，如文拉法辛，氟西汀和帕罗西汀，已显示可减少潮热近60％，并且通常具有良好的耐受性。另一组神经递质调节剂加巴喷丁的试验也得到了相似的结果。可乐定是一种中央性α-肾上腺素能激动剂，仅能有效减少潮热。它们的副作用可能会阻止其使用，但对于潮热的高血压患者可能是合适的选择。尽管缺乏关于安全性的足够数据，但非处方药作为激素替代疗法的自然替代品已广泛流行。目前可获得的证据表明植物雌激素在治疗潮热中无效。黑升麻的试验缺乏方法论质量，并且得出了相互矛盾的结果。其他草药仅包含在单独的试验中。全身性孕激素可有效治疗潮热，但它们对乳腺癌幸存者的长期疗效尚不确定。没有证据支持黄体酮霜可以治疗血管舒缩症状。许多妇女可能会受益于生活方式的改变和定期的体育锻炼。

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