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Home > Blog > Health > 熟女受更年期困擾?  婦女健康管理新指引

熟女受更年期困擾?  婦女健康管理新指引



【健康醫療網/記者蔡岳宏報導】被失眠、焦慮、疲倦、熱潮紅、眼睛乾澀及骨質疏鬆困擾的中年婦女,妳其實是被更年期徵狀所困擾!通常婦產科醫師開的第一張藥方是:運動、營養、減重及減壓:可是還有能緩解更年期徵狀的第二章藥方:賀爾蒙療法! 

更年期荷爾蒙改變 部分身心不適 

更年期,又稱停經期,是指女性大約在45-52歲這段期間,卵巢逐漸停止製造女性荷爾蒙,不再有月經的停經現象。更年期是女性生命發展的自然及必經歷程,這時期因為體內荷爾蒙分泌逐漸減少,婦女會歷經許多身體變化,多半是正常老化現象,部分婦女則會產生生理、情緒變化和身心不適的更年期障礙。 

荷爾蒙療法遭誤解 錯失改善時機 

自2002年美國國立衛生研究院所發表「婦女健康關懷研究」(WHI)更年期婦女荷爾蒙治療報告後,因治療利益風險比降低,引起民眾對更年期荷爾蒙療法對於罹患心臟病、中風、乳癌、及血栓等風險的關心和誤解。這導致部分受更年期血管舒縮障礙、泌尿生殖症候群、骨質疏鬆症危險群等困擾更年期婦女,因而未接受適當治療以來改善生活品質與降低疾病風險。 

近年報告洗刷冤屈 

依據近來WHI持續追蹤參與研究年齡層50-79歲的更年期婦女相關風險長達15年的最新報告,發現使用荷爾蒙療法並不會增加總死亡率、心血管疾病死亡率及罹癌死亡率;如果進一步針對50-59歲年齡層分析,荷爾蒙療法更減少了19-49% 死亡率。 

台灣更年學會提新指引 高風險族群需評估 

台灣更年期學會推出新版的【2018更年期婦女健康管理及藥物治療指引】: 

1.做好更年期自我健康風險評估與健康生活型態;適度的運動、飲食的調整、巔峰骨量維持與提升,都是保健的重要工作。

2.賀爾蒙治療仍然是最有效的治療血管舒縮症狀和更年期泌尿生殖症候群的治療方式,並已被證明可以預防與減少骨質疏鬆症及相關骨折的風險。 

3.賀爾蒙治療的風險因類型、劑量、使用時間、給藥途徑、起始時間以及是否使用黃體素而異。 

4.賀爾蒙治療應該個體化,以確定最適合的賀爾蒙治療類型、劑量、配方、給藥途徑和使用持續時間。 

5.對於年齡小於60歲或在停經期10年內且沒有禁忌症的女性,接受賀爾蒙治療更年期泌尿生殖徵候群以及骨質疏鬆症與相關骨折之風險受益比最高。 

6.對於從停經期開始接受賀爾蒙治療超過10年或年齡在60歲或以上之女性,由於冠心病、中風(靜脈血栓栓塞)、老年失智症的風險增加,因此,利益風險比需經過個案評估。 

7.對於持續性更年期泌尿生殖症候群或骨質疏鬆症與相關骨折,需要較長之賀爾蒙治療時間者,應該透過醫病共享決策和定期重新評估。 

適度運動配合荷爾蒙療法 提升生活品質 

停經後第一階段的黃金六年,經過生活型態的調整、適度的運動、風險評估與作適當即時的處置與治療,必然可大幅減低更年期之後相關疾病的發生與罹病率,比如骨質疏鬆症、更年期血管舒縮障礙,肌少症、神經系統統合功能、心血管疾病、代謝症候群等。而隨著荷爾蒙治療方式與研究不斷的精進,也讓提升更年期婦女後半階段人生的生活品質愈來愈有信心。


資料來源:健康醫療網 https://www.healthnews.com.tw/news/article/40477/
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