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【JCEM】更年期症状的处理
Many women experience menopausal symptoms during the menopausal transition and postmenopausal years. Hot flashes, the most common symptom, typically resolve after several years, but for 15–20% of women, they interfere with quality of life. For these women, estrogen therapy, the most effective treatment for hot flashes, should be considered. The decision to use hormone therapy involves balancing the potential benefits of hormone therapy against its potential risks. Accumulating data suggest that initiation of estrogen many years after menopause is associated with excess coronary risk, whereas initiation soon after menopause is not. Therefore, most now agree that short-term estrogen therapy, using the lowest effective estrogen dose, is a reasonable option for recently menopausal women with moderate to severe symptoms who are in good cardiovascular health. Short-term therapy is considered to be not more than 4–5 yr because symptoms diminish after several years, whereas the risk of breast cancer increases with longer duration of hormone therapy. A minority of women may need long-term therapy for severe, persistent vasomotor symptoms after stopping hormone therapy. However, these women should first undergo trials of nonhormonal options such as gabapentin, selective serotonin reuptake inhibitors, or serotonin norepinephrine reuptake inhibitors, returning to estrogen only if these alternatives are ineffective or cause significant side effects. Low-dose vaginal estrogens are highly effective for genitourinary atrophy symptoms, with minimal systemic absorption and endometrial effects. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 更年期症状的处理
Many women experience menopausal symptoms during the menopausal transition and postmenopausal years.
在绝经过渡期和绝经后数年，许多妇女会经历更年期症状。
Hot flashes, the most common symptom, typically resolve after several years, but for 15–20% of women, they interfere with quality of life.
潮热作为最常见的症状，通常需要几年才能消退，但是有15%到20%的妇女的生活质量会受到影响。
For these women, estrogen therapy, the most effective treatment for hot flashes, should be considered.
对于这些妇女，应该考虑进行雌激素治疗，因为它是对潮热最有效的治疗方式。
The decision to use hormone therapy involves balancing the potential benefits of hormone therapy against its potential risks.
应用激素治疗的决定涉及到平衡激素治疗的潜在益处和潜在风险。
Accumulating data suggest that initiation of estrogen many years after menopause is associated with excess coronary risk, whereas initiation soon after menopause is not.
累积资料表明，在绝经后许多年才开始雌激素治疗与增加的冠心病风险有关，而在绝经后不久即开始雌激素治疗则不会增加这种风险。
Therefore, most now agree that short-term短期（Short-acting短效） 更年期症状的处理
在绝经过渡期和绝经后数年，许多妇女会经历更年期症状。
潮热作为最常见的症状，通常需要几年才能消退，但是有15%到20%的妇女的生活质量会受到影响。
对于这些妇女，应该考虑进行雌激素治疗，因为它是对潮热最有效的治疗方式。
应用激素治疗的决定涉及到平衡激素治疗的潜在益处和潜在风险。
累积资料表明，在绝经后许多年才开始雌激素治疗与增加的冠心病风险有关，而在绝经后不久即开始雌激素治疗则不会增加这种风险。
因此，现在大多数人认同，对于刚绝经不久的妇女，出现中到重度更年期症状而心血管健康状态良好时，短期内应用最低有效剂量的雌激素治疗是一个合理的选择
短期雌激素治疗被认为不应超过四到五年，因为更年期症状在几年之后便会减轻，而同时长期的激素治疗可增加患乳腺癌的风险性。
因为停止激素治疗后出现的严重而持久的血管舒缩症状，少数妇女可能需要长期治疗。
然而，这些妇女应该首先选择进行非激素的治疗，比如加巴喷丁、选择性5-羟色胺再摄取抑制剂或5-羟色胺去甲肾上腺素再吸收抑制剂。只有当这些治疗无效或导致显著副反应的时候才回到雌激素治疗。
小剂量的阴道内雌激素治疗对于泌尿生殖道萎缩症状是非常有效的，而且全身吸收及对子宫内膜影响为最低。 Thank you very much! 路在脚下，牛呀！请问哪里的英译汉最好！ 学习了!
dingdr wrote:
路在脚下，牛呀！请问哪里的英译汉最好！
谢谢，其实更年期症状用中医药来调理也是一种不错的选择阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-03-22 05:12
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