Estrogens, Conjugated

FRIDAY, Nov. 22, 2024 -- Four years of hormone replacement therapy to help women deal with menopausal symptoms causes no harm to the brain, even over the long term, new research shows. "In the present study, approximately 10 years after 48 months of early menopausal therapy... the cognitive performance of women randomized to [hormone replacement therapy] did not differ from those randomized to placebo," concluded a team led by Carey Gleason , of the University of Wisconsin-Madison. Her team published its findings Nov. 21 in the journal PLOS Medicine . For decades, millions of women took supplemental forms of estrogen long-term to help curb hot flashes and other menopausal symptoms. Then in 2002, results from the Women's Health Initiative study linked hormone replacement therapy (HRT) to an increased risk of blood clots, stroke, breast cancer and heart disease. That caused a drastic decline in the use of HRT, but in recent years a more nuanced view of the risks and benefits of the treatment have emerged, with some women only taking HRT for a few years around the time of menopause . Would this shorter course of HRT harm the brain? Four years after stopping four years of HRT, an investigation called the Kronos Early Estrogen Prevention Study had already detected no declines in thinking or memory among users at that point in time. Kronos involved 727 women around the age of menopause, all of whom were in good cardiovascular health. The newly published report looked at Kronos findings for 275 of those women, all of who were tested a full 10 years after they'd wrapped up their four years of hormonal therapy. Again, the result was clear: "Menopausal hormone therapy was not associated with cognitive benefits nor does menopausal hormone therapy prevent cognitive decline," Gleason and team concluded. That means that while HRT does no harm to the brain, it should not also be seen as a means of boosting a woman's neurological health as she ages, the researchers said. “For women in menopause and the health care providers caring for them, getting direct, clear and evidence-based information about menopausal hormone therapy is challenging. And they need data to guide their decisions," Gleason's team wrote. Women in the study received various forms of hormonal supplements ( Premarin , Climara or Prometrium ), given in pill or patch form, or placebo pills or patches. More research into HRT's effect on brain health should be done, Gleason's group said. "These findings highlight the need for further research to explore other potential long-term health outcomes associated with menopausal hormone therapy, beyond cognitive performance," they wrote. "Future studies could focus on areas such as mood and Alzheimer’s disease biomarkers." Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

20 世纪 60 年代有一则广告，展现了一对快乐的夫妇站在运动型帆船上。 广告标题是：「丈夫们也爱倍美力。」 身为船长兼指挥官的丈夫对着镜头露齿一笑，他的妻子崇拜地注视着他。 广告词出现：「她找到了暮色时分的平静！」 为了治疗绝经期的一些更为不适的症状，尤其是潮热、夜间盗汗和阴道干涩，数十年来，女性都在寻求解决方式，包括倍美力以及其他品牌和配方的激素替代疗法药物。 激素替代疗法是有效果的，但这种干扰激素的方式并非没有争议，一些女性也会面临相当大的健康风险。 通往暮色时分的平静的道路并不好走。 良药还是毒药 此前不到 10 年，年轻女性刚刚被开了第一批避孕药。现在，她们的母亲也有了属于自己的药——有时候被叫作「青春药」。 在两代人的两种情况中，由于对药物了解不足，女性的健康都在受到损害，无论她们的症状是生理的还是心理的。 从 20 世纪 90 年代末起，心脏和雌激素/孕酮替代疗法研究及女性健康倡议研究表明，绝经 10 年以上并使用了激素替代疗法的女性心脏病发作、得脑卒中和血栓的风险正在上升。 2002 年，一项涉及女性使用激素替代疗法和安慰剂的大型临床试验被叫停，因为使用激素疗法的女性患乳腺癌的风险会升高。 而且不是仅仅存在「风险」 而已。使用激素替代疗法的病人还起诉了制药商，因为她们被确诊患上了心脏病和癌症。 医生和研究者已证实，雌激素疗法的使用时间和类型非常重要。 比如，在绝经后的 6～10 年内，服用雌激素会降低心脏病风险。但在绝经 10～12 年后，雌激素会提高心脏病发作或得脑卒中的风险。 「激素智慧」 激素替代疗法在现在及未来很长的时间内，仍然是内分泌功能减退类疾病的主要治疗方法。 这种治疗方法是一个长期的过程，不同个体在不同时期可出现不同的症状或病变，治疗必须个体化以适应不同的需要。 18 多年来，制药商也重新调整了产品的配方，试图降低风险。就像激素类避孕方式中的情况一样，药片一直是最受欢迎的激素替代疗法形式，但也可以使用局部贴剂、乳霜、喷雾剂、凝胶、阴道环和栓剂的形式。 安全而成功地使用激素替代疗法是可以做到的，但得到的经验教训也是明确的：应对绝经没有通用的方法，因为每个女性在自己的一生中都有不同的激素体验。 将绝经或者其他任何正常的激素变化定义为一种需要治疗的疾病是错误的方法，对我们帮助不大。 每个女孩和女人都会因为理解激素周期的范围、机制、时间和原因而获益。我们应该熟悉激素对我们行为的潜在影响。我们也应该知道，应对激素行为是一种个人选择，它依赖每个人自己的偏好和目的。 拥有激素智慧才会对我们有益。 本文内容节选自《雌激素》 作者：Martie Haselton 策划：肯德羊｜监制：carollero、z_popeye 留言点赞第一送新书 ↓↓↓