Menopause Rating Scale (MRS) https://www.hormonebalance.org/files/MRS%20QOL%20questionnaire%20.pdf 我得7分。 需要问的问题:开始用激素替代治疗之后 –多久需要follow-up –查血吗? –spotting正常吗? –是不是会推迟停经? –多久就可以有症状的缓解? –如果没有症状缓解,多久就可以认为无效? –停药时候,症状会反弹吗? WHI study的历史背景: Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women JAMA 2002 Prevention study --50-79 years 绝经期妇女,w/ intact uterus, 1993-1998, 不需要有更年期症状 --conjugated equine estrogen 0.625m/day + medroxyprogesterone 2.5mg/d in 1 tablet --Primary endpoint: 心脏病风险降低,乳腺癌不增加. A global index summarizing the balance of risks and benefits: stroke, PE, endometrial ca, colorectal ca, hip fracture and death due to other causes. 注意,这里没有症状缓解和生活治疗的考量。 –In 1990s, 40% of post-menopausal women were on HRT (hormone replacement therapy). It's the top prescribed medication. The prescription dropped by 80% after the above publication. |