泌尿生殖系统绝经期综合征的预防和治疗现状

Q4 Medicine
I. A. Apolikhina, L. A. Tarnaeva
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引用次数: 0

摘要

泌尿生殖系统更年期综合征仍然是一个普遍存在的问题,显著影响绝经后的生活质量。这种状态的原因是雌激素分泌不足,这与更年期有关,并且由于乳酸菌的消除,阴道菌群发生了变化。外阴和阴道微生物群的紊乱为致病微生物的入侵提供了风险,性激素的缺乏与泌尿生殖道上皮的萎缩有关。对已发表的临床研究进行了分析,这些研究使用嗜酸乳杆菌和0.03 mg雌三醇(Gynoflor®E)联合治疗外阴阴道萎缩的绝经后妇女、乳腺癌幸存者和服用芳香酶抑制剂的绝经后乳腺癌妇女。用嗜酸乳杆菌和0.03 mg雌三醇(Gynoflor®E)联合治疗可被评估为安全,没有子宫内膜效应或其他全身效应的风险。绝经后妇女局部雌激素治疗可以恢复阴道上皮,并且需要有益的乳酸菌群来预防泌尿生殖系统感染。局部应用雌三醇是可取的,因为它会引起局部增殖反应,对子宫内膜没有刺激作用。这种治疗方法也可用于芳香化酶抑制剂治疗的激素敏感乳腺癌妇女。然而,目前还没有足够的临床验证研究证明这种治疗方法对乳腺癌妇女的绝对安全性。这种治疗的效果是由于雌三醇和乳酸菌的协同作用而实现的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current trends in the prevention and treatment of genitourinary menopausal syndrome
Genitourinary menopausal syndrome is still a widespread problem that significantly affects the quality of life in postmenopause. The cause of this state is hypoestrogenism that is associated with menopause and the following change in the vaginal microflora due to the elimination of lactobacilli. The disturbance of the vulval and vaginal microflora provides risks for the invasion of pathogenic microorganisms, and the deficiency of sex hormones is associated with atrophy of the epithelium of the urogenital tract. An analysis of published clinical studies using a combination of L. acidophilus and 0.03 mg estriol (Gynoflor® E) in postmenopausal women with vulvovaginal atrophy, breast cancer survivors, in postmenopausal women with breast cancer on aromatase inhibitors was performed. Treatment with a combination of L. acidophilus and 0.03 mg of estriol (Gynoflor® E) can be evaluated as safe without risk of endometrial effects or other systemic effects. Local estrogen therapy in postmenopausal women can restore the vaginal epithelium, and a useful lactobacillus flora is needed to prevent urogenital infections. Local application of estriol is preferable, as it causes a local proliferative response and has no stimulating effect on the endometrium. This method of therapy may also be considered for hormone-sensitive women with breast cancer on aromatase inhibitors. However, today, there are not enough clinically validated studies proving the absolute safety of this treatment method among breast cancer women. The effect of this therapy is achieved due to the synergistic action of estriol and lactobacilli.
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来源期刊
Meditsinskiy Sovet
Meditsinskiy Sovet Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
418
审稿时长
6 weeks
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