生活質量的價值-HRT， WHI的曆史背景

Menopause Rating Scale (MRS) 
https://www.hormonebalance.org/files/MRS%20QOL%20questionnaire%20.pdf

我得7分。

需要問的問題：開始用激素替代治療之後
–多久需要follow-up
–查血嗎？
–spotting正常嗎?
–是不是會推遲停經？
–多久就可以有症狀的緩解？
–如果沒有症狀緩解，多久就可以認為無效？
–停藥時候，症狀會反彈嗎？

WHI study的曆史背景:
Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women
JAMA 2002
Prevention study
--50-79 years 絕經期婦女，w/ intact uterus, 1993-1998， 不需要有更年期症狀
--conjugated equine estrogen 0.625m/day + medroxyprogesterone 2.5mg/d in 1 tablet
--Primary endpoint: 心髒病風險降低，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，這裏沒有症狀緩解和生活治療的考量。
–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.