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. |