思考激素替代疗法？在您决定之前，这是您需要知道的。

The number of American women who take medication to manage menopause plunged after 2002.

That’s when news came out thathormone replacement therapy (HRT)可以增加乳腺癌，心脏病，中风和血栓的风险。

然而内分泌等主要医疗机构Society, North American Menopause Society (NAMS), and the American College of Obstetricians and Gynecologists (ACOG) say that HRT offers more benefits than risks for many women.

据A，即使在60岁之后，美国女性经常经常经历频繁的热闪光和夜间汗水。新研究来自明尼苏达州罗切斯特的Mayo Clinic的超过八年数据 - 和HRT是有效的预防。

最好的方法是要求您的妇科医生在您自己的案例中评估风险和福利，共同作者Paru David博士告诉Healthine。雷竞技app官网“老年妇女应该寻求护理，”她说。

超越潮热，更年期后干燥的阴道可以使性行为痛苦或引起排尿问题。雌激素直接施用于阴道，不会造成任何风险，有帮助。

But though approximately a third of all women eventually experience unpleasant dryness,新研究表明，只有一半的人告诉他们的医生和不到4％的阴道雌激素治疗。

你输入了menopause当你没有连续12个月的时间。

那一刻通常在48和55岁之间到达，一般在过渡的出血过渡后。

Up to 80 percent of women experiencehot flashes，技术上被称为“血管运动症状”。

胸部，脸部和头部的热量升高，然后冲洗，汗水，有时会发冷。在晚上，你可能会发现自己醒来淋上汗水。

那些睡眠中断使世界各地更年期的主要症状，罗宾菲利普斯，纽约妇科医生和“更年期圣经的编辑：管理更加实用指南”，讲述了你的更年期，“健康线条。雷竞技app官网

医生以前认为激素症状持续了六个月到两年，但他们可以持续更长时间。据另一个人介绍，所有经历频繁的潮流频繁的女性的一半超过七年以上 major study 。

如果您的第一次热闪烁闪烁，而在您仍然出现出血时，中位数（较小半）近12年。

非裔美国女性和女性更多的抑制ion or anxiety also tend to endure symptoms longer.

“我们有女性在60年代，70年代和80年代陪伴更年期，”大卫说。“所以我们看了数据。”

The Mayo team found that more than40 percentof women age 60 and up reported “moderate” or “severe” symptoms.

However, David pointed out that 60-plus women who were taking hormones had no hot flashes or night sweats.

虽然HRT是最有效的待遇，但弗吉尼亚州卫生系统大学妇科妇科和妇科教授的执行董事Joann Pinkerton博士警告说，老年妇女并不是那么安全。

“The risks are likely to outweigh the benefits for women starting hormones more than 10 or particularly by 20 years from menopause or over age 60, and certainly starting after 70,” she said.

一种ccording to Phillips, receiving the hormone through your skin — in a patch or gel, rather than a pill — is much safer.

She points out that the problem with pills is that they’re synthesized through the liver.

Phillips says she discusses transdermal HRT with all her patients, pointing out that HRT may actually保护women against breast cancer , a conclusion from research conducted in Finland.

该研究表明，单独服用雌激素，而不是与黄体酮的组合，似乎保护了芬兰女性 心脏病和中风 。

To get the heart protection, “you have to start within a few years of your last period,” Phillips said. “It’s debatable whether it helps if you start later.”

Pinkerton notes other evidence linking estrogen with fewer cases of heart disease but remains concerned, especially as women age.

“NAMS does not recommend using estrogen therapy (oral or transdermal) to prevent heart disease” she said.

一种s for stroke, “observational studies show fewer blood clot risks and stroke with transdermal estradiol [a patch], but that is not the same as preventing stroke,” she said.

Phillips and David also point to data showing that taking estrogen may lower the likelihood of dementia, if you start early.

The Cochrane network of researchers, analyzing studies that focused on U.S. data and oral HRT, 报道 2017年，仅服用雌激素降低乳腺癌和骨折的风险并没有增加心脏病。

However, in this data it appeared to raise the risk of blood clots, stroke, and gallbladder disease.

Combination therapy also raised the risk of heart attack, breast cancer, gallbladder disease, and death from lung cancer.

“We worry about women who are at elevated risk of heart disease, have untreated hypertension, atherosclerotic plaque, or are at high risk for dementia or have changes already present in their brain on MRI scans,” Pinkerton said.

如果您有血凝或中风的风险升高，您也应该警惕，患有雌激素敏感的乳腺癌或子宫癌症或肝脏问题。

风险可能以较高的剂量上升，你使用药物的时间越长，或者你的年龄越长。

When looking for an alternative to hormones to treat hot flashes, David said, “I tend to pick a drug that will benefit patients in another way. If she has a mood disorder, perhaps Effexor or another SSRI [selective serotonin reuptake inhibitor]. If she has chronic pain, gabapentin.”

Pinkerton also notes that clonidine patches, a high blood pressure treatment, has been helpful “off-label,” meaning it hasn’t been approved for that purpose by the U.S. Food and Drug Administration (FDA).

“在临床试验中表现出益处的非前言疗法包括催眠，认知行为疗法和可能针灸，”她补充道。

一种bout half of all women in menopause end up with vaginal dryness, which is uncomfortable and can make sex painful.

For many, urination becomes an issue — waking up frequently to urinate, leaking while sneezing, or embarrassing accidents.

Estrogen (generic estradiol or Vagifem) pills that are fired with a dispenser into the vagina, helps both dryness and urination problems.

Phillips advises that ring devices that release estrogen in the vagina continually at a low dose for three months can help as well.

Estrogen in the vagina doesn’t pose any risk (or benefit) to the rest of the body, since it isn’t absorbed elsewhere. But you might hear otherwise from one of your doctors.

“许多家庭医生，内科医生和一些肿瘤医生并不真正明白，如果适当给药，则只有少量的阴道雌激素被吸收，”注意到Pinkerton。“盒装警告吓到妇女和他们的合作伙伴，即使我们解释了最小的吸收，也是在给老年女性给予的全身性雌激素和孕激素的情况下，也不适用于这些低剂量阴道产物。”

一种 最近的研究 发现药丸在驯服干燥比三个月内的安慰剂更好。但菲利普斯指出，这种治疗仅适用于最近进入更年期的人的三个月。

“The estradiol has to attach to receptors in the vagina and the receptors have to build up, so in some people it can take longer to work. I’ve seen it take two years of treatment for the vagina to completely recover,” she said.

The standard dose is 10 milligrams twice a week. But Phillips said some women need more. “I tell women to go up to three or four times a week until they feel the vagina is where it should be. Then they can go to twice a week for maintenance.”

Pinkerton注意到，只有大约四分之一的所有女性都需要治疗，Pinkerton指出。

如果你尝试过，你可能不必长时间继续。

“大多数女性，即使他们开始激素治疗，也不要继续一年，”她说。

The bottom line?

Most women can safely take HRT within 10 years of menopause for hot flashes. Also, estrogen in the vagina is an under-used safe remedy for other symptoms.

Talk to your doctor about your own risk and benefit calculation so you can make the decision that’s best for you.