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Der Gynäkologe

, Volume 51, Issue 10, pp 828–841 | Cite as

Behandlungsstrategien für Patientinnen mit klimakterischen Beschwerden

  • K. Schaudig
  • A. Schwenkhagen
Leitthema
  • 202 Downloads

Zusammenfassung

Aufgrund der demographischen Entwicklung ist die Betreuung von peri- und postmenopausalen Patientinnen in der gynäkologischen Praxis zunehmend relevant. Um eine optimale Behandlungsstrategie festzulegen, ist eine sorgfältige Evaluierung des individuellen Leidensdrucks sowie der Symptome, die sich während der perimenopausale Übergangsphase verändern können, von entscheidender Bedeutung. Die individuellen Bedürfnisse der Patientin müssen ebenfalls berücksichtigt werden sowie Risikofaktoren, die sich aus der Anamnese und der Untersuchung ergeben. Eine Hormonersatztherapie (HRT) ist die effektivste Behandlung gegen Hitzewallungen. Für Frauen unter 60 Jahren scheint der Nutzen einer Hormonersatztherapie die Risiken zu überwiegen. Patientinnen mit einer Disposition für Thrombose oder Schlaganfall sollten Östrogene bevorzugt transdermal (und nicht oral) erhalten. Eine Reihe von nichthormonellen Therapieansätzen kann ebenfalls in Betracht gezogen werden. Individualisierung ist der Schlüssel zu einer optimalen Betreuung klimakterischer Patientinnen.

Schlüsselwörter

Hitzewallungen Menopause Östrogene, transdermal Hormonersatztherapie Thrombose 

Treatment strategies for patients with menopausal complaints

Abstract

Due to demographic development, the health care of women in the peri- and postmenopausal lifespan is increasingly relevant for practicing gynecologists. For defining the proper treatment strategy, a thorough evaluation of symptoms that may change in the course of the perimenopausal transition and the individual burden of suffering must be taken into account as well as the medical history including risk factors and the patient’s individual needs. Hormone replacement therapy (HRT) is the most effective treatment for hot flushes. For women aged < 60 the benefits of HRT seem to outweigh the risks. Patients with a predisposition for thrombosis or stroke should receive transdermal estrogen (instead of oral application). A number of nonhormonal therapies can also be considered. Individualization is the key to optimal care for climacteric patients.

Keywords

Hot flushes Menopause Estrogen, transdermal Hormone replacement therapy Thrombosis 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

K. Schaudig hat von folgenden Firmen für Vorträge und Beratertätigkeit Honorare sowie Forschungsunterstützung erhalten: Rottapharm, Gedeon Richter, Mylan-Meda; MSD; Dr. KADE; Bayer-Jenapharm; Gedeon Richter; Exeltis; Hexal; Shionogi; Santen; Laborarztpraxis Dres. Walther, Weindl und Partner. A. Schwenkhagen hat von folgenden Firmen für Vorträge und Beratertätigkeit Honorare sowie Forschungsunterstützung erhalten: Rottapharm, Gedeon Richter, Mylan-Meda; MSD; Dr. KADE; Bayer-Jenapharm; Gedeon Richter; Exeltis; Shionogi; Laborarztpraxis Dres. Walther, Weindl und Partner.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Praxis für gynäkologische Endokrinologie Dres. Schaudig & Schwenkhagen, HORMONE HAMBURG, GynaekologicumHamburgDeutschland

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