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Hormonersatztherapie und Prävention gemäß S3-Leitlinie

Hormone replacement therapy and prevention according to S3 guidelines

Zusammenfassung

Eine Hormonersatztherapie kann effektiv klimakterische Beschwerden lindern. Darüber hinaus hat sie Wirkungen, die sich positiv auf die Gesundheit auswirken, aber auch die Anwendung limitieren können. Unbestritten ist der positive Effekt auf die Knochenstruktur mit der Folge einer substanziellen Senkung der Frakturraten. Bezüglich hormonabhängiger Tumoren sind die Effekte gering und gegensätzlich, sodass eine Hormonersatztherapie nicht zur onkologischen Vorsorge geeignet ist. Das gilt auch für die Prävention der koronaren Herzkrankheit, zumal eine Erhöhung des Thrombose- und Schlaganfallrisikos nur durch transdermale Applikation vermieden werden kann. Dadurch werden wiederum günstige Wirkungen auf das Lipidprofil und den Glukosestoffwechsel mitigiert, die zusammen mit einem individuell unterschiedlichen Effekt auf den Blutdruck nach jeweiliger Veranlagung positiv genutzt werden können.

Abstract

Hormone replacement therapy can effectively relieve climacteric complaints. Furthermore, it has effects that have a positive impact on health but can also limit the application. The positive effect on bone structure resulting in a substantial reduction in the fracture rate is undisputed. The effects are low and contradictory with respect to hormone-dependent tumors so that hormone replacement therapy is not suitable for oncological prophylaxis. This is also true for the prevention of coronary heart disease, especially as an increase in the risk of thrombosis and stroke can only be avoided by transdermal application. Thereby, in turn favorable effects on the lipid profile and glucose metabolism are mitigated, which together with an individually variable effect on blood pressure according to the respective predisposition, can be positively utilized.

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Author information

Correspondence to Prof. Dr. med. E. Windler.

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Interessenkonflikt

E. Windler, P. Hadji und O. Ortmann geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Erstveröffentlichung in Gynäkologische Endokrinologie (2019): https://doi.org/10.1007/s10304-019-00297-8

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O. Ortmann, Regensburg

L. Kiesel, Münster

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Windler, E., Hadji, P. & Ortmann, O. Hormonersatztherapie und Prävention gemäß S3-Leitlinie. Gynäkologe (2020). https://doi.org/10.1007/s00129-020-04568-5

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Schlüsselwörter

  • Menopause
  • Frakturrisiko
  • Koronare Herzkrankheit
  • Krebsrisiko
  • Kardiovaskuläre Risikofaktoren

Keywords

  • Menopause
  • Fracture risk
  • Coronary heart disease
  • Cancer risk
  • Cardiovascular riskfactors