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Therapeutische Interventionen bei peri- und postmenopausalen Beschwerden

Treatment interventions for perimenopausal and postmenopausal complaints

Zusammenfassung

Die S3-Leitlinie „Peri- und Postmenopause – Diagnostik und Therapie“ beinhaltet Handlungsanweisungen und Empfehlungen für die Hormonersatztherapie (HRT) zur Behandlung klimakterischer Beschwerden, die von etwa 50 % der perimenopausalen Frauen und bei 30–80 % der postmenopausalen Frauen angegeben werden. Eine HRT mit Östrogenen (ET) oder Östrogenen und Gestagenen (EPT) wird als symptomatische Therapie zur Behandlung von klimakterischen Beschwerden mit klinisch relevanter Beeinträchtigung der Lebensqualität eingesetzt. Alternativ können auch Isoflavone, Cimicifuga-Präparate, Serotonin- bzw. Serotonin-Noradrenalin-Wiederaufnahmehemmer, Clonidin, Gabapentin oder kognitive Verhaltenstherapie angewendet werden. Im vorliegenden Artikel werden Effektivität und Sicherheit sowie Nebenwirkungen und systemische Wirkungen dieser unterschiedlichen Therapieformen entsprechend den Vorgaben der S3-Leitlinie „Peri- und Postmenopause – Diagnostik und Therapie“ dargestellt.

Abstract

The S3 guidelines “Perimenopause and postmenopause—diagnostics and treatment” includes recommendations and practical guidance for hormone replacement therapy for treatment of climacteric complaints. Around 50% of women in the perimenopause and 30–80% in the postmenopause report climacteric symptoms. Hormone replacement therapy with estrogens or with estrogens and gestagens is the current standard of care for the treatment of these complaints with clinically relevant impairment of the quality of life. Alternative interventions include isoflavones, cimicifuga preparations, serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, clonidine, gabapentin and cognitive behavioral therapy. This article discusses the therapeutic efficacy, safety, side effects, and systemic effects of these diverse interventions based on the S3 guidelines “Perimenopause and postmenopause—diagnostics and treatment”.

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Author information

Correspondence to Prof. Dr. Clemens Tempfer MBA.

Ethics declarations

Interessenkonflikt

C. Tempfer und O. Ortmann geben an, dass kein Interessenkonflikt besteht.

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

Additional information

Erstveröffentlichung in Gynäkologe (2019): https://doi.org/10.1007/s00129-019-04509-x.

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O. Ortmann, Regensburg

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Tempfer, C., Ortmann, O. Therapeutische Interventionen bei peri- und postmenopausalen Beschwerden. Gynäkologische Endokrinologie (2020). https://doi.org/10.1007/s10304-020-00306-1

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Schlüsselwörter

  • Progesteron
  • Östrogene
  • Isoflavone
  • Versorgungsstandard
  • Hormonersatztherapie

Keywords

  • Progesterone
  • Estrogens
  • Isoflavones
  • Standard of care
  • Hormone replacement therapy