《2011IMS對絕經(jīng)后激素治療和中年女性健康預(yù)防》內(nèi)容預(yù)覽

The past decade has seen marked fluctuations in opinions concerning the merits and risks of postmenopausal hormone replacement therapy (HRT). In July 2002, menopause management faced a major turning point when the first data from the Women’s Health Initiative (WHI) trial were released.

This study was categorized as a primary prevention trial for coronary heart disease. However, the mean age at recruitment was 63 years, when menopausal symptoms have usually finished and HRT is rarely started, but this important difference from common clinical practice was not acknowl-edged at that time. Instead, WHI investigators concluded that HRT was not cardioprotective and that its risk–benefit ratio did not favor the use of postmenopausal hormones for prevention of chronic diseases. As a result, there was a dramatic change in presc**tion habits following recommen-dations to reserve HRT for very symptomatic women, and to limit its use to the ‘shortest duration needed’ and to ‘the lowest effective dosage’. This was the atmosphere in which the International Menopause Society (IMS) initiated a Workshop held in Vienna (December 2003) and produced the subsequent IMS Position Paper resulting from the Workshop discussions.

Basically, the IMS did not accept some interpretations attributed to the WHI results and, being independent of local or regional constraints imposed by official health authorities, called for a more balanced approach to the scientific data. Because additional information has been accumulated from both arms of the WHI study, from observational trials and from other studies during the following years, the first IMS Statement was updated in 2007, enlarging its scope to menopause management and adult women’s health in general.

This revised Statement was formulated in a Workshop held in Budapest in February 2007, in which 30 experts from the various fields of menopause medicine presented the latest information and delegates from 60 National and Regional Menopause Societies from all continents participated in the discussions.

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