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DOI: 10.1055/s-2007-965452
© Hippokrates Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG
Update Hormonersatz: Bioidentische Hormongaben sind risikoarm
Publikationsverlauf
Publikationsdatum:
21. August 2007 (online)
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Zusammenfassung
Die herkömmliche Hormonersatzherapie (HRT) aus oralen Östrogenen und synthetischen Progestagenen ist kurz- und langfristig risikobehaftet. Zur Risikoreduktion von Hormongaben sind vor allem die Wiederherstellung „natürlicher“ Hormonspiegel anzustreben. Dies gelingt durch die human-physiologischen Hormone 17β-Östradiol und Progesteron sowie eine jeweils geeignete Darreichung. Ein solcher „bioidentischer“ Hormonersatz ist an den genitalen und extragenitalen Zielorganen nebenwirkungsarm und wirkt sich günstig auf die Gesunderhaltung und Alterungsprävention aus.
Schlüsselwörter
Hormonersatztherapie - Prävention - Östradiol - Progesteron - bioidentisch
Literatur
- 1 Bakken K, Alsaker E, Eggen A E, Lund E. Hormone replacement therapy and incidence of hormone-dependent cancers in the Norwegian Women and Cancer Study. Int J Cancer. 2004; 112 (1) 130-134
- 2 Beral V. Million Women Study Collaborators. Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet. 2003; 362 (9382) 419-427
- 3 Beral V, Bull D, Reeves G. Million Women Study Collaborators. Endometrial cancer and hormone-replacement therapy in the Million Women Study. Lancet. 2005; 365 (9470) 1543-1551
- 4 Brincat M P. Hormone replacement therapy and the skin. Maturitas. 2000; 35 (2) 107-117
- 5 Campagnoli C, Clavel-Chapelon F, Kaaks R. et al. . Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. J Steroid Biochem Mol Biol. 2005; 96 (2) 95-108
- 6 Canonico M, Straczek C, Oger E. et al. . Postmenopausal hormone therapy and cardiovascular disease: An overview of main findings. Maturitas. 2006; 54 (4) 372-379
- 7 Chen W Y, Manson J E, Hankinson S E. et al. . Unopposed estrogen therapy and the risk of invasive breast cancer. Arch Intern Med. 2006; 166 (9) 1027-1032
- 8 Clavel-Chapelon F, Fournier A. E3 N-EPIC cohort Update. Abstracts, 11th World Congress on the Menopause. Buenos Aires; Oct./2005 Buenos Aires
- 9 Csizmadi I, Collet J P, Benedetti A. et al. . The effects of transdermal and oral oestrogen replacement therapy on colorectal cancer risk in postmenopausal women. Br J Cancer. 2004; 90 (1) 76-81
- 10 De Lignieres B, Dennerstein L, Backstrom T .. Influence of route of progesterone metabolism. Maturitas. 1995; 21 251-257
- 11 De Lignieres B, de Vathaire F, Fournier S. et al. . Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women. Climacteric. 2002; 5 (4) 332-340
- 12 Den Tonkelaar I, Oddens B J. Determinants of long-term hormone replacement therapy and reasons for early discontinuation. Obstet Gynecol. 2000; 95 (4) 507-512
- 13 Dennison E M, Arden N K, Kellingray S. et al. . Hormone replacement therapy, other reproductive variables and symptomatic hip osteoarthritis in elderly white women: a case-control study. Br J Rheumatol. 1998; 37 (11) 1198-1202
- 14 Dupont A, Dupont P, Cusan L. et al. . Comparative endocrinological and clinical effects of percutaneous estradiol and oral conjugated estrogens as replacement therapy in menopausal women. Maturitas. 1991; 13 (4) 297-311
- 15 Fabre A, Fournier A, Mesrine S. et al. . Oral progestagens before menopause and breast cancer risk. Br J Cancer. 2007; 96 (5) 841-844
- 16 Foidart J M, Colin C, Denoo X. et al. . Estradiol and progesterone regulate the proliferation of human breast epithelial cells. Fertil Steril. 1998; 69 (5) 963-969
- 17 Fournier A, Berrino F, Riboli E. et al. . Breast cancer risk in relation to different types of hormone replacement therapy in the E3 N-EPIC cohort. Int J Cancer. 2005; 114 (3) 448-454
- 18 Grodstein F, Lifford K, Resnick N M, Curhan G C. Postmenopausal hormone therapy and risk of developing urinary incontinence. Obstet Gynecol. 2004; 103 (2) 254-260
- 19 Grodstein F, Manson J E, Stampfer M J. Hormone therapy and coronary heart disease: the role of time since menopause and age at hormone initiation. J Womens Health (Larchmt). 2006 Jan; 15 (1) 35-44
- 20 Harvey P J, Morris B L, Miller J A, Floras J S. Estradiol induces discordant angiotensin and blood pressure responses to orthostasis in healthy postmenopausal women. Hypertension. 2005; 45 (3) 399-405
- 21 Hendrix S L, Cochrane B B, Nygaard I E. et al. . Effects of estrogen with and without progestin on urinary incontinence. JAMA. 2005; 293 (8) 935-948
- 22 Ho S M. Estrogen, progesterone and epithelial ovarian cancer. Reprod Biol Endocrinol. 2003; 1 (1) 73-81
- 23 Huber J C. Hormonveränderungen im Alter: Genitale und extragenitale Auswirkungen. Gynäkologe. 1996; 29 726-734
- 24 Kirsh V, Kreiger N. Estrogen and estrogen-progestin replacement therapy and risk of postmenopausal breast cancer in Canada. Cancer Causes Control. 2002; 13 (6) 583-590
- 25 Kovari E, Gold G, Herrmann F R. et al. . Cortical microinfarcts and demyelination significantly affect cognition in brain aging. Stroke. 2004; 35 (2) 410-414
- 26 Lauritzen C. Die präventive Estrogen-Gestagen-Langzeitsubstitution. Frauenarzt. 2001; 42 (11) 1230-1267
- 27 Le Gal G, Gourlet V, Hogrel P. et al. . Hormone replacement therapy use is associated with a lower occurrence of carotid atherosclerotic plaques but not with intima-media thickness progression among postmenopausal women. The vascular aging (EVA) study. Atherosclerosis. 2003; 166 (1) 163-170
- 28 Leake R. Contents of HRT and mechanisms of action. J Epidemiol Biostat. 1999; 4 (3) 129-133
- 29 Leo J C, Wang S M, Guo C H. et al. . Gene regulation profile reveals consistent anticancer properties of progesterone in hormone-independent breast cancer cells transfected with progesterone receptor. Int J Cancer. 2005; 117 (4) 561-568
- 30 Micheli A, Muti P, Secreto G. et al. . Endogenous sex hormones and subsequent breast cancer in premenopausal women. Int J Cancer. 2004; 112 (2) 312-318
- 31 Mosekilde L, Beck-Nielsen H, Sorensen O H. et al. . Hormonal replacement therapy reduces forearm fracture incidence in recent postmenopausal women - results of the Danish Osteoporosis Prevention Study. Maturitas. 2000; 36 (3) 181-193
- 32 Moskowitz D. A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks. Altern Med Rev. 2006 Sept; 11 (3) 208-223
- 33 Nelson H D, Humphrey L L, Nygren P. et al. . Postmenopausal hormone replacement therapy: Scientific review. JAMA. 2002; 288 (7) 872-881
- 34 Oelkers W K. Effects of estrogens and progestogens on the renin-aldosterone system and blood pressure. Steroids. 1996; 61 (4) 166-171
- 35 O'Sullivan A J, Crampton L J, Freund J, Ho K KY. The route of estrogen replacement therapy confers divergent effects on substrate oxidation and body composition in postmenopausal women. J Clin Invest. 1998; 102 1035-1040
- 36 Ohlinger R, Klein G M, Köhler G. et al. . Altersverteilung bei Patientinnen mit Mammatumoren in Abhängigkeit vom histologischen Befund. Gyn. 2006; 11 110-116
- 37 PEPI-Trial. Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. The Writing Group for the PEPI Trial. JAMA. 1996; 275 (5) 370-375
- 38 Plu-Bureau G, Le M G, Thalabard J C. et al. . Percutaneous progesterone use and risk of breast cancer: results from a French cohort study of premenopausal women with benign breast disease. Cancer Detect Prev. 1999; 23 (4) 290-296
- 39 Rabe T, Geisthövel F, Hadji P. et al. . Hormonersatztherapie - Nutzen und Risiken. J Reproduktionsmed Endokrinol. 2006; 3 (3) 155-165
- 40 Raine-Fenning N J, Brincat M P, Muscat-Baron Y. Skin aging and menopause: implications for treatment. Am J Clin Dermatol. 2003; 4 (6) 371-378
- 41 Ridker P M, Rifai N, Rose L. et al. . Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002; 347 (20) 1557-1565
- 42 Römmler A. Paradigmenwechsel bei der Substitution mit Östrogenen. ZS Orthomol Med. 2003; 3 13-17
-
43 Römmler A.
Neubewertung der HRT: Orale versus transdermale Östrogene sowie Progestagene versus Progesteron - Wege zur Risikoreduktion. Wolf A, Römmler A, Moltz L, Klentze M Anti Aging Medizin 2003. Berlin; Congress Compact Verlag 2004: 168-194 - 44 Römmler A. Die Wahrheit über Hormone. München; Südwest 2006
- 45 Römmler A. Endokrinologische Aspekte der Anti-Aging-Medizin. CME Praktische Fortbildung Gynäkologie, Geburtsmedizin, Gynäkologische Endokrinologie. 2006; 3 18-34
- 46 Römmler A. Wege zur risikoarmen HRT: Bioidentischer Hormonersatz. J Preventive Medicine. 2007;
- 47 Rossouw J E, Anderson G L, Prentice R L. et al. . Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA. 2002; 288 (3) 321-333
- 48 Rylance P B, Brincat M, Lafferty K. et al. . Natural progesterone and antihypertensive action. Br Med J (Clin Res Ed). 1985; 290 (6461) 13-14
- 49 Salpeter S R, Walsh J M, Greyber E. et al. . Mortality associated with hormone replacement therapy in younger and older women: a meta-analysis. J Gen Intern Med. 2004 Jul; 19 (7) 791-804
- 50 Scarabin P Y, Oger E, Plu-Bureau G. Estrogen and Thromboembolism Risk Study Group. Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk. Lancet. 2003; 362 (9382) 428-432
- 51 Scarabin P Y. et al. .Abstracts, 11th World Congress on the Menopause. Buenos Aires; Oct./2005
- 52 Schuback B. Die ältere Patientin im Brennpunkt der gynäkologischen Onkologie - demografische Entwicklung. Gyn. 2006; 11 451-455
- 53 Schumacher M, Guennoun R, Robert F. et al. . Local synthesis and dual actions of progesterone in the nervous system: neuroprotection and myelination. Growth Horm IGF Res. 2004; 14 Suppl A S18-S33
- 54 Stahlberg C, Pedersen A T, Lynge E. et al. . Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe. Int J Cancer. 2004; 109 (5) 721-727
- 55 Stefanick M L, Anderson G L, Margolis K L. et al. . WHI Investigators. Effects of conjugated equine estrogens on breast cancer and mammography screening in postmenopausal women with hysterectomy. JAMA. 2006; 295 (14) 1647-1657
- 56 Stephenson K, Price C, Kurdowska A. et al. . Progesterone cream does not increase thrombotic and inflammatory factors in postmenopausal women. Blood. 2004; 104 116
- 57 Straczek C, Oger E, Yon de Jonage-Canonico M B. et al. . Prothrombotic mutations, hormone therapy, and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration. Circulation. 2005; 112 (22) 3495-3500
- 58 Tollan A, Oian P, Kjeldsen S E. et al. . Progesterone reduces sympathetic tone without changing blood pressure or fluid balance in men. Gynecol Obstet Invest. 1993; 36 (4) 234-238
- 59 Tsuda K, Kinoshita Y, Nishio I. Synergistic role of progesterone and nitric oxide in the regulation of membrane fluidity of erythrocytes in humans: an electron paramagnetic resonance investigation. Am J Hypertens. 2002; 15 (8) 702-708
- 60 Vassilev V, Pretto C M, Cornet P B. et al. . Response of matrix metalloproteinases and tissue inhibitors of metalloproteinases messenger ribonucleic acids to ovarian steroids in human endometrial explants mimics their gene- and phase-specific differential control in vivo. J. Clin Endocrinol Metab. 2005; 90 (10) 5848-5857
- 61 Von Muhlen D, Morton D, Von Muhlen C A, Barrett-Connor E. Postmenopausal estrogen and increased risk of clinical osteoarthritis at the hip, hand, and knee in older women. J Womens Health Gend Based Med. 2002; 11 (6) 511-518
- 62 Vongpatanasin W, Tuncel M, Wang Z. et al. . Differential effects of oral versus transdermal estrogen replacement therapy on C-reactive protein in postmenopausal women. J Am Coll Cardiol. 2003; 41 (8) 1358-1363
- 63 Weiderpass E, Adami H O, Baron J A. et al. . Risk of endometrial cancer following estrogen replacement with and without progestins. J Natl Cancer Inst. 1999; 91 (13) 1131-1137
-
64 Wolf A S.
Progestagene sind nicht Progesteron. Römmler A, Wolf AS. Anti-Aging Sprechstunde, Teil 1: Leitfaden für Einsteiger. Berlin; Congress Compact Verlag 2002: 95-102
Privatdozent Dr. med. Alexander Römmler
Gynäkologische Praxisklinik, Hormonzentrum München
Westendstr. 193 - 195
80686 München
URL: http://www.hormonzentrum.de
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