Dobrobiti i rizici hormonskog nadomjesnog liječenja

master's thesis

• Title (english): Benefits and risks of hormone replacement therapy
• Author: Leonora Bračun
• Mentor: Marina Šprem Goldštajn (mentor)
• Committee member: Tomislav Čanić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Committee member: Marina Šprem Goldštajn (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Hormonsko nadomjesno liječenje se koristi kod žena s nedostatkom estrogena. Simptomi i znaci nedostatka estrogena koji dovode do smanjenja kvalitete života primarno se očituju kod žena reprodukcijske dobi s hipoestrogenim amenorejama, onih s prijevremenom menopauzom, te kod žena u klimakteriju i postmenopauzi. HNL se preporučuje u liječenju vazomotornih tegoba, urogenitalne atrofije, te u prevenciji osteoporotičnih prijeloma. Primjena hormonskog nadomjesnog liječenja je vremenski ograničena zbog povećanog rizika od venske tromboembolije i karcinoma dojke. Liječenje treba provoditi najnižom učinkovitom dozom, kroz najkraće moguće vrijeme. Treba ga individualizirati sukladno potrebama i rizicima svake pacijentice. HNL ne treba provoditi dulje od 5 godina. Rizik karcinoma dojke ovisan je o trajanju korištenja, i putu primjene, a ne o dozi hormona, te se prestankom terapije vraća na početne vrijednosti. Rizik je veći ako se uz estrogene koristi i progestagen. HNL nema učinak primarne ili sekundarne prevencije ishemične bolesti srca ili moždanog udara. Povećava rizik tromboemboličkih incidenata, te se ne provodi u žena s tromboemboličkim incidentom u anamnezi. Žene žive gotovo trećinu života u postmenopauzi, te u Hrvatskoj slično zapadnim zemljama, 18% cijele populacije su žene u postmenopauzi. To nam govori koliko je hormonsko nadomjesno liječenje važan čimbenik u očuvanju zdravlja i kvalitete života žena tijekom procesa starenja. Cilj ovog rada je dati pregled o najnovijim spoznajama, te dobrobitima i rizicima hormonskog nadomjesnog liječenja.

Abstract (english)

Hormone replacement therapy is used in women with estrogen deficiency. Patients in reproductive age with hypoestrogenemic amenorrhea and premature menopause as well as women in climacterium and postmenopause have numerous symptoms and signs of estrogen lack, which may result in decreased quality of life. HRT is recommended for the treatment of vasomotor symptoms, urogenital atrophy, and the prevention of osteoporosis-related fractures. Use of hormone replacement therapy is time limited due to an increased risk of venous thromboembolism and breast cancer. Treatment should be started with lowest effective dose for the shortest possible time. It should be individualized according to the needs and risks of each patient. HRT should not be taken for a period longer then five years. The risk of breast cancer varies with the treatment duration, route of administration, and it doesn’t depend on the dosage of hormones. The risk is greater if used with estrogen and progestin. HRT is not indicated for primary or secondary prevention of cardiovascular disease. Also, it increases the risk for tromboembolic episodes and is not recommended in patients with history of thromboembolism. Women live almost one third of their life in postmenopause, and in Croatia 18% of entire population are post-menopausal women. This leads to conclusion how hormone replacement therapy plays an important role in maintaining the health and quality of life of postmenopausal women. The aim of my thesis is to give the review of the latest findings in the area of benefits and risks of hormone replacement therapy.

• Keywords: hormonsko nadomjesno liječenje; dobrobiti; rizici; postmenopauza; estrogen; progestagen
• Keywords (english): hormone replacement therapy; benefits; risks; postmenopause; estrogen; progestin
• Language: croatian
• URN:NBN: urn:nbn:hr:105:194818
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-09-21 07:32:01