Gestagengabe in der Menopause: Was sind Unterschiede, Vorteile und Nachteile der einzelnen Präparate?
Ursula Gobrecht-Keller
- 27 Apr 2021
- Vol. 24, Iss: 2, pp 58-68
TL;DR: In this article, a menopausale Hormontherapie, einschliesslich der Wahl des Gestagens, sollte immer entsprechend dem Risikoprofil and den Behandlungszielen der Patientin individualisiert werden.
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Abstract: Frauen mit intaktem Uterus mussen bei der Anwendung eines systemisch wirksamen Ostrogens zur Endometriumprotektion ein Gestagen erhalten. Gestagene lassen sich in verschiedene Wirkstoffgruppen einteilen, welche unterschiedliche Partialwirkungen haben. Dies bedeutet, dass es keinen Klasseneffekt der Gestagene gibt, sondern die Effekte auf Metabolismus sowie auf hormonsensible Gewebe wie Brust, Endometrium und Knochen variieren konnen. Mikronisiertes Progesteron und Dydrogesteron scheinen in Hinblick auf Herz-Kreislauf-System und Brust die sicherste Option zu sein. Ihre Effekte auf die Glukosehomoostase und den Lipidstoffwechsel sind neutral. Eine menopausale Hormontherapie, einschliesslich der Wahl des Gestagens, sollte immer entsprechend dem Risikoprofil und den Behandlungszielen der Patientin individualisiert werden.
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