А.Ю. Захарко, А.С. Подгорная, О.В. Мурашко
ГУ «Республиканский научно-практический центр радиационной медицины и экологии человека», г. Гомель, Республика Беларусь
Возрастные аспекты женского здоровья в фокусе внимания кардиологов, гинекологов, эндокринологов уже на протяжении многих лет. Достаточно хорошо изучены физиологические особенности течения пери- и постменопаузального периодов, возможные последствия дефицита эстрогенов. В течение почти 20 лет ведутся споры о соотношении пользы и риска менопаузальной гормональной терапии. Доказательства ее протективного влияния в отношении заболеваний, ассоциированных с возрастом, не оставляют сомнений: профилактическое воздействие в отношении развития остеопороза, сердечно-сосудистых заболеваний, когнитивных расстройств и улучшения качества жизни в целом.
В статье приведены современные данные о связи менопаузальной гормональной терапии с венозными тромбоэмболическими осложнениями в зависимости от вида эстрогенного и прогестагенного компонентов, дозы, режима и способов применения. Рассмотрена целесообразность и безопасность менопаузальной гормональной терапии в условиях пандемии коронавирусной инфекции COVID-19. Опасения возможного потенцирования риска тромбоэмболических осложнений в случае заражения COVID-19 на фоне приема менопаузальной гормональной терапии не были доказаны в клинической практике. Представлены данные новейших публикаций, свидетельствующие о вероятном положительном влиянии женских половых гормонов на течение SARS-CoV-2, и рекомендации ведущих международных сообществ по менопаузе относительно допустимости менопаузальной гормональной терапии в условиях пандемии и ограниченной возможности консультирования пациенток.
ключевые слова: менопаузальная гормональная терапия, венозные тромбоэмболические осложнения, эстрогены, прогестагены, COVID-19.
для цитирования: А.Ю. Захарко, А.С. Подгорная, О.В. Мурашко. Менопаузальная гормональная терапия и риски венозных тромбоэмболических осложнений: современный аспект проблемы. Неотложная кардиология и кардиоваскулярные риски, 2022, Т. 6, № 2, С. 1700–1706.
Menopausal hormone therapy and the risk of venous thromboembolic complications: a modern aspect of the problem
А. Zaharko, A. Podgornaya, O. Murashko
Age-related aspects of women’s health have been in the focus of attention of cardiologists, gynecologists, and endocrinologists for many years. The physiological features of the course of the peri- and postmenopausal periods and the possible consequences of estrogen deficiency are already well-studied. For nearly 20 years, there has been a debate about the benefit-risk ratio of menopausal hormone therapy. The evidence for its protective effect on age-related cases is overwhelming: prevention of osteoporosis development, cardiovascular diseases, cognitive decline, and improvement of the overall quality of life.
The article presents current data on the association of menopausal hormone therapy with venous thromboembolic complications, depending on the type of estrogen and progestogen components, dose, regimen and methods of application. The feasibility and safety of menopausal hormone therapy in the context of the COVID-19 coronavirus pandemic is considered. The probability of increased risk of thromboembolic complications in case of COVID-19 infection during menopausal hormone therapy has not been proven in clinical practice. The data from the latest publications are presented, indicating the likely positive effect of female sex hormones on the course of SARS-CoV-2 and the recommendations of the leading international communities on menopause measurement regarding the admissibility of menopausal hormone therapy during the pandemic and limited ability to counsel patients.
keywords: menopausal hormone therapy, venous thromboembolic complications, estrogens, progestogens, COVID-19.
for references: А. Zaharko, A. Podgornaya, O. Murashko. Menopausal hormone therapy and the risk of venous thromboembolic complications: a modern aspect of the problem. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2022, vol. 6, no. 2, pp. 1700–1706.
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