Professor Wu Jie: What is the relationship between MHT and female malignancies? These questions must be understood!

With the aging of the population, women's post-menopaus period is prolonged, post-menopaus estrogen deficiency will lead to many female-related problems, domestic and foreign guidelines and consensus that post-menopaus hormone therapy (MHT) is the best solution to such problems.
, however, the incidence of malignant tumors in women tends to be younger, and the low female-related problems caused by medically-sourced menoanthia caused by tumor therapy have seriously affected the quality of life of patients.
To this end, China Obstetrics and Gynaecology Online invited Professor Wu Jie of Nanjing Medical University First Affiliated Hospital/Jiangsu Provincial People's Hospital on the relationship between MHT and female malignant tumors, the current application of MHT at home and abroad, the risk and benefit evaluation of MHT, the application points of MHT in female malignant tumor survivors, different MHT drugs and different start-up times.
1, China Obstetrics and Gynecology Online: Hello Professor Wu, thank you very much for your interview with China Obstetrics and Gynecology Online! Post-menopaus estrogen deficiency can lead to many women's health problems, and guidelines and consensus at home and abroad suggest that post-menopaus hormone therapy (MHT) is the most effective solution to this problem.
the incidence of gynaecological malignancies tends to be younger, then what is the effect of MHT on the occurrence and prognosmation of gynaecological malignancies? At present, domestic experts and scholars in this field is also very concerned, please focus on the application of MHT at home and abroad.
Wu Jie: The relationship between the application of menoptrual hormone therapy (MHT) and female malignancies mainly includes: (1) breast cancer, which has been a controversial issue in the industry for nearly two decades.
causes of breast cancer are very complex and closely related to factors such as ethnicity, age, late menoanthia, etc., but so far the application of estrogen and breast cancer is not consistent.
is now widely believed that the application of MHT within five years does not increase the risk of breast cancer.
In addition, the occurrence of breast cancer has a lot to do with the choice of hormone therapy drugs, studies have shown that for those without a uterus, estrogen supplementation alone does not increase the risk of breast cancer;
(2) endometrial cancer, the application of MHT when regulating medication, emphasizing the use of progesterone when giving estrogen requires adequate adequate treatment, will not increase the risk of endometrial cancer, can be used with confidence.
(3) ovarian cancer, the cause of ovarian cancer is complex, more pathological types, so far, MHT application and ovarian cancer risk relationship is uncertain, to be studied.
(4) cervical cancer, MHT is not associated with the occurrence of cervical cancer.
refore, if MHT is applied reasonably and normatively, the effect on breast cancer and gynecological malignancies is small, which can bring greater benefits to peri-menoanth women, gynaecological endocrinologists should recommend it.
2, China Obstetrics and Gynecology Online: MHT is a double-edged sword, although it can treat a series of postmenovascular estrogen deficiency caused by female health problems, but some experts believe that MHT will bring breast cancer, blood clots, stroke risk, then in the actual clinical work should be how to evaluate the risk and benefits of MHT? Professor Wu Jie: In recent years, clinicians have accumulated some experience in the application of MHT, published clinical studies and basic research articles have confirmed that the use of MHT benefits more than disadvantages, for most female friends, the development of a reasonable MHT treatment plan is easier to accept and benefit from.
But MHT is a medical measure and should be individualized by the doctor according to the patient's condition to alleviate menopaus symptoms and genitourinary tract atrophy symptoms, and reduce the risk of osteoporosis and osteoporosis fractures.
But at the same time be aware of the potential risks of MHT: First, to activate MHT during the window period means that it is not the patient who wants to use it, it should be under 60 years of age, the menoanthe starts within 10 years before the patient can really benefit.
, the application process needs to be regularly evaluated, the main points of evaluation include breast examination, pelvic ultrasound, cervical cancer screening, liver and kidney function, blood lipids and so on.
as long as the specification is applied and launched during the window period, and the benefits of MHT are far greater than the risks.
3, China Obstetrics and Gynecology Online: Do you think the evaluation and monitoring of female malignant tumor patients when applying MHT treatment is consistent with the treatment of the associated symptoms caused by post-menotinal estrogen deficiency? Is additional monitoring and evaluation required? Professor Wu Jie: For breast cancer patients, MHT treatment can not be applied, that is, breast cancer belongs to the absolute taboo of MHT application.
Endometrial cancer includes two types, type I endometrial cancer patients can be applied after surgery MHT, generally after surgery 3-12 months to start application;
patients with ovarian cancer, other types can be applied except for granulocytomas and endometrial-like cancers, which cannot be applied.
patients with cervical cancer have underwent surgery, radiotherapy and chemotherapy to develop associated menoanphageal symptoms, whether it is cervical squamous cancer or adenocarcinoma, can be applied to MHT.
It is worth noting that breast cancer and gynecological malignant tumor survivors in MHT, in addition to gynecological endocrinologists to regularly assess it, but also need to have the corresponding oncologists to carry out malignant tumor recurrence and related risk assessment, multidisciplinary collaboration, jointly assess the risk and benefit of patients continue to apply MHT.
4, China Obstetrics and Gynecology Online: The pros and cons of MHT and all types of drugs (especially progesterone types), dosages, programs and start-up times vary, please talk about the different MHT drugs and different start-up times on patients? Professor Wu Jie: MHT has many different drug and options.
, natural estrogens and progesterone are recommended and synthetic estrogens are avoided.
the U.S. WHI showed that choosing to synthesize progesterone increases the risk of breast cancer and blood clots.
, natural estrogen is recommended for MHT and must be used early in the menocean, under the age of 60, within 10 years of menocean.
MHT options depend on the specific circumstances of the patient, such as patients due to uterine fibroids and other diseases to remove the uterus, the use of a separate estrogen program can be used, if the patient has a uterus, the use of estrogen treatment of menophageal-related symptoms, must be added progesterone to protect the endometrium, to reduce the risk of endometrial cancer.
if a woman is simply atrophy of the reproductive tract and has sexual pain, an estrogen preparation through the vagina can be applied.
in short, when applying MHT, different treatment options need to be developed for different treatment purposes, and treatment options should be individual and respect the patient's wishes.
Jie, Director of Obstetrics and Gynaecology, Nanjing Medical University First Affiliated Hospital, Jiangsu Provincial People's Hospital, Professor, Doctoral Mentor.
is currently a member of the Women's Health Committee of the Jiangsu Provincial Importance of Preventive Medicine, a member of the Menoarean/Endocrinology Section of the Obstetrics and Gynecology Branch of the Chinese Medical Association, and a member of the Standing Committee of the Women's Health Branch of the Chinese Importance of Preventive Medicine.
Jiangsu Province, the first batch of "health leaders", "333 projects" leading talents, "135 projects" medical key talents, Nanjing high-level students;
presided over the National Natural Science Foundation of China, Jiangsu Province Natural Science Foundation and other topics 8, won the National Maternal and Child Health Medicine Award, Jiangsu Province Science and Technology Progress Second Prize and provincial medical new technology introduction award, Nanjing Science and Technology Progress Award and other awards, published more than 100 papers, SCI included more than 50 articles, participating in more than 10.
Wu Jie Source: Obstetrics and !-- Gynecology online content display ends -- !-- to determine whether the login ends.