臨床婦人科産科63巻6号

2009年06月発行

今月の臨床 HRTの新ガイドラインを読み解く

投与ルートと薬剤による副作用の違い

著者： 若槻明彦¹

所属機関： ¹愛知医科大学産婦人科

ページ範囲：P.797 - P.803

文献概要

はじめに

　2002年のWomen's Health Initiative（WHI）^1）の報道で閉経後ホルモン療法（HT）の副作用ばかりが注目され，これまで多くの閉経後女性が使用してきたHTは再考すべきと考えられ，その使用が制限されるようになった．確かにHTには更年期障害の改善作用や骨折予防効果など種々の副次的好効果もあるが，心血管疾患（CVD），乳癌，静脈血栓症，胆嚢疾患などのリスクを上昇させる副作用が存在する．しかし，WHIを含めたこれまでの大規模臨床試験ではエストロゲン製剤は経口の結合型エストロゲン製剤がほとんどであった．一方，近年，エストロゲンの貼付製剤やジェル製剤などの経皮製剤が使用可能となり，同じエストロゲン製剤でも，経口と経皮でその作用は異なり，エストロゲンの持つ有害事象にも大きな違いがあることがわかってきた．

　本稿では経口と経皮エストロゲンの投与ルートの違いがエストロゲンの有益・有害事象にどのような影響を与えるかについて概説する．

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