臨床婦人科産科72巻2号

2018年03月発行

今月の臨床 ホルモン補充療法ベストプラクティス─いつから始める？　いつまで続ける？　何に注意する？

効果と注意点（発がんリスクを除いて）

閉経期ホルモン療法と静脈血栓塞栓症

著者： 寺内公一¹

所属機関： ¹東京医科歯科大学大学院医歯学総合研究科女性健康医学講座

ページ範囲：P.253 - P.259

文献概要

●VTEリスク，すなわち①高齢，②肥満，③喫煙，④手術・骨折などによる長期臥床，⑤VTEの家族歴，を有する症例には慎重に閉経期ホルモン療法（MHT）を行う必要がある．

●MHTに伴うVTEリスクは，①経口投与でEの高用量化とともに上昇し，②経皮投与ではEの用量にかかわらず上昇せず，③用いるPの種類によって異なる．

●MHTに伴うVTEリスクを可能な限り低下させるためには，経皮投与を行うことが望ましく，さらにPとしてはDYDを選択するとよいかもしれない．

参考文献

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19）日本産科婦人科学会・日本女性医学学会 : ホルモン補充療法ガイドライン．2017