Maganin maye gurbin Hormone ya ƙunshi, kamar yadda sunansa ya nuna, a cikin shawo kan rashin wadataccen ɓoye na hormonal. Ana iya ba da irin wannan nau'in magani a lokacin menopause da menopause, don ramawa ga dakatarwa a cikin samar da hormones na ovarian. Saboda haka da wani sunan, menopause hormone far (THM).

A matsayin tunatarwa, menopause yakan faru ne a kusa da shekaru 50. Bayan raguwar samfurin follicular, samar da hormones na ovarian (estrogen da progesterone) yana tsayawa, yana haifar da ƙarshen haila. Ana ganin mace ta tafi haila bayan akalla wata 12 da ta daina haila.

Dakatar da samar da hormonal na iya haifar da alamu iri-iri, waɗanda aka sani da "cututtukan yanayi": walƙiya mai zafi, gumi na dare, bushewar farji da matsalolin fitsari. Tsanani da tsawon lokacin waɗannan cututtuka sun bambanta tsakanin mata.

HRT tana da niyyar iyakance waɗannan alamun ta hanyar rama raunin isrogen a asalin waɗannan rikice -rikicen yanayi. A cikin matan da ba a ɓoye ba (har yanzu suna da mahaifa), ana haɗa isrogen akai-akai tare da progestogen na baka don hana fara ciwon daji na endometrial da ke da alaƙa da isrogen.

Wannan maganin yana da tasiri kuma yana rage yawan zafi da zafi, yana inganta bushewar farji da matsalolin jima'i. Hakanan yana da tasirin kariya akan duk karaya (kasusuwan hannu, wuyan hannu, kwatangwalo) a cikin mata bayan haihuwa, ya kammala rahoton HAS na 2004 akan HRT (1).

An rubuta HRT sosai har zuwa farkon 2000s. Duk da haka, tsakanin 2000 zuwa 2002 da dama binciken Amirka, ciki har da Women's Health Initiative wanda aka fi sani da sunan WHI (2), ya ba da rahoton ƙarin haɗarin cutar kansar nono da ciwon nono. cututtukan zuciya da jijiyoyin jini a cikin mata masu ɗaukar HRT.

Wannan aikin ya jagoranci hukumomin kiwon lafiya su sake nazarin haɗarin HRT da daidaita shawarwarin su daidai gwargwado a cikin wannan rahoton na 2004. Aikin yana tunawa da ƙarin haɗarin da aka samu a yayin shan HRT:

• ƙarin haɗarin ciwon nono: haɗuwar maganin estrogen-progestogen yana haifar da haɗarin haɗarin ciwon nono wanda ke da alaƙa da tsawon lokacin takardar, musamman bayan shekaru 5 na amfani (3). Tsakanin 2000 da 2002, 3% zuwa 6% na ciwon daji na nono a cikin mata tsakanin shekarun 40 zuwa 65 an yi la'akari da cewa ana iya danganta su ga maganin hormone don menopause (4);
• haɓakar haɗari na jijiyar jijiyoyi ciki har da ciwon huhu;
• ƙara haɗarin bugun jini. Tsakanin 2000 da 2002, 6,5% zuwa 13,5% na cututtukan bugun jini zai zama sanadiyyar mata masu shekaru 40 da 65 (5);
• Haɗarin haɗarin ciwon daji na endometrial a cikin yanayin maganin estrogen, wanda shine dalilin da yasa koyaushe ake haɗa progestogen a cikin mata ba tare da tsotsewar mahaifa ba.

A gefe guda, estrogen-progestogen HRT yana da rawar kariya daga cutar kansa.

Kada a rubuta HRT akai-akai a kusa da menopause. HAS ya ba da shawarar cewa ku daidaiku ku tantance fa'idar / fa'idar haɗarin kafin ku rubuta HRT. Dole ne a yi nazarin bayanin kowace mace dangane da haɗari (haɗarin zuciya da jijiyoyin jini, haɗarin karaya, tarihin kansar nono) da fa'idodi (a kan rikicewar yanayi da rigakafin osteoporosis) don zaɓar magani, hanyar gudanarwar ta (na baka ko hanyar transdermal) da tsawon sa.

A cikin 2014, HAS ta sabunta shawarwarin ta (6) kuma ta tuno da alamun da ke zuwa ga HRT:

• lokacin da ake ganin rashin lafiya na climacteric a matsayin abin kunya wanda ya isa ya lalata ingancin rayuwa;
• don rigakafin cutar osteoporosis a cikin mata a haɗarin haɗarin raunin kashi da waɗanda ba su da haƙuri ko akasin wasu jiyya da aka nuna don rigakafin osteoporosis.

Har ila yau, yana ba da shawarar rubuta maganin a mafi ƙarancin kashi kuma na ɗan lokaci kaɗan, da sake tantance maganin aƙalla sau ɗaya a shekara. A matsakaita, lokacin takardar sayan magani na yanzu shine shekaru 2 ko 3 dangane da haɓakar alamun cutar.

Saboda hatsarori daban-daban da aka ambata, ana hana HRT a cikin waɗannan lokuta:

• tarihin sirri na ciwon nono;
• tarihin infarction na zuciya, bugun zuciya, bugun jini ko cututtukan jijiyoyin jini;
• babban haɗarin cututtukan zuciya (hauhawar jini, hypercholesterolemia, shan taba, kiba) (7).