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Die Gynäkologie
Erschienen in: Der Gynäkologe 8/2017

04.07.2017 | Hormonsubstitution | Leitthema

Menopausale Hormontherapie und Krebsrisiko

verfasst von: Prof. Dr. O. Ortmann, Dr. med. S. Schüler-Toprak

Erschienen in: Die Gynäkologie | Ausgabe 8/2017

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Zusammenfassung

Hintergrund

Viele Karzinomerkrankungen des weiblichen Genitaltraktes und der Mamma sind hormonabhängig. Die Rolle reproduktiver Faktoren bei der Genese dieser Tumoren wurde in zahlreichen Studien untersucht. Die Hormontherapie (HT) mit Sexualsteroiden in der Peri- und Postmenopause wird häufig zur Linderung von Symptomen wie Hitzewallungen und Schweißausbrüchen eingesetzt. Die Sicherheit dieser Maßnahme ist im Hinblick auf die Beratung von Frauen, die diese Therapien erwägen, von besonderem klinischen Interesse.

Ziel der Arbeit

In dieser Übersicht wird der Kenntnisstand zur HT und ihrer Wirkung auf das Krebsrisiko dargestellt; besondere Berücksichtigung finden dabei das Mammakarzinom und gynäkologische Malignome.

Ergebnisse und Diskussion

Der aktuellen Datenlage zufolge kann eine HT das Mammakarzinomrisiko erhöhen. Dies wurde insbesondere für eine Kombination aus Östrogenen mit Progestagenen (EPT) gezeigt, wobei dieser Effekt zeitabhängig ist und erst bei einer Anwendungsdauer von mehr als 5 Jahren auftritt. Weiterhin konnte gezeigt werden, dass der Beginn einer HT in Relation zum Menopausenalter das Risiko beeinflusst. Eine alleinige Östrogentherapie (ET) erhöht das Endometriumkarzinomrisiko. Dieser Effekt kann durch einen Gestageneinsatz reduziert werden. Auch das Risiko für ein Ovarialkarzinom wird durch eine HT-Anwendung erhöht. Nach einer hormonabhängigen Krebserkrankung ist eine HT grundsätzlich kontraindiziert und nur bei ausgeprägter Beeinträchtigung der Lebensqualität durch klimakterische Symptome vertretbar.
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S3-Leitlinie Maligne Ovarialtumore; Diagnostik, Therapie und Nachsorge, AWMF-Registernummer 032–035OL
Metadaten
Titel
Menopausale Hormontherapie und Krebsrisiko
verfasst von
Prof. Dr. O. Ortmann
Dr. med. S. Schüler-Toprak
Publikationsdatum
04.07.2017
Verlag
Springer Medizin
Erschienen in
Die Gynäkologie / Ausgabe 8/2017
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-017-4093-4

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