经济学人下载:更年期激素替代疗法的利与弊(1)

Leaders
来源于《社论》版块

Menopause
更年期

Second spring
第二春

Hormone-replacement therapy is safer than people think. More women should take it
激素替代疗法比人们认为的更安全。更多的女性应该接受它

It is known colloquially as “the change”. The end of a woman’s natural child-bearing years is a moment of transformation that is welcome to some and miserable for others. But for too many, menopause is also a painful process that can damage their bones, heart and brain. As societies age, the question of how best to preserve women’s health during menopause is becoming more urgent. In 1990 nearly half a billion women were 50 or older (the age when menopause typically begins). Today there are almost twice as many.
它俗称为“变化”。女性自然生育年龄的结束是一个转变的时刻，对此，一些人乐于接受，而另一些人则怅然若失。但对很多人来说，更年期也是一个痛苦的过程，会损害骨骼、心脏和大脑。随着社会老龄化，如何最好地保护更年期女性的健康问题变得越来越紧迫。1990年，50岁以上（更年期通常开始的年龄）的女性人数将近5亿。如今，这个数字几乎是以前的两倍。

About 47m women around the world reach the age of menopause each year. In Western countries, where most research has been conducted, up to 80% will experience symptoms such as hot flushes, night sweats, depression, insomnia, anxiety and memory loss. Symptoms can last up to 12 years. Around a quarter of women going through menopause feel so wretched that their quality of life is dimmed, according to studies in rich countries. Almost half of British women experiencing it say that their work suffers as a result.
全球每年约有4700万女性达到更年期年龄。在大多数研究已经开始进行的西方国家，高达80%的人会出现潮热、盗汗、抑郁、失眠、焦虑和失忆等症状。症状可持续长达12年。根据发达国家的研究，大约有四分之一的女性在经历更年期时感到非常痛苦，以至于生活质量变差了。在英国，几乎一半的女性表示，工作因此受到影响。

Twenty years ago, doctors would routinely have prescribed hormone-replacement therapy ( HRT) to women entering menopause. But in 2002 the results of a huge randomised trial were published, showing that the treatment brought health risks, including a slightly raised chance of breast cancer after five years. Women and doctors were alarmed. Around the world they abandoned hormonal therapy in droves. Before the study, 22% of menopausal women in America took HRT. Six years later that figure had fallen below 5%. In Australia, around 15% of menopausal women with moderate or severe symptoms receive the treatment. Take-up of HRT is now low in most countries. Women are scared and doctors wary.
20年前，医生通常会给进入更年期的女性进行激素替代疗法(HRT)。但在2002年，一项大型随机试验的结果发表了，结果显示，激素替代疗法带来了健康风险，包括5年后患乳腺癌的几率略有增加。妇女和医生对此感到震惊。在世界各地，激素替代疗法陆陆续续被放弃。在这项研究之前，22%的美国更年期妇女接受了激素替代疗法。六年后，这一数字降至5%以下。在澳大利亚，有中度或重度症状的更年期妇女中约有15%接受这种治疗。目前，激素替代疗法在大多数国家的使用率很低。女性很害怕，医生也很警惕。