Tinjauan Risiko dan Manfaat Hormone Replacement Therapy

Isnatin Miladiyah

Abstract


Until now, pharmacological options for the management of perimenopausal and postmenopausal syndromes have been dominated by HRT (hormone re¬placement therapy), with either estrogen alone or estrogen plus progestine. In the recent year, several prospective trials of HRT in postmenopausal women had been carried out. The first two studies about the risks and benefits of HRT were carried out by the Women ’s Health Initiative (WHI) and the Heart and Estrogen/progestin Replacement Therapy (HERS). The main focus of these studies were how menopausal woman can best achieves good quality of life. Those studies find that combination therapy with estrogen and progestine is associated with higher risk of stroke, venous thromboembolism, and a slightly risk of myocardial infarction, and breast cancer in women using HRT long term. This review discuss more detail about the risks and benefits of HRT sup¬ported by evidences. In addition, this review propose several recommenda¬tions about the use of HRT regarding those risks and benefits, though pre¬scribing of any HRT can really achieve qood quality of life of menopausal woman.

Sampai saat ini pilihan terapi farmakologik untuk mengatasi sindroma perimenopause dan pasca menopause masih didominasi oleh penggunaan HRT {hormone replacement therapy atau terapi sulih hormon), baik dengan estrogen saja atau kombinasi estrogen dengan progestin. Dalam beberapa tahun terakhir, telah banyak penelitian prospektif tentang penggunaan HRT pada wanita pasca menopause. Dua penelitian pertama yang membahas tentang risiko dan manfaat HRT ini adalah dari the Women ’s Health Initiative (WHI) dan the Heart and Estrogen/'progestin Replacement Therapy (HERS). Fokus utama penelitian- penelitian ini terutama adalah agar wanita menopause dapat mencapai kualitas hidup yang baik. Hasil dari kedua penelitian tersebut adalah bahwa HRT dikaitkan dengan tingginya risiko mengalami stroke, tromboemboli vena, infark miokard, dan kanker payudara pada penggunaan HRT jangka panjang. Tulisan ini membahas tentang risiko dan manfaat HRT disertai dengan bukti-bukti penelitian yang mendukungnya. Selain itu, tulisan ini juga mengungkap beberapa rekomendasi penggunaan HRT berdasarkan pertimbangan risiko dan manfaat tersebut, sehingga keputusan pemberian HRT benar-benar akan memberikan peningkatan kualitas hidup wanita menopause.


Keywords


menopause; hormone replacement therapy; risiko dan manfaat; menopause; hormone replacement therapy; risks and benefits

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References


Elder, J dan Thacker, H., 2002. Menopause. May 29th 2002. www.clevelandclinicmeded.com. Dicetak tanggal 3 Januari 2003.

Fitzpatrick, L. A., Santen, R.J., 2002. Hot Flashes : The Old and the New, What is Really True? Mayo Clin Proc., 2002;77:1155-1158.

Shanafelt, T.D., Barton, D.L., Adjei, A. A., Loprinzi, C.L., 2002. Pathophysiology and Treat¬ments of Hot Flashes. Mayo Clin Proc., 2002;77:1207-1218

Notelovitz, M., 2002. Why Individualization Hormone Therapy is Crucial: Putting the Results of the WHI Trial Into Perspective. Medscape Women’s Health eJournal 7(4), 2002. www.mcdscape.com/vicwarticle/438356. Dicetak tanggal 6 Juni 2003.

MacLennan, A., Lester, S., Moore, V., 2003. Oral Estrogen Replacement Therapy versus Placebo for Hot Flushes (Cochrane Review) dalam The Cochrane Library, Issue 2 :2003

Cosman, F., Ginsburg, D.B., Morales, E., Silverman, J.E., 1999. Maintaining Postmenopause Health. Bimark Healthcare Communications, http://secure.pharmacvtimes.com. Dicetak tanggal 8 Juni 2003

Barclay, L., 2002. Long-term HRT Does not Protect the Heart. Medscape Medical News 2002. www.medscape.com/viewarticle/437517 print. Dicetak tanggal 11 Juni 2003.

Barclay, L, Sklar, B.M., 2003. Estrogen/progestin Associated With Increased Risk of Stroke and Dementia. Medscape Medical News, 2003.

Barclay, L., 2002. Combination HRT Does not Linked to Endometrial Cancer. BMJ, 2002; 325: 239-242.

Gcorgiev, D.B., Manassiev, N.A., 2002. Effect of Long-term Continuous Combined Hormone Replacement Therapy with Estradiol Valerate and Either Dienogest or Norethisterone Acetate in Mammographic Density in Postmenopausal Women. Medscape Women 's Health eJournal 7 (4), 2002. Dicetak tanggal 6 Juni 2003.

Denncrslein, L., 2002. Quality of Life and Menopause. Dalam 13th Annual Meeting of the North America Menopause Society, October 3-5,2002, Chicago, Illinois, www.mcdscapc.com/vicwarticlc/ 443407 print. Dicetak tanggal 7 Juni 2003.

The National Association of Nurse Practitioners in Women’s Health, 2002. Hormone Replace¬ment Therapy : Guidance From the National Association of Nurse Practitioners in Women’s I leallh. Advanced Practice Nursing eJournal 2 (3), 2002.

Goldman, L., Tostcson, A.N.A., 1991. Uncertainty About Postmenopausal Estrogens: Time for Action Not Debate. New England Journal of Medicine 325 (11): 800-802.

Richardson, K., 2003. The timing of Hormone Replacement Therapy Could be the Key to Success. Center for Clinical Age Management, Inc.

Kaunitz, A.M., 2002. Use of Combination Hormone Replacement Therapy in Light of Recent Data From the Women’s Health Initiative. Medscape Women’s Health eJournal 7 (4), 2002. Dicetak tanggal 6 Juni 2003.


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