更年期医療の現状と展望 : 更年期・老年期障害に対する治療のあり方(特別講演,第58回学術講演会講演要旨)

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The aging process of women includes puberty, reproductive years, climacteric and elderly years, and women experience menarche, pregnancy, labor, puerperium, childcare and menopause during the process. The function of hypothalamic-pituitary-ovarian system shows specific alterations in each life stage, and the general physical and mental activities are greatly influenced by the condition of this system. Especially, in the aging process toward menopause, decreasing ovarian capacity of estrogen production has great impact on total life status, in addition on reproductive functions. Certain numbers of women in perimenopause complain menopausal symptoms, and one has to bear in mind that the latent phases of various disorders and dysfunctions are starting to advance slowly but steadily in this stage, even without any subjective sign. Thus, the risks induced by decreasing beneficial effects of estrogen on total body functions should be emphasized in the life stages of menopause and after. It is obvious the principle of health care for women in menopause and the elderly is prevention of life style relating diseases, which are the cumulative consequences of undesirable life styles in the previous life stages. The health problems should be aware and assessed by women themselves, with the assistance of health care providers. The practical actions for dietary improvement, relaxation, and exercise are organized case by case basis, and the result of actions needs to be follow-up periodically. Epidemiological studies indicate a significant change in population structure due to the low birth rate and longevity in Japan. The stressful situations resulted from the complicated circumstances in such aged society are the additional negative factor to manifest health problems, which reduce the quality of life of menopausal and elderly women. Dialog and counseling have great value for releasing stress and improving health conditions. Hormone replacement therapy: HRT has been a promising candidate of prevention and treatment for disorders and diseases resulted from estrogen deficiency. However, currently reported large scale clinical trials raised questions concerning the safety of HRT. This issue is still controversial and under evaluation and discussion. Japanese Nurses' Health Study in progress is expected to provide further evidence for establishing the tailor made HRT for Japanese women. In conclusion, the health care in menopause and after should be a part of holistic health care program for metal and physical functions covering total life stages. The importance of non medical approaches and managements, as well as that of medical should be recognized.
社団法人日本産科婦人科学会の論文
2006-08-01

更年期医療の現状と展望 : 更年期・老年期障害に対する治療のあり方(特別講演,第58回学術講演会講演要旨)

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