Menopause, defined by the cessation of menstrual cycles after 12 months of amenorrhea not due to other causes, is associated with significant hormonal changes, primarily a decrease in estrogen, androgen, and progesterone levels. This review delves into the effects of estrogen deficiency during the perimenopausal transition and postmenopause, integrating the findings of basic science with clinical trials. Here, we first outline the variation in endogenous estrogens before and after menopause, exploring both genomic and nongenomic actions of estrogen and its estrogen receptors throughout the body. Next, we detail the spectrum of menopausal symptoms, from acute vasomotor, urogenital, and psychological issues during perimenopause to chronic reproductive, cardiovascular, neurological, skeletal, dermatologic, immune, and digestive changes postmenopause. Finally, we evaluate the role of hormone therapy in alleviating these symptoms, weighing its benefits against known risks. Publicizing these findings and an accurate representation of the risks and benefits of estrogen replacement to our aging patients is fundamental to improving their care, quality, and even quantity of life.

中文翻译：

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更年期雌激素缺乏和激素治疗的作用：将基础科学研究结果与临床试验相结合。


更年期是指非因其他原因闭经 12 个月后月经周期停止，与显着的荷尔蒙变化有关，主要是雌激素、雄激素和黄体酮水平的下降。这篇综述深入研究了围绝经期过渡期和绝经后雌激素缺乏的影响，将基础科学的发现与临床试验相结合。在这里，我们首先概述绝经前后内源性雌激素的变化，探索雌激素及其雌激素受体在全身的基因组和非基因组作用。接下来，我们详细介绍更年期症状的范围，从围绝经期期间的急性血管舒缩、泌尿生殖和心理问题到绝经后的慢性生殖、心血管、神经、骨骼、皮肤、免疫和消化变化。最后，我们评估激素疗法在缓解这些症状方面的作用，权衡其益处与已知风险。向老年患者公布这些研究结果以及准确说明雌激素替代疗法的风险和益处对于改善他们的护理、质量甚至生活质量至关重要。