生活质量的价值-HRT， WHI的历史背景

Menopause Rating Scale (MRS) 
https://www.hormonebalance.org/files/MRS%20QOL%20questionnaire%20.pdf

我得7分。

需要问的问题：开始用激素替代治疗之后
–多久需要follow-up
–查血吗？
–spotting正常吗?
–是不是会推迟停经？
–多久就可以有症状的缓解？
–如果没有症状缓解，多久就可以认为无效？
–停药时候，症状会反弹吗？

WHI study的历史背景:
Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women
JAMA 2002
Prevention study
--50-79 years 绝经期妇女，w/ intact uterus, 1993-1998， 不需要有更年期症状
--conjugated equine estrogen 0.625m/day + medroxyprogesterone 2.5mg/d in 1 tablet
--Primary endpoint: 心脏病风险降低，乳腺癌不增加. A global index summarizing the balance of risks and benefits: stroke, PE, endometrial ca, colorectal ca, hip fracture and death due to other causes. 注意，这里没有症状缓解和生活治疗的考量。
–In 1990s, 40% of post-menopausal women were on HRT (hormone replacement therapy). It's the top prescribed medication. The prescription dropped by 80% after the above publication.