7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

1/12

PUNCTE FIERBINI NTRATAMENTULSUBSTITUTIV HORMONAL

POSTMENOPAUZAL (TSH)

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

2/12

TSH I CANCERUL

OVAR

COL UTERIN

COLO-RECTAL

MELANOMUL MALIGN

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

3/12

TSH I CANCERUL DE SN (CS)

Frecvena mare a CS n !"ec#a$ %&"' an#

*en+r& 87%%#n ,eme# - ,ac+r r#!c.v/r!+a

Mr+a$#+a+ea "r#n CS !ca%e $a "ac#en+e$e a,$a+e !&0 TSH

H#"er"$a1#e a+#"#c' $a 0#"!#e S+&%#& $a "ac#en+e$e c& r#!c "r#n #!+r#c ,am#$#a$ "1#+#v

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

4/12

TSH I CANCERUL DE SN

TSH 2# ,rme$e $ca$#1a+e %e CS

TSH %&ce $a %e"#!+area CS n+r- ,rm' c$#n#c' 2# 3#!+"a+$4#c' ,avra0#$'

M%&$a+r## rece"+r#$r e!+r4en#c# (cn+e5+&$ ce$&$ar)

TERA*IA ESTROGENIC6 SCADE MORTALITATEA *RIN CS

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

5/12

TSH I CANCERUL DE SN

D1a "r+ec+are %e 789 m4 E cn:&4a# !a& ; m4 e!+ra%#$ m#crn#1a+ n&e!+e a!c#a+' c& #n%&cerea CS

TAMO

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

6/12

SNGER6RILE SU= TSH

C/n%(c/+ %e %e"ar+e %e#n!+a$area men"a&1e#)>

TSH !ecven#a$'"re!&"&ne !/n4erarec#c$#c'

789 m4 E cn:&4a#; m4 e!+ra%#$ m#crn#1a+

9 mc4 e!+ra%#$+ran!%erm#c

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

7/12

SNGER6RILE SU= TSH

9 m4 me%r5#"r4e!+ern ace+a+

7? m4 nre+3#n%rne

8 m4 "r4e!+ern m#crn#1a+

7;9 m4 %e!4e!+re$ 7?9 m4 $evnr4e!+re$

; m4 c#"r+ern ace+a+

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

8/12

SNGER6RILE SU= TSH

Tera"#acn+#n&'

Ec4ra,#a

=#"!#a%e

en%me+r&

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

9/12

SNGER6RILE I =IO*SIA

=IO*SIA na#n+e %e TSHTra+@ E n an+ece%en+e

Fac+r# %e r#!c (ce %&c $a3#"ere!+r4en#!m)S/n4er'r# %#!,&nc#na$e n

an+ece%en+e

=IO*SIA !&0 TSHAnxietate! (apacientei7

!a& amedicului)Dar e!+r4en# ac&m7 !a&n an+ece%en+eEc4ra,#c7 en%me+r&$

"e!+e 4 mm

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

10/12

ENDOMETRUL

Gr!#mea nrma$' . 4 mm>

Le4'+&ra c& +#"&$ %e TSH - care e!+e va$area !#4&r' !&0 +era"#a !ecven#a$'72# care e!+e va$area !&0 +era"#a cn+#n&'>

Tera"#a cn+#n&' . a+r,#e a en%me+r&$ Gr!#mea en%me+r&$ na#n+e %e TSH

H#!+er!c"#a

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

11/12

ENDOMETRUL

S$#

; H#!+erec+m#a

8 A0$a#a %e en%me+r&7 #nc$&!#v &$+ra!n#c

7/24/2019 Tratamentul Substitutiv Hormonal Postmenopauzal Conf Dr Anca

12/12

*ROGESTATIVUL

E,ec+e$e c$a+era$e

Sc3#m0area "r4e!+a+#v&$

Nre+3#n%rn&$

S+er#$e+&$ c& "r4e!+a+#v (ce$ c& LEVONORGESTREL e$#0erea1' 9 mc4B1#) An%r4en##