Je riziko tromboembolické nemoci opravdu absolutní kontraindikací hormonální substituční terapie?
Authors:
Tomáš Fait 1,2
; S. Šimková 1
; V. Dvořáková 2
Authors‘ workplace:
Department of Gynecology and Obstetrics, 2nd Faculty of Medicine, Charles University Prague and Motol and Homolka University Hospital, Prague
1; Department of Health Care Studies, College of Polytechnics, Jihlava
2
Published in:
Ceska Gynekol 2026; 91(5): 408-416
Category:
doi:
https://doi.org/10.48095/cccg2026408
Overview
Perorální hormonální substituční terapie (MHT – menopause hormone therapy) je spojena se zvýšením relativního rizika tromboembolické nemoci (VTE – venous thromboembolism) na 2–4násobek. Dle většiny studií transdermální podání toto riziko nezvyšuje. Transdermální hormonální substituční terapie je považována na bezpečnou dokonce i u žen ve vysokém riziku tromboembolické nemoci, jako jsou nadváha, obezita, trombofilní stavy, nedávné operační zákroky, imobilizace, varixy nebo kouření. Akutní VTE je absolutní kontraindikací obou forem systémové MHT – orální i transdermální. Osobní anamnéza VTE je absolutní kontraindikací pro perorální MHT, ale pouze relativní kontraindikací pro transdermální aplikaci MHT. Hormonální substituce musí být individuálně indikována pro každou pacientku.
Klíčová slova:
nadváha – trombofilní mutace – tromboembolická nemoc – hormonální substituční terapie – transdermální aplikace – chronický estrogenní deficit
...
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