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Frauenheilkunde up2date 2021; 15(04): 303-316
DOI: 10.1055/a-1079-3763
Gynäkologische Onkologie

Hormonersatztherapie bei gynäkologischen Malignomen

Sabine Elisabeth Segerer
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Klimakterische Beschwerden betreffen viele Frauen nach gynäkologischen Malignomen, sei es infolge der Behandlung oder aber im Rahmen der natürlichen Alterung. Am wirksamsten ist die Hormonersatztherapie (HRT). Jedoch sind viele gynäkologische Malignome hormonabhängig, sodass sich hier häufig die Frage stellt, ob eine HRT überhaupt eingesetzt werden darf oder ob diese möglicherweise sogar das Rezidivrisiko steigert.
Kernaussagen

  • Eine HRT sollte bei Frauen nach einem Mammakarzinom nicht durchgeführt werden. Bei Versagen nichthormoneller Therapiemaßnahmen und erheblicher Einschränkung der Lebensqualität kann ein Einsatz im Einzelfall jedoch erfolgen.

  • Eine systemische HRT bzw. vaginale Östrogentherapie kann nach Ausschöpfung nichthormoneller Therapieoptionen und Risikoaufklärung der Patientin insbesondere bei Low-grade, early-stage Endometriumkarzinomen (FIGO I – II) bei Versagen nichthormoneller Alternativen erwogen werden.

  • Bei erheblicher Einschränkung der Lebensqualität kann eine HRT bei Frauen mit nicht serösem Ovarialkarzinom oder malignem Keimzelltumor in der Vorgeschichte durchgeführt werden.

  • Eine systemische oder vaginale HRT bei Vulva-, Vaginal- und Plattenepithelkarzinom der Zervix ist nicht kontraindiziert.

Schlüsselwörter

HRT - Mammakarzinom - Ovarialkarzinom - Endometriumkarzinom - Zervix- und Vulvakarzinom


Publication History

Article published online:
24 August 2021

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