Je riziko tromboembolické nemoci opravdu absolutní kontraindikací hormonální substituční terapie?

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Autoři: Tomáš Fait ^1,2 ; S. Šimková ¹ ; V. Dvořáková ²
Působiště autorů: 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
Vyšlo v časopise: Ceska Gynekol 2026; 91(5): 408-416
Kategorie: Přehledová práce
doi: https://doi.org/10.48095/cccg2026408

Souhrn

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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Zdroje

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