高劑量雌激素治療

高劑量雌激素治療（英語：High-dose estrogen therapy）是一種荷爾蒙療法，其中給予高劑量的雌激素。^[1] 當與高劑量的孕激素聯合使用時，它被稱為假孕。^[2]^[3]^[4]^[5] 「假孕」的稱呼來源於其達到的雌激素和孕激素水平與妊娠期間這些激素的高水平相當。^[6] 它們被用於醫學中一些激素依賴性的適應症的治療，如乳癌、前列腺癌和子宮內膜異位症等。^[1]^[7]^[2]

醫學用途

女性的雌激素受體（英語：Estrogen receptor）陽性乳癌^[1]
作為雄激素剝奪治療（英語：Androgen deprivation therapy）男性前列腺癌和良性前列腺增生症的一種手段^[7]^[8]^[9]
與孕激素聯合治療女性的子宮內膜異位症。雖然最初是單獨使用，但在20世紀60年代和70年代加入了孕激素。^[10]
女性的骨質減少症（英語：Osteopenia）和骨質疏鬆症^[3]
預防身材高大的青春期女孩的高大身材^[11]
抑制肢端肥大症和巨人症患者的IGF-1水平^[12]
作為跨性別女性荷爾蒙療法的一個組成部分，以實現雌性化和抑制雄激素^[13]^[14]
乳房發育不良，或作為女性荷爾蒙豐胸的一種手段^[15]^[16]
女性的子宮發育不良^[17]^[3]^[4]
女性的經前綜合症和經期憂鬱症^[18]
女性的產後抑鬱症和產後精神病（英語：Postpartum psychosis）^[19]^[20]

可用藥物

以下類固醇雌激素已用於高劑量雌激素治療：^[1]^[21]^[22]

結合型雌激素
雌二醇及其雌二醇酯（例如，苯甲酸雌二醇（英語：Estradiol benzoate）、十一酸雌二醇、戊酸雌二醇、聚磷酸雌二醇）
雌莫司汀磷酸鈉（英語：雌莫司汀磷酸钠）（一種也是抑制細胞的抗腫瘤劑的雌二醇酯；僅用於前列腺癌）
炔雌醇、其醚美雌醇及其酯Ethinylestradiol sulfonate

以及以下非類固醇雌激素（現在很少或根本不使用）：^[21]己烯雌酚、乙烯雌酚二磷酸酯（英語：Fosfestrol）、Bifluranol及其他乙烯雌酚

用於假孕方案的孕激素包括己酸孕酮（英語：Hydroxyprogesterone caproate）、醋酸甲羥孕酮（英語：Medroxyprogesterone acetate）和醋酸環丙孕酮等。^[2] 孕酮由於其不良的藥代動力學（例如，低口服生物利用度和短半衰期）而很少用於這些目的。^[23]

參見

激素替代療法

參考資料

^ ^1.0 ^1.1 ^1.2 ^1.3 Coelingh Bennink HJ, Verhoeven C, Dutman AE, Thijssen J. The use of high-dose estrogens for the treatment of breast cancer. Maturitas. January 2017, 95: 11–23. PMID 27889048. doi:10.1016/j.maturitas.2016.10.010  .
^ ^2.0 ^2.1 ^2.2 Victor Gomel; Andrew Brill. Reconstructive and Reproductive Surgery in Gynecology. CRC Press. 27 September 2010: 90–. ISBN 978-1-84184-757-3.
^ ^3.0 ^3.1 ^3.2 Ulrich U, Pfeifer T, Lauritzen C. Rapid increase in lumbar spine bone density in osteopenic women by high-dose intramuscular estrogen-progestogen injections. A preliminary report. Hormone and Metabolic Research. September 1994, 26 (9): 428–31. PMID 7835827. doi:10.1055/s-2007-1001723.
^ ^4.0 ^4.1 Ulrich U, Pfeifer T, Buck G, Keckstein J, Lauritzen C. High-dose estrogen-progestogen injections in gonadal dysgenesis, ovarian hypoplasia, and androgen insensitivity syndrome: Impact on bone density. Adolescent and Pediatric Gynecology. 1995, 8 (1): 20–23. ISSN 0932-8610. doi:10.1016/S0932-8610(12)80156-3.
^ Kistner RW. The Treatment of Endometriosis by Inducing Pseudopregnancy with Ovarian Hormones. Fertility and Sterility. 1959, 10 (6): 539–556. ISSN 0015-0282. doi:10.1016/S0015-0282(16)33602-0.
^ Kenneth L. Becker. Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. 2001: 1059–1060. ISBN 978-0-7817-1750-2.
^ ^7.0 ^7.1 Oh WK. The evolving role of estrogen therapy in prostate cancer. Clinical Prostate Cancer. September 2002, 1 (2): 81–9. PMID 15046698. doi:10.3816/cgc.2002.n.009.
^ Lycette JL, Bland LB, Garzotto M, Beer TM. Parenteral estrogens for prostate cancer: can a new route of administration overcome old toxicities?. Clinical Genitourinary Cancer. December 2006, 5 (3): 198–205. PMID 17239273. doi:10.3816/CGC.2006.n.037.
^ Turo R, Smolski M, Esler R, Kujawa ML, Bromage SJ, Oakley N, et al. Diethylstilboestrol for the treatment of prostate cancer: past, present and future. Scandinavian Journal of Urology. February 2014, 48 (1): 4–14. PMID 24256023. S2CID 34563641. doi:10.3109/21681805.2013.861508.
^ Berkowitz RS, Barbieri RL, Kistner RW, Ryan KJ. Kistner's Gynecology: Principles and Practice. Mosby. 1995: 263. ISBN 978-0-8151-7479-0. Hormonal therapy. During the past 40 years, the medical management of endometriosis has become significantly more sophisticated. In the early 1950s the high-dose estrogen regimen of Karnaky was the only available hormonal treatment for endometriosis. In the 1960s and 1970s, Kistner's "pseudopregnancy" and "progestin-only" regimens dominated the medical management of endometriosis.69 During the 1980s, danazol became the primary hormonal agent used in the treatment of endometriosis. In the 1990s the GnRH agonists have become the most frequently used drugs for the treatment of endometriosis. These advances have significantly expanded the hormonal armamentarium of the gynecologist when treating endometriosis.
^ Albuquerque EV, Scalco RC, Jorge AA. Management of Endocrine Disease: Diagnostic and therapeutic approach of tall stature. European Journal of Endocrinology. June 2017, 176 (6): R339–R353. PMID 28274950. doi:10.1530/EJE-16-1054  .
^ Duarte FH, Jallad RS, Bronstein MD. Estrogens and selective estrogen receptor modulators in acromegaly. Endocrine. November 2016, 54 (2): 306–314. PMID 27704479. S2CID 10136018. doi:10.1007/s12020-016-1118-z.
^ Smith KP, Madison CM, Milne NM. Gonadal suppressive and cross-sex hormone therapy for gender dysphoria in adolescents and adults. Pharmacotherapy. December 2014, 34 (12): 1282–97. PMID 25220381. S2CID 26979177. doi:10.1002/phar.1487.
^ Mueller A, Dittrich R, Binder H, Kuehnel W, Maltaris T, Hoffmann I, Beckmann MW. High dose estrogen treatment increases bone mineral density in male-to-female transsexuals receiving gonadotropin-releasing hormone agonist in the absence of testosterone. European Journal of Endocrinology. July 2005, 153 (1): 107–13. PMID 15994752. doi:10.1530/eje.1.01943  .
^ Gunther Göretzlehner; Christian Lauritzen; Thomas Römer; Winfried Rossmanith. Praktische Hormontherapie in der Gynäkologie. Walter de Gruyter. 1 January 2012: 385–. ISBN 978-3-11-024568-4.
^ Hartmann BW, Laml T, Kirchengast S, Albrecht AE, Huber JC. Hormonal breast augmentation: prognostic relevance of insulin-like growth factor-I. Gynecological Endocrinology. April 1998, 12 (2): 123–7. PMID 9610425. doi:10.3109/09513599809024960.
^ Kaiser R. [Therapeutic pseudopregnancy]. Geburtshilfe und Frauenheilkunde. July 1959, 19: 593–604. PMID 13853204 （德語）.
^ Cronje WH, Studd JW. Premenstrual syndrome and premenstrual dysphoric disorder. Primary Care. March 2002, 29 (1): 1–12, v. PMID 11856655. doi:10.1016/s0095-4543(03)00070-8.
^ Gentile S. The role of estrogen therapy in postpartum psychiatric disorders: an update. CNS Spectrums. December 2005, 10 (12): 944–52. PMID 16344831. S2CID 24450591. doi:10.1017/s1092852900010518.
^ Sharma V. Pharmacotherapy of postpartum psychosis. Expert Opinion on Pharmacotherapy. October 2003, 4 (10): 1651–8. PMID 14521476. S2CID 23193276. doi:10.1517/14656566.4.10.1651.
^ ^21.0 ^21.1 Christoffel Jos van Boxtel; Budiono Santoso; I. Ralph Edwards. Drug Benefits and Risks: International Textbook of Clinical Pharmacology. IOS Press. 2008: 458–. ISBN 978-1-58603-880-9.
^ Michael Oettel; Ekkehard Schillinger. Estrogens and Antiestrogens II: Pharmacology and Clinical Application of Estrogens and Antiestrogen. Springer Science & Business Media. 6 December 2012: 540–. ISBN 978-3-642-60107-1.
^ Roy G. Farquharson; Mary D. Stephenson. Early Pregnancy. Cambridge University Press. 2 February 2017: 259–. ISBN 978-1-107-08201-4.

[pmid27889048-1] 1.0 ^1.1 ^1.2 ^1.3 Coelingh Bennink HJ, Verhoeven C, Dutman AE, Thijssen J. The use of high-dose estrogens for the treatment of breast cancer. Maturitas. January 2017, 95: 11–23. PMID 27889048. doi:10.1016/j.maturitas.2016.10.010  .

[GomelBrill2010-2] 2.0 ^2.1 ^2.2 Victor Gomel; Andrew Brill. Reconstructive and Reproductive Surgery in Gynecology. CRC Press. 27 September 2010: 90–. ISBN 978-1-84184-757-3.

[pmid7835827-3] 3.0 ^3.1 ^3.2 Ulrich U, Pfeifer T, Lauritzen C. Rapid increase in lumbar spine bone density in osteopenic women by high-dose intramuscular estrogen-progestogen injections. A preliminary report. Hormone and Metabolic Research. September 1994, 26 (9): 428–31. PMID 7835827. doi:10.1055/s-2007-1001723.

[UlrichPfeifer1995-4] 4.0 ^4.1 Ulrich U, Pfeifer T, Buck G, Keckstein J, Lauritzen C. High-dose estrogen-progestogen injections in gonadal dysgenesis, ovarian hypoplasia, and androgen insensitivity syndrome: Impact on bone density. Adolescent and Pediatric Gynecology. 1995, 8 (1): 20–23. ISSN 0932-8610. doi:10.1016/S0932-8610(12)80156-3.

[Kistner1959-5] Kistner RW. The Treatment of Endometriosis by Inducing Pseudopregnancy with Ovarian Hormones. Fertility and Sterility. 1959, 10 (6): 539–556. ISSN 0015-0282. doi:10.1016/S0015-0282(16)33602-0.

[Becker2001-6] Kenneth L. Becker. Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. 2001: 1059–1060. ISBN 978-0-7817-1750-2.

[pmid15046698-7] 7.0 ^7.1 Oh WK. The evolving role of estrogen therapy in prostate cancer. Clinical Prostate Cancer. September 2002, 1 (2): 81–9. PMID 15046698. doi:10.3816/cgc.2002.n.009.

[pmid17239273-8] Lycette JL, Bland LB, Garzotto M, Beer TM. Parenteral estrogens for prostate cancer: can a new route of administration overcome old toxicities?. Clinical Genitourinary Cancer. December 2006, 5 (3): 198–205. PMID 17239273. doi:10.3816/CGC.2006.n.037.

[pmid24256023-9] Turo R, Smolski M, Esler R, Kujawa ML, Bromage SJ, Oakley N, et al. Diethylstilboestrol for the treatment of prostate cancer: past, present and future. Scandinavian Journal of Urology. February 2014, 48 (1): 4–14. PMID 24256023. S2CID 34563641. doi:10.3109/21681805.2013.861508.

[Kistner1995-10] Berkowitz RS, Barbieri RL, Kistner RW, Ryan KJ. Kistner's Gynecology: Principles and Practice. Mosby. 1995: 263. ISBN 978-0-8151-7479-0. Hormonal therapy. During the past 40 years, the medical management of endometriosis has become significantly more sophisticated. In the early 1950s the high-dose estrogen regimen of Karnaky was the only available hormonal treatment for endometriosis. In the 1960s and 1970s, Kistner's "pseudopregnancy" and "progestin-only" regimens dominated the medical management of endometriosis.69 During the 1980s, danazol became the primary hormonal agent used in the treatment of endometriosis. In the 1990s the GnRH agonists have become the most frequently used drugs for the treatment of endometriosis. These advances have significantly expanded the hormonal armamentarium of the gynecologist when treating endometriosis.

[pmid28274950-11] Albuquerque EV, Scalco RC, Jorge AA. Management of Endocrine Disease: Diagnostic and therapeutic approach of tall stature. European Journal of Endocrinology. June 2017, 176 (6): R339–R353. PMID 28274950. doi:10.1530/EJE-16-1054  .

[pmid27704479-12] Duarte FH, Jallad RS, Bronstein MD. Estrogens and selective estrogen receptor modulators in acromegaly. Endocrine. November 2016, 54 (2): 306–314. PMID 27704479. S2CID 10136018. doi:10.1007/s12020-016-1118-z.

[pmid25220381-13] Smith KP, Madison CM, Milne NM. Gonadal suppressive and cross-sex hormone therapy for gender dysphoria in adolescents and adults. Pharmacotherapy. December 2014, 34 (12): 1282–97. PMID 25220381. S2CID 26979177. doi:10.1002/phar.1487.

[pmid15994752-14] Mueller A, Dittrich R, Binder H, Kuehnel W, Maltaris T, Hoffmann I, Beckmann MW. High dose estrogen treatment increases bone mineral density in male-to-female transsexuals receiving gonadotropin-releasing hormone agonist in the absence of testosterone. European Journal of Endocrinology. July 2005, 153 (1): 107–13. PMID 15994752. doi:10.1530/eje.1.01943  .

[GöretzlehnerLauritzen2012-15] Gunther Göretzlehner; Christian Lauritzen; Thomas Römer; Winfried Rossmanith. Praktische Hormontherapie in der Gynäkologie. Walter de Gruyter. 1 January 2012: 385–. ISBN 978-3-11-024568-4.

[pmid9610425-16] Hartmann BW, Laml T, Kirchengast S, Albrecht AE, Huber JC. Hormonal breast augmentation: prognostic relevance of insulin-like growth factor-I. Gynecological Endocrinology. April 1998, 12 (2): 123–7. PMID 9610425. doi:10.3109/09513599809024960.

[pmid13853204-17] Kaiser R. [Therapeutic pseudopregnancy]. Geburtshilfe und Frauenheilkunde. July 1959, 19: 593–604. PMID 13853204 （德語）.

[pmid11856655-18] Cronje WH, Studd JW. Premenstrual syndrome and premenstrual dysphoric disorder. Primary Care. March 2002, 29 (1): 1–12, v. PMID 11856655. doi:10.1016/s0095-4543(03)00070-8.

[pmid16344831-19] Gentile S. The role of estrogen therapy in postpartum psychiatric disorders: an update. CNS Spectrums. December 2005, 10 (12): 944–52. PMID 16344831. S2CID 24450591. doi:10.1017/s1092852900010518.

[pmid14521476-20] Sharma V. Pharmacotherapy of postpartum psychosis. Expert Opinion on Pharmacotherapy. October 2003, 4 (10): 1651–8. PMID 14521476. S2CID 23193276. doi:10.1517/14656566.4.10.1651.

[BoxtelSantoso2008-21] 21.0 ^21.1 Christoffel Jos van Boxtel; Budiono Santoso; I. Ralph Edwards. Drug Benefits and Risks: International Textbook of Clinical Pharmacology. IOS Press. 2008: 458–. ISBN 978-1-58603-880-9.

[OettelSchillinger2012-22] Michael Oettel; Ekkehard Schillinger. Estrogens and Antiestrogens II: Pharmacology and Clinical Application of Estrogens and Antiestrogen. Springer Science & Business Media. 6 December 2012: 540–. ISBN 978-3-642-60107-1.

[FarquharsonStephenson2017-23] Roy G. Farquharson; Mary D. Stephenson. Early Pregnancy. Cambridge University Press. 2 February 2017: 259–. ISBN 978-1-107-08201-4.

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