高剂量雌激素治疗

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高剂量雌激素治疗（英語：High-dose estrogen therapy）是一种荷爾蒙療法，其中给予高剂量的雌激素。[1] 当与高剂量的孕激素联合使用时，它被称为假孕。[2][3][4][5] “假孕”的称呼来源于其达到的雌激素和孕激素水平与妊娠期间这些激素的高水平相当。[6] 它们被用于医学中一些激素依赖性的适应症的治疗，如乳癌、前列腺癌和子宮內膜異位症等。[1][7][2]

医学用途

• 女性的雌激素受体（英语：Estrogen receptor）阳性乳癌[1]
• 作为雄激素剥夺治疗（英语：Androgen deprivation therapy）男性前列腺癌和良性前列腺增生症的一种手段[7][8][9]
• 与孕激素联合治疗女性的子宮內膜異位症。虽然最初是单独使用，但在20世纪60年代和70年代加入了孕激素。[10]
• 女性的骨质减少症（英语：Osteopenia）和骨質疏鬆症[3]
• 预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]
• 作为跨性別女性荷爾蒙療法的一个组成部分，以实现雌性化和抑制雄激素[13][14]
• 乳房发育不良，或作为女性荷尔蒙丰胸的一种手段[15][16]
• 女性的子宫发育不良[17][3][4]
• 女性的经前综合症和经期忧郁症[18]
• 女性的产后抑郁症和产后精神病（英语：Postpartum psychosis）[19][20]

可用药物

以下类固醇雌激素已用于高剂量雌激素治疗：[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（英语：Estradiol benzoate）、十一酸雌二醇、戊酸雌二醇、聚磷酸雌二醇）
• 雌莫司汀磷酸钠（英语：雌莫司汀磷酸钠）（一种也是抑制细胞的抗肿瘤剂的雌二醇酯；仅用于前列腺癌）
• 炔雌醇、其醚美雌醇及其酯Ethinylestradiol sulfonate

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

用于假孕方案的孕激素包括己酸孕酮（英语：Hydroxyprogesterone caproate）、醋酸甲羟孕酮（英语：Medroxyprogesterone acetate）和醋酸环丙孕酮等。[2] 孕酮由于其不良的药代动力学（例如，低口服生物利用度和短半衰期）而很少用于这些目的。[23]

参见

• 激素替代療法

参考资料

1. 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. Victor Gomel; Andrew Brill. Reconstructive and Reproductive Surgery in Gynecology. CRC Press. 27 September 2010: 90–. ISBN 978-1-84184-757-3. 
3. 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. 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. 
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. 
6. Kenneth L. Becker. Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. 2001: 1059–1060. ISBN 978-0-7817-1750-2. 
7. 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. 
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. 
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. 
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. 
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 . 
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. 
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. 
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 . 
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. 
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. 
17. Kaiser R. [Therapeutic pseudopregnancy]. Geburtshilfe und Frauenheilkunde. July 1959, 19: 593–604. PMID 13853204 （德语）. 
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. 
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. 
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. 
21. 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. 
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. 
23. Roy G. Farquharson; Mary D. Stephenson. Early Pregnancy. Cambridge University Press. 2 February 2017: 259–. ISBN 978-1-107-08201-4.