Substitutionstherapie im Klimakterium: Soll bei hysterektomierten Frauen auf Progestogene verzichtet werden?

The replacement therapy in postmenopausal women is seen to be for transformation of the oestrogen-stimulated endometrium only, which does not apply to hysterectomised women. Because of the influence of estrane on lipids, one often advises against a replacement therapy with progestogens in hysterectomised women. With increasing knowledge of encountered extragenital functions of sexual steroids, the latter is questionable, if natural progesterone is given, which is (said to be) lipid-neutral, performing the function of the progestogens, which is quite more than reproduction only, more efficiently than estrane or gonane. Due to the competitive blocking of aldosterone the effect of progesterone is sodium-diuretic and diuretic, being as important as the therapy of climacteric complaints, as well as the consequence, which is the result of the physiological connection between progesterone and encephalics. Moreover, the effect of the progestogens is to tonicise the vascular system and is linked to a number of intestinal hormones in order to adjust their function. Therefore, progesterone seems to perform a great variety of extragenital functions. Menopausal women should not be deprived of the benefits of these functions within the framework of a replacement therapy.