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24.02.2020 | Originalien

Der Einfluss der Gestagene auf die Knochengesundheit

verfasst von: Dr. med. Maki Kashiwagi, Vanadin Seifert-Klauss

Erschienen in: Gynäkologie in der Praxis | Ausgabe 1/2020

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Zusammenfassung

Progesteron und synthetische Gestagene verfügen neben der Fähigkeit zur Endometriumtransformation über eine Reihe weiterer nichtgenomischer und genomischer Wirkmechanismen, die in ihrer Vielzahl noch Gegenstand aktueller Forschung sind. Während Medroxyprogesteronacetat in hoher Dosis (Depotgestagene) mit einer Verminderung des Knochenaufbaus assoziiert ist, wirken in niedriger Dosis (tägliche Gabe) Gestagene unterschiedlich stark auch zusätzlich zum antiresorptiven Östrogen positiv – vor allem anabol – auf den Knochen. Bereits in der Perimenopause und damit vor dem Östrogendefizit der Meno‑/Postmenopause kommt es zu einem markanten Knochendichteverlust. Vom gesamten menopausalen trabekulären Verlust verlieren manche Frauen 50 % in der Perimenopause. Mehrere Untersuchungen weisen hierbei auf eine Assoziation mit gestörten Lutealphasen und damit verbundenem relativem Progesteronmangel hin. Bei klimakterischen Beschwerden könnte somit der sequenzielle Einsatz von Progesteron oder gezielt ausgewählten synthetischen Gestagenen zusammen mit Östrogenen einen zusätzlichen Beitrag zur Osteoporoseprävention leisten.
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Metadaten
Titel
Der Einfluss der Gestagene auf die Knochengesundheit
verfasst von
Dr. med. Maki Kashiwagi
Vanadin Seifert-Klauss
Publikationsdatum
24.02.2020
Verlag
Springer Vienna
Erschienen in
Gynäkologie in der Praxis / Ausgabe 1/2020
Print ISSN: 3005-0758
Elektronische ISSN: 3005-0766
DOI
https://doi.org/10.1007/s41974-020-00125-z

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