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Karger AG","issue":"4","license":[{"start":{"date-parts":[[2006,1,1]],"date-time":"2006-01-01T00:00:00Z","timestamp":1136073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2006,1,1]],"date-time":"2006-01-01T00:00:00Z","timestamp":1136073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gyn\u00e4kol Geburtshilfliche Rundsch"],"published-print":{"date-parts":[[2006]]},"abstract":"<jats:p>F\u00fcr eine Hormonersatztherapie (HRT) gelten absolute und relative Kontraindikationen, die in den Fachinformationen prim\u00e4r unter Annahme von Gruppeneffekten nach dem \u00abWorst-case\u00bb-Prinzip gelistet sind, um forensischen Anforderungen zu gen\u00fcgen. Bei starkem Leidensdruck kann es aber sinnvoll erscheinen, eine HRT auch bei erh\u00f6htem Risiko durchzuf\u00fchren. Zur Risikominimierung ergibt sich neben einer allgemeinen Dosisreduktion eine differenzierte Wahl der Pr\u00e4parate vor allem bez\u00fcglich der Gestagenkomponente und Applikationsform. F\u00fcr internistische Risikopatientinnen ist dabei h\u00e4ufig die Bevorzugung von transdermalem \u00d6stradiol in Form von Pflastern oder Gelen und neutralen Gestagenen wie Progesteron und Dydrogesteron bzw. Kombipflaster zur komplett transdermalen HRT zu empfehlen. In der Women\u2019s Health Initiative, einer Studie mit einem kardiovaskul\u00e4r stark belasteten Kollektiv, ergaben sich als wichtigste Risiken ven\u00f6se Thrombosen und Hirninsulte, im hohen Alter auch Herzinfarkte. Im direkten Zusammenhang damit haben die Risikogruppen mit Diabetes, Hypertonie und Dyslipoprotein\u00e4mie sowie allgemein Raucherinnen besondere Bedeutung. Weitere h\u00e4ufige internistische Risikogruppen sind Frauen mit Schilddr\u00fcsenerkrankungen und Leber-\/Gallenwegserkrankungen; seltene, aber prognostisch wichtige Erkrankungen wie Porphyrien und Lupus erythematodes gelten als relative Kontraindikationen. Die Datenlage bei diesen Risikogruppen wird dargestellt und praktische Empfehlungen werden gegeben.<\/jats:p>","DOI":"10.1159\/000095726","type":"journal-article","created":{"date-parts":[[2006,10,27]],"date-time":"2006-10-27T10:10:49Z","timestamp":1161943849000},"page":"174-190","source":"Crossref","is-referenced-by-count":6,"title":["Hormonersatztherapie bei internistischen Risikopatientinnen"],"prefix":"10.1159","volume":"46","author":[{"given":"Alfred 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