大江 发表于 2022-8-28 00:02:44

经期乳腺增生正常的生理现象,无需特殊药物治疗

体检下来大部分女生都有“乳腺增生”问题,这个时候很多女性往往会跑去医院问医生会不会癌变成乳腺癌?是不是要吃点药才能消灭增生?其实,大部分乳腺增生的患者根本不用治疗。

乳腺增生是人类乳房的正常或自发增大。乳腺增生通常发生在女性青春期和怀孕期间,以及月经周期的某些时期。当它发生在男性身上时,它被称为男性乳房发育症,被认为是病理性的。当它发生在女性身上并且极度过度时,它被称为巨乳症(也称为巨乳症或乳房肥大),同样被认为是病理性的。乳腺增生可能是由于乳房充血,这是由于母乳的产生和储存与哺乳和/或溢乳(过多或不适当的乳汁产生)相关而导致的乳房暂时增大。乳痛(乳房压痛/疼痛)经常与乳房发育症同时发生。

在月经周期的黄体期(后半期),由于高循环雌激素和/或黄体酮浓度导致乳房血流量增加和/或经前体液潴留,乳房会暂时变大,女性会出现这种情况如饱胀、沉重、肿胀和刺痛感。



乳腺增生可能是多种药物的作用或副作用,包括雌激素、抗雄激素如螺内酯、醋酸环丙孕酮、比卡鲁胺和非那雄胺、生长激素和提高催乳素水平的药物如抗精神病药(如利培酮)等 D2 受体拮抗剂,甲氧氯普胺、多潘立酮和某些抗抑郁药,如选择性血清素再摄取抑制剂 (SSRI) 和三环类抗抑郁药 (TCA)。使用文拉法辛等血清素-去甲肾上腺素再摄取抑制剂 (SNRI) 的风险似乎较小。 “非典型”抗抑郁药米氮平和安非他酮不会增加催乳素水平(安非他酮实际上可能会降低催乳素水平),因此使用这些药物可能没有风险。其他与乳腺增生有关的药物包括 D-青霉胺、布西拉明、新西他酮、环孢素、茚地那韦、大麻和西咪替丁。

1997 年的一项研究发现,在 59 名女性参与者中,有 23 名(39%)的 SSRIs 与乳腺增生症之间存在关联。研究还发现 SSRIs 和溢乳之间存在关联。这些副作用似乎是由这些药物诱导的高催乳素血症(催乳素水平升高)引起的,这种作用似乎是由血清素介导的抑制催乳素分泌的结节漏斗多巴胺能神经元的抑制引起的。已发现这些药物可能导致的乳腺增生与伴随的体重增加高度相关(在 1997 年的研究中,83% 体重增加的人也经历过乳腺增生,而只有 30% 没有体重增加的人经历过乳腺增生)。据报道,与 SSRIs 相关的乳腺增生在停药后是可逆的。 SSRIs 显著与适度增加的乳腺癌风险相关。这与较高的催乳素水平与乳腺癌风险增加有关。

在性腺机能减退女孩的青春期诱导和跨性别女性的女性化激素治疗中,以及乳房发育不全或小乳房女性的激素丰胸中,乳房发育症是一种理想的效果。

最典型的莫过于经期引起的乳腺增生,女性月经前乳房会特别不舒服,感觉胀胀的,还有点痛,但生理期过了胀痛就渐渐消失。正常的生理现象,无特别的治理方法,极少数会发展为乳腺癌,注意定期复查即可。只要每天保持良好心态,少吃含激素较高的食品,坚持适量运动、瑜伽、冥想等缓解乳腺增生。

参考资料:
Nathanson, Ira T. (1946). "Present Concepts of Benign Breast Disease". New England Journal of Medicine. 235 (15): 548–553. doi:10.1056/NEJM194610102351505. ISSN 0028-4793. PMID 20998969.
Ismail Jatoi; Manfred Kaufmann (11 February 2010). Management of Breast Diseases. Springer Science & Business Media. pp. 21–. ISBN 978-3-540-69743-5.
Nagrath Arun; Malhotra Narendra; Seth Shikha (15 December 2012). Progress in Obstetrics and Gynecology--3. Jaypee Brothers Medical Publishers Pvt. Ltd. pp. 393–394. ISBN 978-93-5090-575-3.
Ora Hirsch Pescovitz; Erica A. Eugster (2004). Pediatric Endocrinology: Mechanisms, Manifestations, and Management. Lippincott Williams & Wilkins. pp. 349–. ISBN 978-0-7817-4059-3.
Arnold G. Coran; Anthony Caldamone; N. Scott Adzick; Thomas M. Krummel; Jean-Martin Laberge; Robert Shamberger (25 January 2012). Pediatric Surgery. Elsevier Health Sciences. pp. 773–. ISBN 978-0-323-09161-9.
David J. Dabbs (2012). Breast Pathology. Elsevier Health Sciences. pp. 19–. ISBN 978-1-4377-0604-8.
J.P. Lavery; J.S. Sanfilippo (6 December 2012). Pediatric and Adolescent Obstetrics and Gynecology. Springer Science & Business Media. pp. 99–. ISBN 978-1-4612-5064-7.
G. P. TALWAR; L .M. SRIVASTAVA (1 January 2002). TEXTBOOK OF BIOCHEMISTRY AND HUMAN BIOLOGY. PHI Learning Pvt. Ltd. pp. 959–. ISBN 978-81-203-1965-3.
Christoph Zink (1 January 1988). Dictionary of Obstetrics and Gynecology. Walter de Gruyter. pp. 152–. ISBN 978-3-11-085727-6.
Michael Heinrich Seegenschmiedt; Hans-Bruno Makoski; Klaus-Rüdiger Trott; Luther W. Brady, eds. (15 April 2009). Radiotherapy for Non-Malignant Disorders. Springer Science & Business Media. pp. 719–. ISBN 978-3-540-68943-0.
Ruth A. Lawrence; Robert M. Lawrence (26 October 2015). Breastfeeding: A Guide for the Medical Profession. Elsevier Health Sciences. p. 60. ISBN 978-0-323-35776-0. The cyclic changes of the adult mammary gland can be associated with the menstrual cycle and the hormonal changes that control that cycle. Estrogens stimulate parenchymal proliferation, with formulation of epithelial sprouts. This hyperplasia continues into the secretory phase of the cycle. Anatomically, when the corpus luteum provides increased amounts of estrogen and progesterone, there is lobular edema, thickening of the epithelial basal membrane, and secretory material in the alveolar lumen. Lymphoid and plasma cells infiltrate the stroma. Clinically, mammary blood flow increases in this luteal phase. This increased flow is experienced by women as fullness, heaviness, and turgescence. The breast may become nodular because of interlobular edema and ductular-acinar growth.
Milligan D, Drife JO, Short RV (1975). "Changes in breast volume during normal menstrual cycle and after oral contraceptives". Br Med J. 4 (5995): 494–6. doi:10.1136/bmj.4.5995.494. PMC 1675650. PMID 1192144. any women report breast changes during the normal menstrual cycle, with a feeling of fullness and a tingling sensation immediately before menstruation.1 Women taking oral contraceptives also seem to experience similar breast symptoms.2 It has been claimed that there are also pronounced changes in breast volume during the normal menstrual cycle, with maximum values occurring in the week before menstruation.3
Robert Alan Lewis (23 March 1998). Lewis' Dictionary of Toxicology. CRC Press. pp. 470–. ISBN 978-1-56670-223-2.
Jeffrey K. Aronson (2 March 2009). Meyler's Side Effects of Cardiovascular Drugs. Elsevier. pp. 255–. ISBN 978-0-08-093289-7.
Elizabeth Martin (28 May 2015). Concise Medical Dictionary. Oxford University Press. pp. 189–. ISBN 978-0-19-968781-7.
Patrick C. Walsh; Janet Farrar Worthington (31 August 2010). Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, Second Edition. Grand Central Publishing. pp. 258–. ISBN 978-1-4555-0016-1.
Harvey B. Simon (3 February 2004). The Harvard Medical School Guide to Men's Health: Lessons from the Harvard Men's Health Studies. Simon and Schuster. pp. 403–. ISBN 978-0-684-87182-0.
Jeffrey K. Aronson (21 February 2009). Meyler's Side Effects of Endocrine and Metabolic Drugs. Elsevier. pp. 155–. ISBN 978-0-08-093292-7.
Jacqueline Burchum; Laura Rosenthal (2 December 2014). Lehne's Pharmacology for Nursing Care. Elsevier Health Sciences. pp. 802–. ISBN 978-0-323-34026-7.
Sat Dharam Kaur (2003). The Complete Natural Medicine Guide to Breast Cancer: A Practical Manual for Understanding, Prevention & Care. R. Rose. p. 79. ISBN 978-0-7788-0083-5.
Souza, Flavio Moutinho; Collett-Solberg, Paulo Ferrez (2011). "Adverse effects of growth hormone replacement therapy in children". Arquivos Brasileiros de Endocrinologia & Metabologia. 55 (8): 559–565. doi:10.1590/S0004-27302011000800009. ISSN 0004-2730. PMID 22218437.
Torre DL, Falorni A (2007). "Pharmacological causes of hyperprolactinemia". Ther Clin Risk Manag. 3 (5): 929–51. PMC 2376090. PMID 18473017.
Madhusoodanan, Subramoniam; Parida, Suprit; Jimenez, Carolina (2010). "Hyperprolactinemia associated with psychotropics-a review". Human Psychopharmacology: Clinical and Experimental. 25 (4): 281–297. doi:10.1002/hup.1116. ISSN 0885-6222. PMID 20521318. S2CID 6851723.
Jeffrey A. Lieberman; Allan Tasman (16 May 2006). Handbook of Psychiatric Drugs. John Wiley & Sons. pp. 75–. ISBN 978-0-470-02821-6.
Kaufman, K. R.; Podolsky, D.; Greenman, D.; Madraswala, R. (2013). "Antidepressant-Selective Gynecomastia". Annals of Pharmacotherapy. 47 (1): e6. doi:10.1345/aph.1R491. ISSN 1060-0280. PMID 23324513. S2CID 32428598.
Amsterdam JD, Garcia-España F, Goodman D, Hooper M, Hornig-Rohan M (1997). "Breast enlargement during chronic antidepressant therapy". J Affect Disord. 46 (2): 151–6. doi:10.1016/s0165-0327(97)00086-4. PMID 9479619.
Dancey, Anne; Khan, M.; Dawson, J.; Peart, F. (2008). "Gigantomastia – a classification and review of the literature". Journal of Plastic, Reconstructive & Aesthetic Surgery. 61 (5): 493–502. doi:10.1016/j.bjps.2007.10.041. ISSN 1748-6815. PMID 18054304.
Coker F, Taylor D (2010). "Antidepressant-induced hyperprolactinaemia: incidence, mechanisms and management". CNS Drugs. 24 (7): 563–74. doi:10.2165/11533140-000000000-00000. PMID 20527996. S2CID 20016957.
Mondal, S.; Saha, I.; Das, S.; Ganguly, A.; Das, D.; Tripathi, S. K. (2013). "A new logical insight and putative mechanism behind fluoxetine-induced amenorrhea, hyperprolactinemia and galactorrhea in a case series". Therapeutic Advances in Psychopharmacology. 3 (6): 322–334. doi:10.1177/2045125313490305. ISSN 2045-1253. PMC 3840809. PMID 24294485.
Benjamin Sadock (26 November 2013). Kaplan & Sadock's Pocket Handbook of Psychiatric Drug Treatment. Lippincott Williams & Wilkins. pp. 312–. ISBN 978-1-4698-5538-7.
Boursi B, Lurie I, Mamtani R, Haynes K, Yang YX (2015). "Anti-depressant therapy and cancer risk: A nested case-control study". Eur Neuropsychopharmacol. 25 (8): 1147–57. doi:10.1016/j.euroneuro.2015.04.010. PMID 25934397. S2CID 19884975.
Hankinson, S. E.; Willett, W. C.; Michaud, D. S.; Manson, J. E.; Colditz, G. A.; Longcope, C.; Rosner, B.; Speizer, F. E. (1999). "Plasma Prolactin Levels and Subsequent Risk of Breast Cancer in Postmenopausal Women". JNCI Journal of the National Cancer Institute. 91 (7): 629–634. doi:10.1093/jnci/91.7.629. ISSN 0027-8874. PMID 10203283.
Tworoger, S. S. (2004). "Plasma Prolactin Concentrations and Risk of Postmenopausal Breast Cancer". Cancer Research. 64 (18): 6814–6819. doi:10.1158/0008-5472.CAN-04-1870. ISSN 0008-5472. PMID 15375001.
de Muinck Keizer-Schrama SM (2007). "Introduction and management of puberty in girls". Horm. Res. 68 Suppl 5 (5): 80–3. doi:10.1159/000110584. PMID 18174716.
Gunther Göretzlehner; Christian Lauritzen; Thomas Römer; Winfried Rossmanith (1 January 2012). Praktische Hormontherapie in der Gynäkologie. Walter de Gruyter. pp. 385–. ISBN 978-3-11-024568-4.
R.E. Mansel; Oystein Fodstad; Wen G. Jiang (14 June 2007). Metastasis of Breast Cancer. Springer Science & Business Media. pp. 217–. ISBN 978-1-4020-5866-0.
Hartmann BW, Laml T, Kirchengast S, Albrecht AE, Huber JC (1998). "Hormonal breast augmentation: prognostic relevance of insulin-like growth factor-I". Gynecol. Endocrinol. 12 (2): 123–7. doi:10.3109/09513599809024960. PMID 9610425.
页: [1]
查看完整版本: 经期乳腺增生正常的生理现象,无需特殊药物治疗