Second spring
Hormone-replacement therapy is safer than people think. More women should take it
激素替换疗法比人们想象的更安全。更多的女性都应该去尝试。
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It is known colloquially as “the change”. The end of a woman’s natural childbearing years is a moment of transformation that is welcome to some and miserable for others. But for too many, menopause is also a painful process that can damage their bones, heart and brain. As societies age, the question of how best to preserve women’s health during menopause is becoming more urgent. In 1990 nearly half a billion women were 50 or older (the age when menopause typically begins). Today there are almost twice as many.
- colloquially : (of language) used in ordinary or familiar conversation: not formal or literary: colloquial and everyday language
- childbearing: the process of giving birth to children
- welcome: 这里是形容词作表语，that引导主语从句。A be welcome to B. A 受B的欢迎，B喜欢A
- miserable for: 对...来说是悲伤的，不幸的
- menopause: the ceasing（结束） of menstruation(经期) ==绝经，更年期
人们常说“改变”。 女性自然生育年限的结束是一个有人欢喜有人忧的转变的时刻。但是对大多数人来说，更年期也是一个会伤害他们的骨头、心脏和大脑的痛苦过程。随着社会发展，如何更好的保护更年期女性健康变得越来越紧迫。在1990年，有5亿女性在50岁以上（通常情况下更年期开始的年龄）。如今有几乎两倍之多。
About 47m women around the world reach the age of menopause each year. In Western countries, where most research has been conducted, up to 80% will experience symptoms such as hot flushes, night sweats, depression, insomnia, anxiety and memory loss. Symptoms can last up to 12 years. Around a quarter of women going through menopause feel so wretched that their quality of life is dimmed, according to studies in rich countries. Almost half of British women experiencing it say that their work suffers as a result.
- flush: n a reddening of the face, skin, typically caused by illness or strong emotion
v (of a person's skin, face, etc) become red and hot, typical as the result of illness or strong emotion - wretch: an unfortunate or unhappy person
- dim: (of a light, color, or illuminated object) not shining brightly or clearly; not clearly recalled or formulated in the mind; stupid or slow to understand
世界上每年有近4700万女性进入更年期。大量研究表明，在西方国家高达80%女性会有潮热、夜间盗汗、抑郁、失眠、焦虑和记忆力减退等症状，这些症状将持续12年。根据富裕国家的研究来看，大约四分之一的女性在经历更年期会感到非常不幸，导致他们的生活质量下降。 几乎一半的经历更年期的英国女性说，他们的工作受到了影响。
Twenty years ago, doctors would routinely have prescribed hormone-replacement therapy(HRT) to women entering menopause. But in 2002 the results of a huge randomized trial were published, showing that the treatment brought health risks, including a slightly raised chance of breast cancer after five years. Women and doctors were alarmed. Around the world they abandoned hormonal therapy in droves. Before the study, 22% of menopausal women in America took HRT. Six years later that figure had fallen below 5%. In Australia, around 15% of menopausal women with moderate or severe symptoms receive the treatment. Take-up of HRT is now low in most countries. Women are scared and doctors wary.
- randomize: make unpredictable, unsystematic, or random in order or arrangement; employ random selection or sampling in (an experiment or procedure)
- drove: a herd or flock of animals being driven in a body; in droves 成群结队的
- wary: feeling or showing caution about possible dangers or problems
20年前，医生会例行为进入更年期女性开具激素替代疗法。但是在2002年发表了一个大型随机实验结果，该实验表明，该疗法会带来健康风险，包括五年后患乳腺癌的概率略有升高。全世界开始集体弃用激素疗法。在这项实验之前，美国22%的更年期女性接受过这种治疗。 6年后，这个数字降到了5%以下。在澳大利亚，具有适度或严重症状的更年期女性中大约15%的人接受了这项治疗。 现在在大多数国家HTR的接受程度较低。女性很害怕，医生更加警惕。
And yet the conclusions of the study in 2002 were rapidly debunked (see International section). A re-examination of its results showed that women aged between 50 and 59 who took HRT were 31% less likely to die of any cause during their five to seven years of treatment with the hormones than those who did not. For a woman who has had her uterus removed or who starts menopause before the age of 45, HRT greatly reduces the risk of heart disease, a life-saving effect. It can also prevent osteoporosis, a disease in which bones become brittle. One study of post- menopausal American women over a ten-year period found that, of those who had had hysterectomies, between 18,000 and 91,000 died prematurely because they had shunned hormone therapy. HRT also lowers women’s risk of uterine and colon cancers. Fears about the increased risks of breast cancer have been overplayed.
- debunk: expose the falseness or hollowness of(a myth, idea, or belief)
- osteoporosis: a medical condition in which the bones become brittle and fragile from loss of tissue 骨质疏松症
- brittle: hard but liable to break or shatter easily 易碎的
- hysterectomy: a surgical operation to remove all or part of the uterus.
- permaturely: before the due time; ahead of time
- shun: persistently avoid, ignore, or reject through antipathy or caution
- colon: 结肠；冒号（:）
然而2002年的研究结论迅速被推翻， 对该结果的一项重新检验表明，接受激素替换疗法50岁到59岁之间的女性在接受激素治疗后5到7年之间，死于任何原因的可能性比未接受激素治疗的女性低31%。对切除了子宫或者在45岁之前绝经的女性来说，HTR极大程度上降低了患心脏病的风险，这有挽救生命的作用。它同样可以预防骨质疏松症，一种骨头变的易碎的疾病。 一项对绝经后女性长达十年的研究表明， 其中切除了子宫手术的人中，有18000至91000的女性因未接受激素治疗而过早死亡。HTR还降低了女性患子宫癌和结肠癌的风险。人们对乳腺癌风险增加的担忧被夸大了。
Hormonal therapies are typically off-patent and inexpensive. In Britain the annual price tag is only £125 ($165); in the United States generic pills are similarly affordable. And the benefits vastly outweigh the costs. Nothing else controls the symptoms of menopause so well, and a heightened risk of any one disease must be weighed against the lowered risks of contracting several others.
- patent: a government authority or license conferring a right or title for a set period, especially the sole right to exclude others from making, using, or selling an invention
- off-patent: no longer subject to patent restrictions.
- weigh against: compare the importance of on factor with that of (another)
激素治疗通常是非专利性的并且不昂贵的。在英国年度价格仅125英镑（165美元）；在美国仿制药价格也是差不多的。而且利润远远高于成本。没有任何其他药品可以更好的控制更年期症状，因此必须将任何一种疾病的患病风险增加与其他多种疾病的风险降低相权衡。
Hormonal therapies are not appropriate for all menopausal women. For some, the symptoms are insufficiently severe for it to be worthwhile. The treatment might not be suitable for those with liver disease, or a history of blood clots, or breast or ovarian cancer. But for serious symptoms, alternative treatments are worse than taking HRT. Herbal supplements, yoga and faddy diets—to which some turn in the absence of medical help—may alleviate the unpleasantness of menopause but do not offer the long-term health benefits of HRT. Moreover, the symptoms can portend serious health problems in the future. Doctors could usefully prescribe HRT far more widely than they do today.
- liver: a large lobed glandular organ in the abdomen of vertebrates, involved in many metabolic processes. 肝脏
- clot: a thick mass of coagulated liquid, especially blood, or of material stuck together. blood clot血栓
- ovarian: 卵巢的
- herbal: relating to or made from herbs, especially those used in cooking and medicine 草本植物的
- portend: be a sign or warning that( something, especially something momentous or calamitous) is likely to happen
激素治疗并不适用于所有的更年期女性。对部分人来说，他们的症状不足够严重到让其发挥作用。该治疗不适用于患有肝脏疾病，或者有血栓历史、乳腺或卵巢癌的人。但是对于严重的症状，可选的治疗方案比接受激素治疗更糟糕。在缺少药物帮助的情况下，某些人采用草本药物补充，瑜伽和挑剔的饮食的方式可以减轻更年期的不适，但不能为激素疗法提供长期的益处。而且，这些症状将来可能预示着严重的健康问题。医生可以有效的开出比今天更广泛的激素疗法。
盲点汇总
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