微创激光治疗
微创激光治疗 (Minimally invasive laser treatment, MonaLisa Touch) 旨在通过刺激胶原蛋白产生来治疗阴道萎缩。目前没有对其有效性加以评估的安慰剂对照试验。[74]Arunkalaivanan A, Kaur H, Onuma O. Laser therapy as a treatment modality for genitourinary syndrome of menopause: a critical appraisal of evidence. Int Urogynecol J. 2017 May;28(5):681-85.http://www.ncbi.nlm.nih.gov/pubmed/28154914?tool=bestpractice.com[75]Pitsouni E, Grigoriadis T, Falagas ME, et al. Laser therapy for the genitourinary syndrome of menopause. A systematic review and meta-analysis. Maturitas. 2017 Sep;103:78-88.http://www.ncbi.nlm.nih.gov/pubmed/28778337?tool=bestpractice.com 尽管此疗法广受推广，但这种情况并未改变。
脱氢表雄酮 (dehydroepiandrosterone, DHEA)/普拉睾酮
脱氢表雄酮 (DHEA) 是一种睾酮和雌激素的雄激素前体，基于为期 12 周的安慰剂对照试验，已获准用于治疗绝经后因外阴阴道萎缩而导致的性交疼痛。[76]Labrie F, Archer DF, Koltun W, et al. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2016 Mar;23(3):243-56.http://www.ncbi.nlm.nih.gov/pubmed/26731686?tool=bestpractice.com 一篇针对 18 项临床试验的综述总结，与安慰剂相比，DHEA 可轻微改善性功能。[77]Scheffers CS, Armstrong S, Cantineau AE, et al. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev. 2015;(1):CD011066.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011066.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/25879093?tool=bestpractice.com 然而，它与雄激素副作用相关（主要是痤疮），并且其作用仍然不明确。[77]Scheffers CS, Armstrong S, Cantineau AE, et al. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev. 2015;(1):CD011066.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011066.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/25879093?tool=bestpractice.com
星状神经节阻滞
星状神经节阻滞通常用于治疗疼痛综合征和血管功能不全，在无法接受基于雌激素治疗的女性中，采用该方法治疗潮热可能有效。[78]Kontos M, Agbaje OF, Rymer J, et al. What can be done about hot flushes after treatment for breast cancer? Climacteric. 2010 Feb;13(1):4-21.http://www.tandfonline.com/doi/full/10.3109/13697130903291058http://www.ncbi.nlm.nih.gov/pubmed/20067430?tool=bestpractice.com 还需要进一步的研究。[79]Walega DR, Rubin LH, Banuvar S, et al. Effects of stellate ganglion block on vasomotor symptoms: findings from a randomized controlled clinical trial in postmenopausal women. Menopause. 2014 Aug;21(8):807-14.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110158/http://www.ncbi.nlm.nih.gov/pubmed/24496086?tool=bestpractice.com
替勃龙
替勃龙是一种从山药中提取的类固醇，对多种组织具有雌激素、黄体酮和睾酮样混合作用。一项 Cochrane 评价结论指出，在减少血管舒缩症状方面，替勃龙比安慰剂更有效，但不如激素治疗。[80]Formoso G, Perrone E, Maltoni S, et al. Short-term and long-term effects of tibolone in postmenopausal women. Cochrane Database Syst Rev. 2016 Oct 12;(10):CD008536.https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008536.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/27733017?tool=bestpractice.com 不建议对具有乳腺癌病史的女性使用，[29]Stuenkel CA, Davis SR, Gompel A, et al. Treatment of symptoms of the menopause: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015 Nov;100(11):3975-4011.https://academic.oup.com/jcem/article/100/11/3975/2836060http://www.ncbi.nlm.nih.gov/pubmed/26444994?tool=bestpractice.com 它还可能会增加老年女性卒中风险。[81]Cummings SR, Ettinger B, Delmas PD, et al. The effects of tibolone in older postmenopausal women. N Engl J Med. 2008 Aug 14;359(7):697-708.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684062/http://www.ncbi.nlm.nih.gov/pubmed/18703472?tool=bestpractice.com 替勃龙已在欧洲上市，但还未在美国上市。
