Biosynthesis and physiologic effects of estrogen and pathophysiologic effects of estrogen deficiency: a review

Article Abstract:

The extended life-span of women has increased the time spent in the postmenopausal period, which begins around the age of 50 years. Diagnosis of menopause is difficult to determine due to the unpredictable menstrual pattern that occurs during its onset. When estrogen production by the ovaries stops, a negative feedback system sends a message to the pituitary gland to increase the release of two other hormones, luteinizing hormone and follicle stimulating hormone. In fat tissue, estrone may be converted to estrogen. However, the level of estrogen produced by this pathway is nonprotective, except in obese women with an abundance of fat cells. When estrogen is reduced during menopause, menstrual periods become lighter and less frequent. The skin, urinary tract, ovaries, vagina, and cells lining the uterus have receptors which have a particular affinity for estrogen. Reduction in estrogen affects the character of these tissues. The vagina becomes dry, muscle tone of structures holding female organs becomes weakened, bladder symptoms develop and changes in the skin occur. The lack of estrogen causes increased risks for coronary heart disease and osteoporosis, a condition in which bones become fragile due to increased bone resorption. Self-limiting hot flashes, which occur during the onset of menopause, are caused by the rapid dilation of blood vessels. Depression, anxiety and decreased sexual drive are commonly experienced. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Estrogen replacement and cardiovascular disease: serum lipids and blood pressure effects

Article Abstract:

During menopause estrogen is no longer produced by the ovaries. Estrogen is known to protect women from coronary heart disease, a leading cause of death in older women. High blood pressure, poor sugar (glucose) tolerance, abnormal blood lipids (fats), cigarette smoking, and old age are other factors associated with an increased risk for coronary heart disease. Abnormal blood lipids contribute to the development of atherosclerotic plaques inside the coronary arteries which supply the heart muscle. There is a relationship between high density lipoproteins (HDL) and low density lipoproteins (LDL) cholesterol and coronary heart disease. High HDL and low LDL decrease the risk for coronary heart disease. Estrogen replacement therapy increases the level of HDL and lowers LDL, thereby reducing the risk of potential for coronary heart disease. Some studies indicate that estrogen replacement therapy rarely causes high blood pressure or aggravates existing high blood pressure. Estrogen consistently lowers blood pressure very slightly. The death rate from coronary heart disease is four times higher than that of endometrial and breast cancer, which have been related to the use of sole estrogen replacement therapy (that is, estrogen administered without progestin). The beneficial effects of estrogen replacement therapy in the prevention of coronary heart disease outweigh the risks for potential endometrial or breast cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Drug therapy, Estrogen, Estrogens, Lipoproteins, Blood lipoproteins

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Androgens and bone: clinical implications for menopausal women

Article Abstract:

Combining estrogen with androgens in hormone replacement therapy may prevent osteoporosis in postmenopausal women. Androgens are male sex hormones and they can prevent bone loss that occurs after menopause.

Health aspects, Injuries, Postmenopausal women, Androgens, Fractures (Injuries), Fractures

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