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Endocrine Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Symptoms of oestrogen deficiency include hot flashes, depression, loss of libido and vaginal dryness. Features of hyperandrogenism include hirsutism, acne, alopecia, seborrhoea and clitoromegaly. Endocrine disorders cause infertility as a result of anovulation and luteal phase insufficiency.
Fenugreek in Management of Immunological, Infectious, and Malignant Disorders
Published in Dilip Ghosh, Prasad Thakurdesai, Fenugreek, 2022
Rohini Pujari, Prasad Thakurdesai
Several reports on breast cancer have exhibited that the risk of occurrence of breast cancer increases with increased levels of estrogens in the human body (Albini et al. 2014; Howland et al. 2020; Samavat and Kurzer 2015; Tin, Reeves, and Key 2021). On the other hand, natural plant-based estrogen-like compounds, such as phytoestrogens, can restore endogenous balanced estrogens and have been explored as a possible management option to prevent and treat breast cancer (Basu and Maier 2018; Branca and Lorenzetti 2005; Chen and Chien 2019; Hsieh et al. 2018; Tanwar et al. 2020).
Endocrine Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Estrogen (17β-estradiol) has effects on the growth and function of reproductive tissues and also preserves bone mineral density, thus reducing the risk of osteoporosis and protecting the cardiovascular system by reducing cholesterol levels (Figure 8.1). Estrogens act as promoters, rather than initiators, of breast tumor development, and can also facilitate tumor invasiveness by stimulating the production of proteases which can degrade the extracellular matrix and facilitate metastases. Schematic diagram of the biosynthesis of the four major steroid families (i.e., the mineralocorticoids, estrogens, progestagens, and androgens) from acetate and cholesterol. The first three are primarily involved in physiological processes relating to sexual development and reproduction, whereas the mineralocorticoids are mainly involved with the retention and balance of water and minerals in the body.
The role of microbiota in the management of genitourinary syndrome of menopause
Published in Climacteric, 2023
G. Stabile, G. A. Topouzova, F. De Seta
Nowadays, it is estimated that about 1.5 million women are reaching menopause every year and approximately 25–50% of this population report symptoms such as vaginal dryness, atrophy, urinary incontinence and sexual dysfunction that are associated with a poor quality of life [1,2]. This syndrome was previously called vulvovaginal atrophy (VVA), but in 2014 this was replaced with the more inclusive term genitourinary syndrome of menopause (GSM) [3]. A good knowledge of postmenopausal physiology represents the basis for realization of effective therapies that can relieve painful symptomatology occurring in this period of life. Appropriate management of GSM and VVA is strongly related in reducing the considerable socioeconomic burden of these disorders. The symptoms are not due simply to lack of estrogen, but other mechanistic pathways may be involved. One possible contributing cause of symptoms is the vaginal microbiota. The vaginal microbiota is a dynamic entity and plays a critical role in the pathogenic interplay of postmenopausal changes [4]. Understanding how estrogens influence vaginal milieu and which modifications occur in vaginal microbiota and mucosal immunity in postmenopause is decisive to ensure appropriate management of GSM and VVA. At present, there are an increasing number of articles on the relationship between estrogen, vaginal flora and the capacity of microbiota in promoting a healthy vagina [5]. A better knowledge in this field could prevent administration of ineffective therapies and will give the possibility of managing menopausal symptoms by vaginal microbiota modulation.
Psychometric properties of the French Hot Flash Related Daily Interference Scale (HFRDIS)
Published in Climacteric, 2023
I. Cavadias, R. Rouzier, M. Milder, C. Bonneau, J. Mullaert, D. Hequet
The menopausal transition in women is associated with a fluctuation in hormones produced by the ovaries. It is induced by a progressive decrease, until total cessation, of ovarian activity at menopause. These hormonal changes translate into more or less significant symptoms reflecting estrogen deficiency at menopause. The main symptoms reported by patients are vasomotor symptoms, vaginal discomfort associated with vulvovaginal atrophy, and sleep and mood disorders. Vasomotor symptoms, including hot flashes and night sweats, are very common. Hot flashes affect approximately 80% of postmenopausal women, 25% of whom in a very disabling way [1]. These symptoms last on average 5–7 years but can last beyond 10 years [2,3]. The frequency and intensity of hot flashes are extremely variable depending on the individual and can significantly affect quality of life.
Primary choice of estrogen and progestogen as components for HRT: a clinical pharmacological view
Published in Climacteric, 2022
However, as we have been invited to write an Editorial [55], we argued that the question of the cardiovascular risk profile needs clinical endpoint studies. Cardiovascular risks such as venous thromboembolism, stroke and coronary heart disease can be expected whenever estrogens are used orally. This new option for HRT might not replace transdermal E2 to reduce these risks. We therefore still recommend transdermal E2 plus free additional combination of oral progesterone as the ‘golden standard’, especially for at-risk patients. If problems occur, transdermal E2 combined with the synthetic progestogens can be prescribed according to Table 6, whereby we often use dydrogesterone in our menopause clinic. Unfortunately, we had to conclude on the basis of another review [56] that, to date, it is not possible to achieve US Food and Drug Administration-approved endometrial safety using transdermal progesterone in preparations obviously offered as gels from various pharmacies, so women have to use two different routes of administration, which can reduce compliance [56].