China
Africa
Explore chapters and articles related to this topic
Sexual Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
The estrogen vaginal ring is another way to improve vaginal health. It is placed into the vagina for 3 months. Estradiol is released from the ring on a continuous basis and provides the highest dose of all the commercially available products. This method is very convenient and improves the quality of life for women suffering with significant vaginal dryness/atrophy. The biggest negative is the cost, currently $500 for 3 months, and it is often not covered by insurance. Given likely out-of-pocket expenses, you could use compounding pharmacies for vaginal estradiol (E2) or estriol (E3) creams. Many compounding pharmacies (not FDA approved) will make up a vaginal cream that has the same product as a commercially available estrogen but costs up to two-thirds less and often has fewer chemical additives.
Hormones and Cardiovascular Disease
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Before menopause, ovarian production of estradiol provides partial protection to keep blood vessels relaxed and lipids in a healthier range.6 Menopause heralds many changes. Untreated vasomotor symptoms are linked to impaired endothelial function,39 as well as an increased risk of hypertension and CVD,40 diminished cardiac vagal tone,41 fracture,42 poor or disrupted sleep,43 depression,44 increased white matter hyperintensities in the brain,45 and cognitive impairment, possibly leading to a greater risk of Alzheimer’s disease.12 In fact, vasomotor symptoms are emerging as an important biomarker of future disease, not just nuisance symptoms to be managed with nonpharmacologic agents.
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Estradiol is a naturally occurring hormone that circulates endogenously within the human body. It is the most potent form of mammalian estrogenic steroids and acts as the major female sex hormone. As such, estradiol plays an essential role in the regulation of the menstrual cycle, in the development of puberty and secondary female sex characteristics, as well as in ageing and several hormonally-mediated disease states. Estradiol and estradiol esters (esterification of estradiol aims to improve absorption and bioavailability after oral administration or to sustain release from depot intramuscular injections) are commercially available in oral, transdermal, and injectable hormone therapy products for managing conditions associated with reduced estrogen production such as menopausal and peri-menopausal symptoms as well as hypoestrogenism. It is also used in transgender hormone therapy, as a component of oral contraceptive pills for preventing pregnancy (most commonly as ethinylestradiol), and is sometimes used for the palliative treatment of some hormone-sensitive cancers like breast and prostate cancer (1).
Brain fog in menopause: a health-care professional’s guide for decision-making and counseling on cognition
Published in Climacteric, 2022
Cognitive complaints are frequent in midlife women and are associated with decreased quality of life [1]. These cognitive complaints are reliably validated and documented across the menopause transition (MT). Basic and clinical studies show a role for estradiol (E2) in mediating menopause-related changes in cognition [2]. In addition, menopause symptoms, including vasomotor symptoms (VMS), sleep disturbances and mood changes contribute to cognitive difficulties at midlife [3], but there are critical gaps in the data as to whether this period of cognitive dysfunction predicts dementia risk, and whether menopausal hormone therapy (MHT) is protective against late-onset dementia or increases the risk. The theme for the 2022 World Menopause Day is Cognition and Mood, and the goal of this International Menopause Society-commissioned White Paper on cognition is to provide menopause practitioners with an overview of data informing clinical care of menopausal women and a framework for clinical counseling and decision-making for their patients.
Transdermal delivery of bioidentical estrogen in menopausal hormone therapy: a clinical review
Published in Expert Opinion on Drug Delivery, 2020
Many CHT products are formulated into creams for transdermal delivery. Although they contain multiple estrogens, the most potent estrogen in the formulations is estradiol which has a binding affinity for the estrogen receptor α and β of 100 [46]. The proportion of the estrogens contained within the creams can vary based on the specific prescription and compounding pharmacy. The majority of CHT estrogen products contain a mixture of estrogens that are plant derived and bioidentical to those produced by the human ovary. Tri-est (10:10:80) typically contains a mixture of Estrone (10%) Estradiol (10%) and Estriol (80%). Bi-est (80:20) usually contains Estrone (20%) and Estriol (80%) in combination (Table 3). In order to ensure that the transdermal cream contains the aforementioned proportions of each estrogen, the prescriber must include the desired percentages of each estrogen in the prescription as lack of FDA oversight allows for different recipes to represent the products of Tri-est and Bi-est. Prescriptions are typically written to reflect total daily dose of all the estrogen (E1+ E2+ E3) delivered to the patient. For example, Triest 5 mg (10:10:80) would convey E1 0.5 mg, E2 0.5 mg and E3 4 mg. This can be confusing and lead to prescriptions written by providers who do not have a full understanding of what they are prescribing [48].
Will estradiol/progesterone capsules for oral use become the best choice for menopausal hormone therapy?
Published in Climacteric, 2019
The cardiometabolic parameters assessed in the REPLENISH study are laboratory parameters commonly used for screening purposes in internal medicine and thus it can be concluded that E2/P4 combinations, used orally in postmenopausal women in good cardiovascular health, are neutral with respect to lipid and glucose metabolism and within the coagulation system. This has also been reported in studies using estradiol transdermally combined with orally applied micronized progesterone4,5. In contrast, a variety of studies using oral estrogens combined with synthetic progestogens showed negative changes, such as a decrease of high-density lipoprotein cholesterol (especially when using androgenic progestogens), an increase of triglycerides, and, in some studies using higher dosages of synthetic progestogens, also disturbances in glucose metabolism4,6.