China
Africa
Explore chapters and articles related to this topic
Thermal Physiology and Thermoregulation
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Exogenous estrogens can have profound effects on breast vasculature and skin temperature if given in high doses (see Figure 5.15). These effects may take over 6 months or more to resolve after stopping the hormone. Estrogenic overstimulation can be followed thermographically, and the effect can be strong enough to change the breast TH classification. On the other hand, progesterone applied transdermally in doses of 20 mg per day appears to have little, if any, effect on the thermographic breast image. Newer transdermal hormone preparations also contain 0.75 mg of estriol, applied once daily. Whether this dose of estriol, a mild estrogen with poor skin absorption, will have discernable thermographic effects remains to be seen. Of greater concern is the advent of non-prescription estriol vaginal suppositories, which contain a therapeutic dose (2 mg) given via a highly-absorbent route. Subjects undergoing thermographic imaging should be questioned about all hormones they may be taking, both prescription and non-prescription “supplements.”
Sexual Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
Vaginal estrogens come in a variety of formulations, including creams and tablets/inserts/suppositories. Vaginal creams such as Estrace or Premarin are commercially available; also, compounding pharmacies make less expensive formulations of estradiol (E2) and estriol (E3). An added benefit of the compounding product is you can get one that is hypoallergenic. Creams are beneficial because they can be applied intravaginally and can also be used on the vulva area if it is dry and irritated. Many women also apply a small amount of cream around the urethra if this is contributing to urinary irritation and frequency. The drawbacks of vaginal cream are that some women find it “messy” and/or don’t like the feeling of wetness in the vulva area.
Managing Pain in the Presence of Autoimmune Disease
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Now why use estriol and not just estradiol alone? Estriol is the weakest of the three estrogens the body produces but has many functions in the body. It is not strong enough to prevent cardiovascular disease and keep the bones strong though, thus the 20% estradiol. Estradiol is powerful enough to produce improvement in cardiovascular risk and bone health but can turn into estrone excessively.80 Topical estradiol is available in patch form, but great caution needs to be exercised because of its tendency to convert excessively to estrone. Estrogen should never be used without also using progesterone. For one reason, they work together for many processes. Progesterone helps to make good strong bones, and estrogen prevents excessive loss of bone. Also, we do not want excessive estrogen impact on breast tissue without progesterone to protect the breast.81 The same goes for estrogen dominance and its negative impact on autoimmune disease prevention or reversal.74
Management of postmenopausal vulvovaginal atrophy: recommendations of the International Society for the Study of Vulvovaginal Disease
Published in Gynecological Endocrinology, 2021
Faustino R. Pérez-López, Nancy Phillips, Pedro Vieira-Baptista, Bina Cohen-Sacher, Susana C. A. V. Fialho, Colleen K. Stockdale
Ultra-low dose concentration of estriol, formulated as a vaginal gel application (1 gram containing 30 μg of estriol) significantly improves both the Vaginal Maturation Index (VMI) and pH, when compared to placebo, after 12 weeks. It also improved signs of VVA and adverse events were similar in both groups [12]. Vaginal tablets of estriol combined with a probiotic are also available [13,14]. Few studies have addressed the safety of the use of ultra-low doses of estriol in women with a history of breast cancer, showing that despite an initial peak the systemic levels remain within normal postmenopausal range [15]. Diedrich et al. [16] studied the effect of vaginal estrogens on the microcirculation architecture, density and capillary tortuosity in women with and without VVA. In the former, it is less dense and devoid of capillary loops, which can be restored by topical estrogens.
Compounding for women’s health: a compounder’s perspective – need, regulations, and future
Published in Climacteric, 2021
Estrogen needs vary widely depending on the goal of therapy. Topical application of estrogen is proving to become a preferred method of delivery because it avoids the hepatic first pass and side-steps the negative actions of oral estrogen therapy36,37. Bioidentical estradiol-containing commercial products are available in many forms, including sprays38, patches39, emulsion gels40, and vaginal rings41. However, due to the aforementioned reasons, these may not be suitable for every patient. Prescribing estradiol alone, estriol alone, or a combination of estradiol and estriol are all tools that a prescriber can add to their armamentarium of treatment choices. One therapeutic option with estriol is its use in breast cancer survivors and vaginal/pelvic floor health42,43.
Testosterone and estrogen in multiple sclerosis: from pathophysiology to therapeutics
Published in Expert Review of Neurotherapeutics, 2018
Nicolas Collongues, Christine Patte-Mensah, Jérôme De Seze, Ayikoe-Guy Mensah-Nyagan, Tobias Derfuss
Based on the gender differences in the prevalence and clinical progression of MS, various studies suggested that, like male hormones (see section above), female steroids including estrogens and progestagens can also modulate MS symptoms. Estrogens are divided into three types of molecules: estrone, estradiol, and estriol. Estriol is only found in women during the pregnancy. Both estriol and estradiol can bind to nuclear estrogen receptors α (ERα, mostly related to estradiol effect) and β (ERβ, mostly related to estriol effect), and act differently as a ligand-activated transcription factor via the classical pathway. In addition to these cytosolic receptors, membrane-expressed receptors like the G protein-coupled receptor 30 (GPR30) or the nonsteroidal receptor can act through fast nongenomic effects. Nuclear ERβ receptors are widely expressed in the brain and endothelial cells, whereas ERα are mainly found in the hypothalamus. Both are also expressed in immune cells and can act on the transcription of NF-kB and MMP-9 and influence antigen presentation [13].