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Placental Biosynthesis, Metabolism, and Transport of Eicosanoids
Published in Murray D. Mitchell, Eicosanoids in Reproduction, 2020
The disparity in these results may again demonstrate the problems of trying to measure a local hormone which is synthesized on demand, acts, and is then immediately metabolized; hence, the concept of an in vivo level and attempts to measure it are contentious.
Radioautographic Localization of Estrogen Receptors in the Rat Uterus: A Tool for the Study of Classical and Nontraditional Mechanisms of Hormone Action
Published in Louis P. Pertschuk, Sin Hang Lee, Localization of Putative Steroid Receptors, 2019
Andrei N. Tchernitchin, Miguel A. Mena, Angel Rodriguez, Mauricio Maturana
Estrogen binding by cytosol-nuclear receptors depends on local estrogen levels in target organs.3 Accordingly, the uterine genomic responses to estrogen depend on local hormone levels in the uterus.76,188 On the contrary, estrogen-induced uterine eosinophilia and edema are dependent on estrogen levels in the blood but not in the uterus.76
The menopause and postreproductive health
Published in Helen Bickerstaff, Louise C Kenny, Gynaecology, 2017
Both systemic and locally administered HRT have significant beneficial effects on the lower genital tract. There is good evidence that its administration improves vulvovaginal dryness, irritation, soreness and dyspareunia. There is also an improvement in symptoms of cystitis and occasionally dysuria. Local hormone therapy is unlikely to cure prolapse but may improve some of the symptoms of prolapse. There is no evidence that local HRT improves incontinence. Many women considering local HRT are dissuaded from its use due to concerns about the published risks. They can often be reassured that were they to use the form of local hormone therapy as a 10 µg twice weekly dose vaginal tablet, they would only be administering approximately the equivalent of a 1 mg oral tablet over a whole year.
The Effects of Hormonal and Non-Hormonal Intrauterine Devices on Female Sexual Function: A Systematic Review
Published in International Journal of Sexual Health, 2023
Katherine Ogle, Ariel B. Handy
It is also possible that IUDs may negatively impact female sexual function. Hormones are integral to the physiology of sexual function, and altering local hormone levels may impact genital tissue or other physiologically-based components of sexual function (e.g., lubrication). As the progestins found within LNG-IUDs thin the endometrium (Jones & Critchley, 2000), it is possible that other biological systems in the genital tract are also impacted. For example, Moncla et al. (2016) discovered that cervical and vaginal fluid glycomes in the genital tract can respond to internal, biological signals such as hormones and vaginal microflora. In addition, Cu-IUDs can increase menstrual bleeding and cause irregular bleeding patterns among users (Hubacher et al., 2009). These menstrual side effects may negatively impact sexual function, specifically desire, as research has shown that women using non-hormonal contraceptives (NHCs) report decreases in desire during bleeding days (Elaut et al., 2016).
Vaginal Health: Insights, Views & Attitudes survey in Latin America (VIVA-LATAM): focus on Brazil
Published in Climacteric, 2021
L. M. Pompei, M. C. O. Wender, N. R. de Melo, J. Kulak, D. Pardini, R. B. Machado, C. E. Fernandes, S. Palacios, R. E. Nappi
While 11% of the Brazilian women believed that no effective treatment was available for vaginal discomfort, 79% reported being aware of at least one management option. More than half the cohort were aware of lubricating gels and creams (54%), and 39% of those experiencing vaginal discomfort had used this treatment option (Figure 3). Furthermore, more than half of the overall cohort were aware of vaginal hormone creams (52%) (Figure 3). Indeed, Brazilian women were more likely to be aware of vaginal hormone creams than women from other countries (52% vs. 40% for the overall survey population). Consistent with their levels of awareness, Brazilian women were also more likely to have used vaginal hormone creams than women from other countries (36% vs. 23% for the overall survey population). Overall, 56% of the Brazilian cohort were aware of some form of local hormone therapy and 40% of those experiencing vaginal discomfort had used such treatment. Although 43% of the cohort had no associations with local hormone therapy (neither positive nor negative beliefs associated with its use), 70% stated that they would consider this option if they knew it to be effective and capable of maintaining normal hormone levels.
Vulvovaginal atrophy in women after cancer
Published in Climacteric, 2019
There is considerably more advice on the management of women on systemic hormone therapy than there is about local hormone therapy following a diagnosis of breast cancer25. The British Menopause Society’s consensus statement on management of estrogen deficiency symptoms in women treated for breast cancer advises that lifestyle modification or non-hormonal treatments should be first line. However, if these are ineffective then, following specialist advice, low-dose systemic hormone therapy or topical estrogens may be initiated26. Topical estrogen is not recommended in women on aromatase inhibitors. However, switching from an aromatase inhibitor to tamoxifen may improve symptoms; this possibility should be discussed with the oncologist. If this is ineffective, then topical estrogens can be considered26. The British Menopause Society also highlights the importance of referral for psychosexual counseling and support for body image concerns26.