Fenugreek in Management of Female-Specific Health Conditions
Dilip Ghosh, Prasad Thakurdesai in Fenugreek, 2022
There is a good body of evidence for herbal remedies and dietary supplements to manage menopausal symptoms, including cognitive problems (Clement et al. 2011). The phytoestrogens from natural sources are known to provide excellent estrogenic activity (Adlercreutz et al. 1992; Messina, Barnes, and Setchell 1997; Pitkin 2012). The presence of phytoestrogens in the hydroalcoholic extract of fenugreek seed demonstrated cognitive improvement, neuroprotective effect, and antioxidant effect in ovariectomized (OVX) rats (Anjaneyulu et al. 2017). In rats, ovariectomy mimics natural and surgical menopause, making it a suitable animal model for menopause and cognitive aging research (Zakaria et al. 2019). The oral supplementation of fenugreek seed hydroalcoholic extract (200 mg/kg/day for 30 days) could prevent OVX-induced learning and memory decline and shrinkage and death of hippocampal CA3 neurons (Anjaneyulu et al. 2017).
Endocrine Therapies
David E. Thurston, Ilona Pysz in Chemistry and Pharmacology of Anticancer Drugs, 2021
The three major naturally occurring estrogens in women are estrone (E1), estradiol (E2), and estriol (E3) (Figure 8.1). Estradiol is the most prominent estrogen in nonpregnant females who are between the menarche and menopause stages of life. However, during pregnancy estriol becomes the predominant estrogen, and after the menopause there is a change to estrone as the main form of estrogen. There is also a fourth type of estrogen known as estetrol (E4) which has a fourth hydroxy group (at the C15-position) and is produced only during pregnancy. Estradiol is the most potent of the estrogens, with a potency approximately 80 times that of estriol, which has the lowest potency of all the estrogens, perhaps explaining why it is produced in greater abundance than the others. All of these different forms of estrogen are biosynthesized from the androgens androstenedione and testosterone by the aromatase enzyme (Figure 8.1), and all four major families of steroids have their origins in cholesterol at the beginning of the biosynthetic process, which is synthesized itself from acetate residues.
Hormone Receptors and Endocrine Therapy in Breast Cancer
Sherry X. Yang, Janet E. Dancey in Handbook of Therapeutic Biomarkers in Cancer, 2021
The selection of appropriate endocrine therapy depends on the disease state—early versus recurrent or metastatic, and patient hormonal status—premenopausal versus postmenopausal. In premenopausal women, most estrogen is produced in the ovaries in response to pituitary-derived luteinizing and follicle-stimulating hormones. In postmenopausal women, estrogen is produced mainly in peripheral tissues by aromatase conversion of androstenedione and testosterone produced in the adrenal gland. The inhibition of peripheral conversion of estrogen precursors to estrogen in premenopausal patients may lead to a reduced feedback of estrogen to the hypothalamus and pituitary axis and, consequently, stimulation of ovarian estrogen production [41]. Because of this concern, use of AIs should be avoided in premenopausal women with functional ovaries.
Recent advances in the management of postmenopausal women with non-atypical endometrial hyperplasia
Published in Climacteric, 2023
H. Ren, Y. Zhang, H. Duan
In postmenopausal women, the incidence of NEH was 4–5% [9–11]. Estrogen in women of childbearing age is mainly produced by the ovaries. After menopause, the function of the ovaries has basically disappeared. At this time, estrogen and progesterone will not be secreted. The concentration of estrogen in the blood will decrease significantly, but estrogen still exists in the body. The main source of estrogen in women is transformed from androgens secreted by the adrenal gland, and the transformation sites are in adipose tissue, the liver and the kidney. The most important risk factor for NEH is the chronic imbalance of estrogen and progesterone. The endometrium is exposed to persistent estrogen without progesterone antagonism. Endogenous or exogenous hormones can cause this effect [12,13].
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.