Perimenopause: The Complex Endocrinology of the Menopausal Transition

Prior, Jerilynn C.

doi:10.1210/edrv.19.4.0341

Cited by 254 publications

(192 citation statements)

References 167 publications

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“…While the reasons for the increased female vulnerability to mood disorders remain to be fully understood, the strongest candidate remains the influence of cycling levels of gonadal steroids on neurotransmitter systems and mood regulatory systems (Steiner et al, 2003), perhaps interacting with genetic vulnerability and life stress (Caspi et al, 2003). The finding that previously asymptomatic women demonstrated increased risk for depression during the perimenopause suggests that perimenopausal associated instability in previously stable ovarian hormonal cycling (Prior, 1998) can induce mood instability even in women with few risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Estrogen Administration Negatively Alters Mood Following Monoaminergic Depletion and Psychosocial Stress in Postmenopausal Women

Newhouse

Dumas

Hancur-Bucci

et al. 2007

Neuropsychopharmacol

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Differences in the rates of affective disorders between women and men may relate to gender differences in gonadal steroid levels such as estrogen that have effects on brain monoamines important to mood regulation. Changes in estrogen secretion patterns during the perimenopause and menopause may be relevant to the increased risk for affective symptoms at that time. This study examined whether 17b-estradiol (E2) administration can modify the mood effects of experimental psychosocial stress following acute monoamine depletion in postmenopausal women. Subjects consisted of 15 normal postmenopausal women (PMW) (ages 67.1711.2 years) blindly placed on either oral placebo or E2 (1 mg/day for 1 month, then 2 mg/day for 2 months). At the end of the 3-month treatment phase, subjects participated in three blinded depletion challenges in which they ingested each of three amino-acid mixtures: deficient in tryptophan, deficient in phenylalanine/tyrosine, or nutritionally balanced. After 5 h, subjects performed the Trier Social Stress Test (TSST), followed by mood and anxiety ratings. E2-treated subjects exhibited a significant increase in negative mood and anxiety after the TSST compared to placebo-treated women. These effects were independent of monoamine depletion and were not manifest before the TSST or at baseline. Exogenous estrogen administration in PMW may alter or modulate emotional reactivity to stressful events and may alter the sensitivity of emotional regulation. This modulation appears to be independent of alterations in monoaminergic neurotransmission. The dose of estrogen used after menopause may be important in determining the effects of gonadal steroids on emotional regulation.

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Section: Introductionmentioning

confidence: 99%

“…Estrogen levels vary widely during the perimenopause and postmenopause and this variability is associated with symptomatology, particularly vasomotor (Prior, 1998). After menopause, estrogen levels become lower but more stable concomitant with a decreased risk of depression.…”

Section: Introductionmentioning

confidence: 99%

Estrogen Administration Negatively Alters Mood Following Monoaminergic Depletion and Psychosocial Stress in Postmenopausal Women

Newhouse

Dumas

Hancur-Bucci

et al. 2007

Neuropsychopharmacol

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“…However, hormonally, perimenopause and menopause are as different as chalk and cheese. Compared with premenopausal women, oestrogen levels are erratically higher in perimenopause 8 and stably lower in menopause; progesterone levels silently decline and become lower in the perimenopausal years before the last flow 9 . In contrast to conventional wisdom 10 , perimenopause begins with changes in experiences within regular cycles at a time when oestrogen levels are already higher and progesterone levels already lower than in premenopause 11 .…”

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confidence: 90%

Perimenopause and menopause as oestrogen deficiency while ignoring progesterone

Prior

2015

Nat Rev Dis Primers

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“…Los síntomas vasomotores ocurren en la mayoría de las mujeres peri y posmenopáusicas como consecuencia de una fluctuación o disminución de la producción de estrógenos por los ovarios (9). Para su manejo se han utilizado diversos tratamientos hormonales y no hormonales, con diferente éxi-to.…”

Section: Síntomas Vasomotoresunclassified

Estetrol: Desde Un Estrógeno Fetal Hasta El Tratamiento De La Menopausia

2009

Rev. chil. obstet. ginecol.

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RESUMENEstetrol es un esteroide estrogénico sintetizado exclusivamente por el hígado fetal, que traspasa a la circulación materna por la placenta. Descrito por primera vez por Diczfalusy en 1965. Desde esa fecha se han realizado diversas investigaciones preclínicas. En los últimos años, el interés por el estetrol ha aumentado, dado el logro de su síntesis en el laboratorio y la demostración de su buena biodisponibilidad y larga vida media al administrarlo por vía oral a mujeres. Se presenta una revisión de su síntesis, metabolismo y de la información científica existente de sus diferentes efectos en los tejidos estrógeno sensibles en distintos modelos animales.PALABRAS CLAVE: Estetrol, efecto estrogénico, menopausia, terapia hormonal de reemplazo SUMMARYEstetrol is an estrogenic steroid synthesized exclusively by the fetal liver. It crosses over from the placenta to the maternal circulation. It was first described in 1965 by Diczfalusy and from this date onwards, several preclinical investigations have been carried out. In recent years, the interest for estetrol has been growing due to its laboratory synthesis and the demonstration of its good bioavailability together with its long half life, when administered orally to women. A review of its synthesis, metabolism and existing scientific information on its different effects on estrogen sensitive tissues, in a variety of animal models, is here presented. KEY WORDS: Estetrol, estrogenic effect, menopause, hormonal replacement therapy INTRODUCCIÓNEl esteroide estrogénico estetrol (E4) fue descrito en 1965 por Diczfalusy y cols (1). En los años siguientes diversos investigadores demostraron que esta molécula con 4 grupos hidroxilo (C18H24O4) era sintetizada en forma exclusiva por el hígado fetal durante el embarazo humano (2-3) y traspasada a la circulación materna por la placenta (Figura 1).El E4 puede ser detectado ya a las 9 semanas de embarazo en la orina materna alcanzando altas concentraciones en el plasma materno en el segundo trimestre con un aumento sostenido hasta el momento del parto (4). Los niveles de E4 no conjugado en el plasma fetal en el momento del parto son 12 a 19 veces mayores que en la madre. La concentración en el líquido amniótico corresponde a un tercio de la fetal, pero 5 -6 veces mayor que la del plasma materno (5). Casi no sufre cambios metabólicos, siendo eliminado por la orina como monoglucuronido, no participando de la circulación entero-hepática. REV CHIL OBSTET GINECOL 2009; 74(2): 123 -126

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Perimenopause: The Complex Endocrinology of the Menopausal Transition

Cited by 254 publications

References 167 publications

Estrogen Administration Negatively Alters Mood Following Monoaminergic Depletion and Psychosocial Stress in Postmenopausal Women

Estrogen Administration Negatively Alters Mood Following Monoaminergic Depletion and Psychosocial Stress in Postmenopausal Women

Perimenopause and menopause as oestrogen deficiency while ignoring progesterone

Estetrol: Desde Un Estrógeno Fetal Hasta El Tratamiento De La Menopausia

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