Serum Estradiol-Binding Profiles in Postmenopausal Women Undergoing Three Common Estrogen Replacement Therapies

Nachtigall, Lila E.; Raju, Uma; Banerjee, Sila; Wan, Livia; Levitz, Mortimer

doi:10.1097/00042192-200007040-00006

Cited by 57 publications

(29 citation statements)

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“…Oral estrogen therapy leads to elevations in SHBG level and subsequently decreases bioavailable fractions of sex steroids, and these "first-pass" effects through the liver could influence CVD risk [66]. Oral, but not transdermal estrogen therapy, is associated with enhanced platelet reactivity [67].…”

Section: Randomized Trialsmentioning

confidence: 99%

“…[66] Similarly, trials of T therapy have not noted that the risks of benefit of T therapy vary by baseline level of T, even as T levels after replacement are often not recorded continuously [9]. While the cutpoint for hypogonadism varied, approximately 10.4-16.4 nmol/l or 300 ng/dl to 475 ng/dl is a common range for hypogonadism in clinical trials [9,[72][73][74][75].…”

Section: Randomized Trialsmentioning

confidence: 99%

See 1 more Smart Citation

A Review of the Relationships between Endogenous Sex Steroids and Incident Ischemic Stroke and Coronary Heart Disease Events

Kim¹,

Cushman²,

Kleindorfer³

et al. 2015

CCR

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For decades, it has been recognized that men have a higher age-adjusted risk of ischemic cardiovascular (CVD) events compared to women, thus generating hypotheses that sex steroids contribute to CVD risk. Potential mechanisms include genomic and non-genomic effects of sex steroids as well as mediation through classic CVD risk factors and obesity. However, results from randomized studies suggest that sex steroid supplementation in men and women do not result in improved CVD outcomes and may increase CVD risk. In contrast, prospective observations from endogenous sex steroid studies, i.e. among participants not using sex steroids, have suggested the opposite relationship. We reviewed the findings of prospective observational studies in men (17 studies) and women (8 studies) that examined endogenous sex steroids and CVD risk. These studies suggested a lack of association or that lower levels of testosterone or dihydrotestosterone are associated with higher CVD risk in both men and women. Higher, rather than lower, estradiol levels were associated with higher CVD risk in women. There were several significant gaps in the literature. First, it is unclear whether more sensitive measures of sex steroid levels might detect significant differences. Second, there are few prospective studies in women. Similarly, no studies report outcomes for high-risk groups such as African-Americans and Hispanics. Finally, few studies report upon ischemic coronary disease as opposed to ischemic stroke separately, although relationships between sex steroids and CVD may vary by vascular bed. Future investigations need to examine high risk groups and to distinguish between subtypes of CVD.

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Section: Randomized Trialsmentioning

confidence: 99%

Section: Randomized Trialsmentioning

confidence: 99%

A Review of the Relationships between Endogenous Sex Steroids and Incident Ischemic Stroke and Coronary Heart Disease Events

Kim¹,

Cushman²,

Kleindorfer³

et al. 2015

CCR

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show abstract

“…This has significant therapeutic implications. Oral CEE and other oral estrogen preparations may result in up to 10-fold higher levels of circulating estrone sulphate than transdermally administered estradiol at comparable or even higher doses [47,49]. Not only do estrogen-sensitive target tissues such as breast and endometrium have high capacity to metabolize estrone sulphate through to estradiol, but estradiol can also be synthesized in these sites from androgens and act locally at these sites as a paracrine or even intracrine factor [45].…”

Section: Estrogenmentioning

confidence: 99%

Drugs for the treatment of menopausal symptoms

Davis

Jane

2010

Expert Opinion on Pharmacotherapy

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“…Esse efeito é muito mais intenso quando a administração de estrogênios se faz por via oral, sendo atenuado quando se empregam as vias não orais (Nachtigall et al, 2000).…”

Section: O Tratamento Com Estrogênios E Androgêniosunclassified

Síndrome de insuficiência androgênica: critérios diagnósticos e terapêuticos

Fernandes¹,

Rennó

Nahás³

et al. 2006

Rev. psiquiatr. clín.

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ResumoA síndrome da insuficiência androgênica na mulher (SIA) desperta, mesmo nos dias atuais, muitas discussões e encerra muitas controvérsias. Sabe-se, no entanto, que os níveis plasmáticos de testosterona declinam progressivamente ao longo do período reprodutivo. Conceitua-se a SIA como o conjunto de sintomas clínicos, a presença de biodisponibilidade diminuída de testosterona e os níveis normais de estrogênios. Entre os principais sintomas, citam-se o comprometimento do bem-estar, o humor disfórico, a fadiga sem causa aparente, o comprometimento do desejo sexual, o emagrecimento e a instabilidade vasomotora em mulheres pós-menopáusicas sob terapêutica estrogênica. Esses sintomas, no entanto, são potencialmente atribuíveis a diferentes etiologias e dificultam o correto diagnóstico na maioria dos casos, ainda que ele seja lembrado com freqüência em pacientes que se submetem à ooforectomia bilateral. O diagnóstico da SIA parece ser essencialmente clínico, não havendo a necessidade das dosagens laboratoriais para a sua comprovação. Não se deve indicar a terapêutica androgênica (TA) em pacientes que não estejam adequadamente estrogenizadas. Considera-se a testosterona o hormônio ideal para a TA. As pacientes com sintomas sugestivos de SIA, excluídas outras causas identificáveis, especialmente se pós-menopáusicas, são candidatas à TA. Não existem dados de segurança sobre a TA em usuárias em longo prazo. A via transdérmica -através de adesivos, cremes e gel -parece ser preferível à oral.Palavras-chave: Deficiência androgênica, terapêutica androgênica, disfunção sexual feminina.

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Serum Estradiol-Binding Profiles in Postmenopausal Women Undergoing Three Common Estrogen Replacement Therapies

Cited by 57 publications

References 0 publications

A Review of the Relationships between Endogenous Sex Steroids and Incident Ischemic Stroke and Coronary Heart Disease Events

A Review of the Relationships between Endogenous Sex Steroids and Incident Ischemic Stroke and Coronary Heart Disease Events

Drugs for the treatment of menopausal symptoms

Síndrome de insuficiência androgênica: critérios diagnósticos e terapêuticos

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