The History of Estrogen Therapy

Abstract

Introduction: Menopausal hormone therapy (MHT) has proven an effective treatment for the amelioration of symptoms of menopause. The idea that a substance was the missing factor in a woman's body after menopause dates to the 1800's when cow ovarian tissue was injected into German women in a successful attempt to reverse the sexual symptoms of menopause. The early 1900's saw the rise of commercialized menopause "treatments" that ranged in substance, and even theoretical, efficacy. The role of estrogen was first accurately described in Guinea pigs in 1917 by Dr. Papanicolaou.Aim: Here we tell a detailed history of how estrogen was discovered and the controversy surrounding MHT.Methods: A literature search was conducted using PubMed to identify relevant studies and historical documents regarding the history of estrogen therapy. Results:The history of estrogen supplementation and its controversies are interesting stories and relevant to today's ongoing investigation into hormone replacement. Conclusion:The controversy of MHT remained until the first randomized trials examining MHT in the early 1990s that suggested MHT to be cardioprotective for post-menopausal women, though this conclusion was contradicted in subsequent trials. In the present day, MHT is approved only for short term use for the symptomatic treatment of menopause.

Aromatase Inhibition Eliminates Sexual Receptivity Without Enhancing Weight Gain in Ovariectomized Marmoset Monkeys

“…This is of considerable importance to clinical management of women’s health. For example, the oral, nonsteroidal aromatase inhibitor letrozole, employed in the current NHP study, is widely used in clinical practice, including minimizing recurrence of estrogen receptor positive breast cancer following surgical intervention [ 105 , 106 ] and enabling menopausal hormone therapy [ 107 , 108 ]. Not surprisingly, such long-term aromatase inhibition can exert a highly negative effect on female sexuality, engaging personally distressing sexual dysfunction, vaginal atrophy, and dyspareunia [ 42 , 106 , 109 ].…”

Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency

“…Therapeutic interventions for the prevention and management of HFpEF in postmenopausal women has solely been the use of menopausal hormonal treatment until the findings of the Women's Health Initiative randomized controlled trial and others, reporting the side effects and discouraged their usage significantly (Rossouw et al, 2002;Modena et al, 2005;Schierbeck et al, 2012;Antoine et al, 2016;Iorga et al, 2017;Kohn et al, 2019). Exploration of the mechanisms causing the reported side effects revealed that the late initiation of menopausal hormonal treatment and the usage of the combination of conjugated equine estrogen with medroxyprogesterone acetate as the probable causes (LaCroix et al, 2011;Maria Grazia, 2016;Hickey et al, 2018;Shufelt et al, 2018).…”

Soy isoflavones alleviate periodontal destruction in ovariectomized rats

“…Moreover, the dose and duration of ET remain conservative owing to an increased risk of heart disease, stroke, and breast cancer. 19 Numerous studies have shown that estrogen regulates cellular proliferation, differentiation, and keratinization of the gingival epithelium. [20][21][22] Phytoestrogens, especially soy isoflavones (SI), are associated with a low risk of adverse effects.…”

“…Although estrogen supplementation is highly effective in preventing PMO and also Food and Drug Administration (FDA)‐approved, the effect of ET on periodontitis still needs to be studied. Moreover, the dose and duration of ET remain conservative owing to an increased risk of heart disease, stroke, and breast cancer 19 . Numerous studies have shown that estrogen regulates cellular proliferation, differentiation, and keratinization of the gingival epithelium 20–22 .…”