Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline

Stuenkel, Cynthia A.; Davis, Susan Ruth; Gompel, Anne; Lumsden, Mary Ann; Murad, M. Hassan; Pinkerton, Jo Ann V.; Santen, Richard J.

doi:10.1210/jc.2015-2236

Cited by 612 publications

(463 citation statements)

References 381 publications

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“…A summary of recent literature and guidelines indicates that the pendulum is now swinging back toward the use of MHT for women within 10 years of menopause onset and without moderate or high risks of breast cancer and heart disease. These principles were espoused in the recent Endocrine Society guidelines on menopause (Stuenkel et al 2015). The choice of CEE vs oestradiol remains a matter of controversy with clear national preferences.…”

Section: Oestrogen Therapy and Menopausementioning

confidence: 99%

Celebrating 75 years of oestradiol

Simpson

Santen

2015

Journal of Molecular Endocrinology

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Oestrogens exert important effects on the reproductive as well as many other organ systems in both men and women. The history of the discovery of oestrogens, the mechanisms of their synthesis, and their therapeutic applications are very important components of the fabric of endocrinology. These aspects provide the rationale for highlighting several key components of this story. Two investigators, Edward Doisy and Alfred Butenandt, purified and crystalized oestrone nearly simultaneously in 1929, and Doisy later discovered oestriol and oestradiol. Butenandt won the Nobel Prize for this work and Doisy's had to await his purification of vitamin K. Early investigators quickly recognized that oestrogens must be synthesized from androgens and later investigators called this process aromatization. The aromatase enzyme was then characterized, its mechanism determined, and its structure identified after successful crystallization. With the development of knock-out methodology, the precise effects of oestrogen in males and females were defined and clinical syndromes of deficiency and excess described. Their discovery ultimately led to the development of oral contraceptives, treatment of menopausal symptoms, therapies for breast cancer, and induction of fertility, among others. The history of the use of oestrogens for postmenopausal women to relieve symptoms has been characterized by cyclic periods of enthusiasm and concern. The individuals involved in these studies, the innovative thinking required, and the detailed understanding made possible by evolving biologic and molecular techniques provide many lessons for current endocrinologists. Discovery of oestrogenThe concept that substances secreted by one organ could then be transported internally to another via the blood stream is the underpinning of the field of endocrinology. The 'father of physiology', Claude Bernard, articulated the concept of internal secretion by describing how the liver produces glucose, which then travels to and is utilized by other tissues in the body. This concept underlies studies on the ovaries, which became a focus of investigation later in the century. In 1896, Emil Knauer, a 29-year-old Austrian, excised the ovaries of adult rabbits and then re-implanted pieces into different locations in the same animals (Watkins 2007 Doisy then enlisted a nurse in the obstetrics clinic to supply each pregnant patient with a 1 gal jug and ask for her urine. This provided the needed material but was fraught with difficulties. Suspected to be a bootlegger because of the large jugs of yellow material in his car, one of Doisy's drivers was nearly arrested until he suggested using the sniff test with the response 'My god, it is urine'. Doisy, then being recruited to St Louis University, continued his efforts to purify the active substance. Each extract was tested with a bioassay and its effect on uterine stimulation. Urine, the material of choice for study, was initially extracted with a very large countercurrent apparatus (Fig. 1). Costing the exorbitan...

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Section: Oestrogen Therapy and Menopausementioning

confidence: 99%

Celebrating 75 years of oestradiol

Simpson

Santen

2015

Journal of Molecular Endocrinology

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“…A HPK-k kapcsán tumorkeltő tulajdonságot állapítottak meg az emlőben és az endometriumban, illetve a már kialakult tumorok méretének növekedését tapasztalták, ami a sejtproliferációt fokozó hatással magyarázható. Az ösztrogének serkentik a véral-vadási faktorok és a fibrinogén szintézisét, emiatt fokozódik a véralvadásra való hajlam, a vénás thromboembolia kialakulásának rizikója [14].…”

Section: öSszefoglaló Közleményunclassified

Fitoösztrogének a menopauza terápiájában

Remport

Blázovics

2017

Orvosi Hetilap

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A korábbi évszázadokban a társadalmi és gazdasági körülmények, az orvostudomány hiányosságai, a járványok és a háborúk miatt rövid volt a várható élettartam, így a nők többsége meg sem érte a változókort. Napjainkban a fejlett országokban az emberek átlagosan 75-80 éves korukig élnek, az átlagéletkor kitolódásával nő a menopauzában érin-tettek, illetve a menopauzában töltött évek száma, mára már a nők életük harmadát menopauzában töltik. A kellemetlen tünetek kezelésének egyetlen hatékony módját évszázadokon át a gyógynövények alkalmazása jelentette, amely ismeret szájhagyomány útján terjedt. A XX. században a szintetikus gyógyszergyártás kialakulásával és a hormonpótló kezelés bevezetésével ez a terápiás forma háttérbe szorult. A média hatására a XX. században kialakult az a társadalmi igény a nők körében, hogy minél tovább megőrizzék szépségüket és fiatalságukat. A hormonpótló terápia nagy népszerűségnek örvendett, mert a nők átmenetileg megszabadultak életminőségüket rontó tüneteiktől, viszont évekkel később kiderült, hogy a hormonpótlás komoly veszélyekkel járhat. A gyógynövényes terápiáknak határozott előnye a hormonpótló kezelésben használt szintetikumokkal szemben a kedvezőbb mellékhatásprofil. A nők ezért ismét szívesen fordulnak a bevált természetes gyógymódokhoz. Egyre növekszik az érdeklődés a gyógynövénytartal-mú készítmények iránt. A fitoösztrogének hatásának tanulmányozása mára már a kutatások aktív területévé vált. Az állatokon és embereken végzett vizsgálatok eredményei azonban ellentmondásosak, egyes források szerint a fitoöszt-rogének hatékonynak és biztonságosnak bizonyulnak, más szerzők szerint hatástalanok menopauzában vagy kifejezetten veszélyesek, nem ajánlhatók mindenkinek. A nők testi, mentális egészsége és biztonsága érdekében fontos ezzel a kérdéssel foglalkozni, alkalmazásuk előtt ezért szükséges felmérni az előnyöket és a rizikót. Orv Hetil. 2017; 158(32): 1243-1251.Kulcsszavak: menopauza, hormonpótló kezelés, fitoösztrogének, izoflavonoidok, szója Phytoestrogens in the treatment of menopauseIn previous centuries many women did not even live until their menopause years due to poor economic conditions, deficiencies of medicine, epidemics and wars. Nowadays in the developed countries, people live until they are 75-80 years old, and with the expansion of average age, the number of people affected by menopause and the years spent in that state increase. Nowadays women spend one third of their lives in the menopausal stage. The only effective way to treat unpleasant symptoms for centuries was with the use of herbs, and the knowledge about them spread through oral tradition. In the 20th century, this therapeutic form was pushed into the background by the development of synthetic drug production and the introduction of hormone replacement therapy. Thanks to the influence of media in the 20th century, women began to have the social need for preserving their beauty and youth for as long as they could. Hormone replacement therapy enjoyed great popularity because women were temporarily relieved...

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“…It is also produced in the ovaries, but in much smaller quantities than either of the other two. 4 The subtle balance of the estrogen amalgam of these three constituents helps to reduce the incidence of heart attack, slows the rate of bone loss, reduces vaginal dryness, improves skin tone, and it can regulate mood swings, in the context of both menstruation and menopause. With the onset of menopause, estrogen levels disminish markedly, but they do not drop to Zero, as some estrogen is still produced in the fat cells which continue to provide the supporting tissue around the ovaries.…”

Section: Understanding the Relationship Between Menstruation And Menomentioning

confidence: 99%

From Menstruation to Menopause: Have We Medicalised the Physiology of Normalcy? (Part 1)

Laura¹

2017

Women Health Open J

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Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline

Cited by 612 publications

References 381 publications

Celebrating 75 years of oestradiol

Celebrating 75 years of oestradiol

Fitoösztrogének a menopauza terápiájában

From Menstruation to Menopause: Have We Medicalised the Physiology of Normalcy? (Part 1)

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