scholarly journals Hormonal treatments for endometriosis: The endocrine background

2021 ◽  
Author(s):  
Silvia Vannuccini ◽  
Sara Clemenza ◽  
Margherita Rossi ◽  
Felice Petraglia
Keyword(s):  
Ovarian Function ◽  
Hormonal Treatment ◽  
Disease Recurrence ◽  
Endometrial Cells ◽  
Estrogen Receptor Modulators ◽  
Sites Of Action ◽  
Key Events ◽  
Receptor Modulators ◽  
Hormonal Treatments

AbstractEndometriosis is a benign uterine disorder characterized by menstrual pain and infertility, deeply affecting women’s health. It is a chronic disease and requires a long term management. Hormonal drugs are currently the most used for the medical treatment and are based on the endocrine pathogenetic aspects. Estrogen-dependency and progesterone-resistance are the key events which cause the ectopic implantation of endometrial cells, decreasing apoptosis and increasing oxidative stress, inflammation and neuroangiogenesis. Endometriotic cells express AMH, TGF-related growth factors (inhibin, activin, follistatin) CRH and stress related peptides. Endocrine and inflammatory changes explain pain and infertility, and the systemic comorbidities described in these patients, such as autoimmune (thyroiditis, arthritis, allergies), inflammatory (gastrointestinal/urinary diseases) and mental health disorders.The hormonal treatment of endometriosis aims to block of menstruation through an inhibition of hypothalamus-pituitary-ovary axis or by causing a pseudodecidualization with consequent amenorrhea, impairing the progression of endometriotic implants. GnRH agonists and antagonists are effective on endometriosis by acting on pituitary-ovarian function. Progestins are mostly used for long term treatments (dienogest, NETA, MPA) and act on multiple sites of action. Combined oral contraceptives are also used for reducing endometriosis symptoms by inhibiting ovarian function. Clinical trials are currently going on selective progesterone receptor modulators, selective estrogen receptor modulators and aromatase inhibitors. Nowadays, all these hormonal drugs are considered the first-line treatment for women with endometriosis to improve their symptoms, to postpone surgery or to prevent post-surgical disease recurrence. This review aims to provide a comprehensive state-of-the-art on the current and future hormonal treatments for endometriosis, exploring the endocrine background of the disease.

scholarly journals Incident Type 2 Diabetes Risk of Selective Estrogen Receptor Modulators in Female Patients with Breast Cancer

2021 ◽  
Vol 14 (9) ◽  
pp. 925
Author(s):  
Yeo-Jin Choi ◽  
Keunhyeong Bak ◽  
Yoon Yeo ◽  
Yongwon Choi ◽  
Sooyoung Shin
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Metastatic Cancer ◽  
Selective Estrogen Receptor Modulators ◽  
Diabetes Risk ◽  
Incident Diabetes ◽  
Estrogen Receptor Modulators ◽  
Increase Diabetes Risk ◽  
Receptor Modulators

Accumulating evidence indicates a link between diabetes and cancer. Selective estrogen receptor modulators (SERMs) may increase diabetes risk via antiestrogen effects. This study investigated incident diabetes risk of SERM treatment and its effects on metastatic cancer and death prevention in breast cancer survivors. This retrospective cohort study included female patients with early-stage breast cancer, treated with or without SERMs, between 2008 and 2020 in a tertiary care hospital in Korea. Four propensity score-matched comparison pairs were designed: SERM use versus non-use, long-term use (≥1500 days) versus non-use, tamoxifen use versus non-use, and toremifene use versus non-use; then, logistic regression analysis was performed for risk analysis. SERMs in general were not associated with an elevated risk of diabetes; however, when used for ≥1500 days, SERMs—especially toremifene—substantially increased diabetes risk in breast cancer patients (OR 1.63, p = 0.048). Meanwhile, long-term SERM treatment was effective at preventing metastatic cancer (OR 0.20, p < 0.001) and death (OR 0.13, p < 0.001). SERM treatment, albeit generally safe and effective, may increase diabetes risk with its long-term use in women with breast cancer. Further studies are required to verify the association between toremifene treatment and incident diabetes.

scholarly journals Selective Estrogen Receptor Modulators: A Potential Option For Non-Binary Gender-Affirming Hormonal Care?

2021 ◽  
Vol 12 ◽  
Author(s):  
Jane Y. Xu ◽  
Michele A. O’Connell ◽  
Lauren Notini ◽  
Ada S. Cheung ◽  
Sav Zwickl ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Treatment Guidelines ◽  
Hormonal Treatment ◽  
Selective Estrogen Receptor Modulators ◽  
Sex Characteristics ◽  
Estrogen Receptor Modulators ◽  
Gender Diverse ◽  
Puberty Suppression ◽  
And Gender ◽  
Receptor Modulators

Gender dysphoria describes the distress associated with having a gender identity that differs from one’s birth-assigned sex. To relieve this distress, transgender, and gender diverse (henceforth, trans) individuals commonly undergo medical transition involving hormonal treatments. Current hormonal treatment guidelines cater almost exclusively for those who wish to transition from male to female or vice versa. In contrast, there is a dearth of hormonal options for those trans individuals who identify as non-binary and seek an androgynous appearance that is neither overtly male nor female. Though prolonged puberty suppression with gonadotrophin releasing hormone agonists (GnRHa) could in theory be gender-affirming by preventing the development of unwanted secondary sex characteristics, this treatment option would be limited to pre- or peri-pubertal adolescents and likely have harmful effects. Here, we discuss the theoretical use of Selective Estrogen Receptor Modulators (SERMs) for non-binary people assigned male at birth (AMAB) who are seeking an androgynous appearance through partial feminization without breast growth. Given their unique range of pharmacodynamic effects, SERMs may represent a potential gender-affirming treatment for this population, but there is a lack of knowledge regarding their use and potentially adverse effects in this context.

Selective estrogen receptor modulators (SERMs) in postmenopausal women's health

2000 ◽  
Vol 8 (3) ◽  
pp. 215-228 ◽  
Author(s):  
DW Purdie ◽  
P Albertazzi
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement ◽  
Term Treatment ◽  
Age Group ◽  
Estrogen Receptor Modulators ◽  
Long Term Treatment ◽  
Prevention Of Osteoporosis ◽  
The Uk ◽  
Receptor Modulators

Over the past ten years mortality for breast cancer in the UK has been falling. The decrement has been more substantial in the 20 to 69 age group, which has seen a 22% decrease, while in the 70 to 79 age group the decrease has been milder at 12%. The incidence of the disease, however, is increasing and many women have a relative or friend with a disease that they perceive to be extremely mutilating. Fear of breast cancer is such among women that it is mistakenly viewed as the most common cause of death in females. Postmenopausal hormone replacement therapy (HRT) has many benefits and is particularly effective in the prevention of osteoporosis. But, to obtain this effect, HRT has to be continued for many years and long-term treatment has been shown to slightly increase the risk of breast cancer. This fact forcefully stimulated the imagination of both press and public alike.

NCCN Bone Health Task Force: Key Recommendations

2014 ◽  
Vol 12 (5S) ◽  
pp. 813-816 ◽  
Author(s):  
Azeez Farooki
Keyword(s):  
Bone Health ◽  
Task Force ◽  
Standard Of Care ◽  
Bisphosphonate Therapy ◽  
Annual Conference ◽  
Estrogen Receptor Modulators ◽  
Antiresorptive Agents ◽  
Safety Considerations ◽  
Receptor Modulators

For patients with advanced cancers involving bone, the standard of care for maintaining bone health is the use of antiresorptive therapies such as bisphosphonates, selective estrogen-receptor modulators, and denosumab. However, although long-term adverse events are rare and the risk-benefit ratio of these agents is usually markedly in favor of treatment, clinicians should be aware that they can occur. At the NCCN 19th Annual Conference, Dr. Azeez Farooki presented the key findings of the NCCN Bone Health Task Force, focusing on such topics as screening for osteoporosis; the controversial use of drug holidays from chronic bisphosphonate therapy; the provocative yet unclear story surrounding the potential anticancer benefits of antiresorptive agents; imaging for metastatic bone disease; and safety considerations linked to calcium supplements, vitamin D, and bone-strengthening agents.

INCREASED CHROMATIN ACID LABILITY AND ACTINOMYCIN-D BINDING IN ENDOMETRIAL CELLS UNDER THE ACTION OF SEX STEROIDS

1972 ◽  
Vol 52 (3) ◽  
pp. 525-531 ◽  
Author(s):  
F. LEROY ◽  
A. M. PREUMONT ◽  
P. GALAND ◽  
J. BRACHET
Keyword(s):  
Sex Steroids ◽  
Actinomycin D ◽  
Hormonal Treatment ◽  
Cell Types ◽  
Staining Intensity ◽  
Endometrial Cell ◽  
Feulgen Staining ◽  
Endometrial Cells ◽  
Curve Patterns ◽  
Hormonal Treatments

SUMMARY Modifications of chromatin activity, induced by sex steroids, were studied in rat endometrial tissues by the following semi-quantitative cytochemical methods: 'staining' of fixed uteri by [3H]actinomycin-D followed by radioautography and cytophotometric evaluation of Feulgen reaction kinetics in isolated endometrial nuclei. The following hormonal treatments were applied to groups of animals: oestradiol-17β (10 μg); progesterone (2 mg); progesterone (2 mg daily for 4 days) with oestradiol-17β (0·05 μg on the 4th day). With both cytochemical methods, different hormonal treatments were found to induce different patterns of response in endometrial cell types. In luminal epithelium and endometrial stroma, hormonal treatment increased the binding of actinomycin-D in a variable manner as judged from autoradiographic grain counts. Sex steroids also induced an overall increased DNA acid-lability as estimated by cytophotometric evaluation of Feulgen staining intensity. Hormonal treatments induced different hydrolysis curve patterns in both endometrial nuclear types.

Treatment of Menopause-Related Mood Disturbances

CNS Spectrums ◽  
2005 ◽  
Vol 10 (6) ◽  
pp. 489-497 ◽  
Author(s):  
Claudio N. Soares ◽  
Jennifer Prouty ◽  
Leslie Born ◽  
Meir Steiner
Keyword(s):  
Hormone Therapy ◽  
Hot Flashes ◽  
Menopausal Transition ◽  
Health Initiative ◽  
Estrogen Receptor Modulators ◽  
Increased Risk ◽  
Hormonal Fluctuations ◽  
Night Sweats ◽  
Receptor Modulators

AbstractMore than 1.7 million American women are expected to reach menopause each year. Recent Canadian statistics show that a 50-year-old woman can now expect to live until her mid-80s, which implies living at least one-third of her life after menopause. The menopausal transition is typically marked by intense hormonal fluctuations, accompanied by vasomotor symptoms (eg, hot flashes, night sweats), sleeps disturbance, and changes in sexual function, as well as increased risk for osteoporosis, cardiovascular disease, and cognitive decline. More importantly, recent studies have demonstrated a significant association between menopausal transition and a higher risk for developing depression. In the post-Women's Health Initiative Study era, physicians and patients are questioning the safety and efficacy of long-term hormone therapy use. This article reviews the current literature on the benefits and risks of using hormone therapy for the treatment of menopause-related mood disturbances and alternate strategies currently available for the management of menopause-related problems, including antidepressants, complementary and alternative medicine, and selective estrogen receptor modulators.

Menopause and psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. S46-S46
Author(s):  
J. Usall ◽  
E. Huerta-Ramos
Keyword(s):  
Clinical Trials ◽  
Postmenopausal Women ◽  
Negative Symptoms ◽  
Late Onset ◽  
Preventive Treatment ◽  
Estrogen Receptor Modulators ◽  
Competing Interest ◽  
Receptor Modulators ◽  
Better Than

There has been little research into the effects of menopause on symptoms, social and cognitive functioning in women with schizophrenia, and the results are controversial. The most replicated finding is that late-onset schizophrenia is more prevalent in women than in men and that this fact appears to be related to the diminution of estrogen levels during menopause.Estrogens have a known protective effect on CNS. Animal research has shown that estrogen has a modulating effect on the dopaminergic, glutamatergic and serotonergic systems.There are concerns about long-term use of sexual hormone therapy in postmenopausal women with regard to breast cancer risk, and the use of the selective estrogen receptor modulators (SERMS's) can be a better option.Raloxifene is a SERM that is used in the preventive treatment of postmenopausal osteoporosis and has no effect in the breast and uterus. A number of studies seem to indicate that raloxifene acts on brain dopamine and serotonin systems in a similar way to conjugated estrogens.In this presentation, I will show the results of some clinical trials that have studied the efficacy of raloxifene as a coadjuvant treatment of patients with schizophrenia. Our team has done two clinical trials that studied the efficacy of 60 mg of raloxifene for the treatment of negative symptoms in postmenopausal women with schizophrenia. Our results showed that raloxifene improved the negative symptoms better than placebo. We concluded that raloxifene seems to be a promising option to treat some patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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