Here, we review evidence in rodents and humans on the role of estrogens and their receptors in regulating metabolic homeostasis in health and disease. To address this growing problem, improved understanding of how estrogens contribute to energy balance and glucose homeostasis promises to yield novel therapeutic applications for an increasingly large segment of the female population. Thus, the contribution of estrogen deficiency in the pathobiology of multiple chronic diseases in women is emerging as a new therapeutic challenge of the 21st century. Apart from degenerative diseases of the cardiovascular, skeletal, and central nervous systems, estrogen deficiency enhances metabolic dysfunction predisposing to obesity, the metabolic syndrome, type 2 diabetes, and certain cancers (eg, breast and colon, and hepatocellular carcinoma) ( 6, 7). As a result of dramatic increases in life expectancy in developed countries, many women will spend the second half of their lives in a state of estrogen deficiency. In fact, current scientific evidence suggests that among symptomatic menopausal women younger than age 60 or within 10 years of menopause, the benefits of HRT outweigh the risks ( 5). However, the overall conclusions from the WHI do not apply to most menopausal women who initiate HRT in their 50s. Results of the WHI led many women and their physicians to overestimate the individual-level risk associated with HRT use.
Notably, this ambitious study focused on clinical events and did not consider outcomes associated with symptom relief among participants.
#Debra schwartz r.n. dallas tx trial
The WHI was a large clinical trial in postmenopausal women that tested whether HRT could prevent age-related health problems like cardiovascular disease and osteoporosis. It was not until the Women's Health Initiative (WHI) was abruptly halted in 2002 as a result of a link between HRT and increased risk of coronary heart disease events, stroke, and breast cancer that the health benefits of HRT were seriously questioned ( 4). This led to the addition of progesterone for treatment among women with an intact uterus ( 2, 3). The widespread enthusiasm for estrogen replacement therapy experienced its first hesitation in the 1970s when it was linked to uterine cancer. In 1995, approximately 38% of postmenopausal women in the United States used hormone replacement therapy (HRT), consisting of estrogen with or without progestin, to treat symptoms of menopause and to prevent chronic conditions such as cardiovascular disease, osteoporosis, and Alzheimer's disease ( 1).
In the following decades, exogenous estrogen acquired the reputation as an antidote to a variety of health-related consequences of aging in a number of different tissues. In 1941, estrogen products were approved by the US Food and Drug Administration as a hormone supplement to treat postmenopausal symptoms. Contribution of Sex Hormones to Metabolic Diseases
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