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Steroids arriving from the gonads via the circulation modulate brain function, affecting gender differentiation and sexually differentiated behavioral responses, but also the ability of the brain to process, store and retrieve sensory information. Androgens play a pivotal neuroactive role during the “organizational/developmental” phase, mainly in the fetal–neonatal period, when participated to the...
Quality of life (QOL) is generally not precisely defined or measured. This has resulted in confusing and often misleading conclusions in multiple publications, including those coming from both the HERS and the WHI writing groups. Health-related QOL and global QOL are accurately defined, and current instruments for measuring them are available. In the continuing effort to determine the true risks and...
The World Health Organization (WHO) classified oestrogens as carcinogenic in humans. One of the main arguments has been that oestrogens not only can promote cancers but also may initiate mutations caused by certain oestrogen metabolites. Indeed there is evidence that they can have biological properties even at very low concentrations which can exceed manifold those of their parent substance. Highly...
In a series of studies we showed that menopause in women causes alterations not only in the neuronal expression of estrogen receptors (ER) α and β, but also in local estrogen production in several brain areas and in the rate of neuronal metabolism. Although such changes are clearly brain region-specific, there seems to be no evidence at present for a decrease in neuronal metabolic rate. On the contrary,...
The trends in postmenopausal hormonal therapy (HT) seem to favor the non-oral delivery routes for both the estrogen and the progestin for women with an intact uterus. Targeting the lowest possible dose of the progestin or of the natural hormone progesterone to be delivered directly to the uterus, the target organ for which it is designed, would avoid the possible drawbacks of systemic effects of progestins...
This article follows the milestones in the history of postmenopausal hormone treatment, with a look into the future. In the first era, hormones were regarded as an anti-aging panacea, the fountain of eternal youth. It was recommended then that every postmenopausal woman should consider the use of hormone replacement therapy. In the second era, people realized that hormones are medications, and as...
Although much attention has been given to measuring the risks associated with menopausal hormone therapy (HT), decisions about HT should be guided largely by individual patient preferences and values. Because the magnitude of the risks associated with HT for healthy 50-year-old women are exceedingly small (typically <1 in 1000) and its impact on survival are negligible, patient preferences and...
From early embryonic life to death, estrogen is a primary regulator of brain neurogenesis and cell number, synaptogenesis and synaptolysis, multiple cognitive and autonomic functions, vascular function, immune responses and defense measures against brain lesions and dystrophy. Although recent attention has focused on the roles of estrogen during the climacteric, knowing estrogen's role in brain development...
There is evidence that suggests that androgen might play an important role in different tissues and in modulating sexual response. In women of reproductive age the most important source of androgens present in the blood is the ovary. Androgens complement the contribution of adrenal precursors, which in peripheral organs and target tissue can be transformed into bioactive androgens. The human brain...
Tibolone has been widely accepted as remedy for vasomotor symptoms and for prevention of bone loss. Studies over the past 25 years have documented its effects on bone mineral density in younger and older women. Tibolone reduces bone turnover substantially (about the same amount as hormone therapy). Increases in bone mineral density (BMD) accompany this reduction in bone turnover, but like all other...
Epidemiological studies provide a valuable tool for the investigation of the causes of disease. However, such studies alone are rarely able to prove cause. No study is perfect and the evaluation of results must take account of the design and execution of the study together with the analytic methods used. Before imputing cause it is important to consider the findings against the criteria set out by...
Complex correlations between women's sexual function and psychosexual variables confound the identification of any etiological role for estrogen and androgen deficiencies in sexual dysfunction. Although serum levels of androgens show minimal correlation with women's sexual function, the intracellular production of testosterone from adrenal and ovarian precursors may be relevant. Current research involves...
Increasing numbers of women are requesting non-hormonal treatments for menopausal symptoms. Estrogen-containing HRT is the most effective treatment for menopausal symptoms in healthy women but is contraindicated for some women and avoided by many others. This review will assess the evidence regarding the safety and efficacy of non-hormonal treatments for menopausal symptoms. Relatively few high quality...
Lifestyle changes, such as exercise, might reduce the risk of breast cancer. Tamoxifen and raloxifene reduce the risk of breast cancer but have potential adverse effects and, therefore, should be considered by women at high risk of breast cancer. Breast density is a strong risk factor for breast cancer; assessment of breast density can be combined with risk factors to estimate a woman's risk of breast...
Estrogen exerts a primary regulatory role on a wide variety of physiological processes in different tissues and organs. Agonistic ad antagonistic compounds are widely used in human health and, therefore, a deep understanding of their mechanisms of action at the molecular level is mandatory. The effect of 17β-estradiol and three antiestrogenic drugs, comprising two selective estrogen receptor modulator...
The timely publication of accurate and unbiased results of research is necessary to ensure that the knowledge gained is effectively shared with both the scientific community and the public. The ability to publish will be dependent not only on the significance of the findings, but also on the editorial staff of the journal and the peer review process. The manner in which the peer review process can...
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