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1.
Rev. osteoporos. metab. miner. (Internet) ; 15(4): 144-153, oct.-dic. 2023. graf
Artigo em Inglês, Espanhol | IBECS | ID: ibc-229299

RESUMO

El hueso es un tejido dinámico, que se encuentra en constante adaptación durante la vida de los vertebrados con el fin de alcanzar tamaño, forma, preservar la integridad estructural del esqueleto y regular la homeostasis mineral. Su desarrollo durante la infancia es determinante para alcanzar la estatura, así como la resistencia a fracturas en edad avanzada. Las hormonas sexuales juegan un papel importante en el remodelado óseo, tanto en hombres como en mujeres y las alteraciones en los perfiles hormonales pueden conducir al desarrollo de enfermedades asociadas con el metabolismo del hueso. En mujeres, la deficiencia de estrógenos durante la menopausia es una de las principales causas de osteoporosis, mientras que en hombres los andrógenos pueden influir en la salud ósea al unirse directamente a los receptores de andrógenos o indirectamente a receptores de estrógenos. En esta revisión se explora el papel y los efectos de las hormonas sexuales sobre el metabolismo óseo, las vías de señalización implicadas y los efectos que pueden conducir al desarrollo de enfermedades como la osteoporosis. (AU)


Bone is a dynamic tissue that undergoes constant adaptation throughout the life of vertebrates to achieve size, shape, preserve the structural integrity of the skeleton, and regulate mineral homeostasis. Bone growth during childhood is crucial to achieve height and resistance to fractures later in life. Sex hormones play a key role in bone remodeling in men and women alike, and changes to hormonal profiles can trigger bone metabolism-related diseases. In women, estrogen deficiency during menopause is one of the leading causes of osteoporosis, while in men, androgens can have an impact on bone health by binding directly to androgen receptors or indirectly to estrogen receptors. This review explores the role and effects of sex hormones on bone metabolism, the signaling pathways involved, and the effects that can trigger diseases such as osteoporosis. (AU)


Assuntos
Humanos , Masculino , Osteoporose/classificação , Osteoporose/prevenção & controle , Homeostase , Hormônios Esteroides Gonadais/fisiologia , Androgênios , Estrogênios , Testosterona
2.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 49(4): 100772-100772, Oct-Dic. 2022.
Artigo em Espanhol | IBECS | ID: ibc-211846

RESUMO

Introducción: El angioedema hereditario es una enfermedad genética rara que carece de tratamiento específico. Principales síntomas: Se caracteriza por la aparición recurrente de episodios de edema que afectan fundamentalmente a piel y mucosa. Diagnósticos principales: Existen tres tipos de angioedema hereditario, habiéndose relacionado el tipo III con situaciones que presentan niveles elevados de estrógenos. Intervenciones terapéuticas: Exponemos el caso de una paciente con angioedema hereditario tipo III, que presenta crisis de angioedema coinciciendo con el periodo periovulatorio y premenstrual. Ante dicha relación hormonal, se pautó terapia con gestágenos para intentar reducir el número de ovulaciones. Resultados: Tras varios meses en tratamiento con desogestrel la paciente refiere disminución del número y gravedad de las crisis. Conclusión: La terapia con gestágenos parece resultar útil en el control de los episodios de angioedema hereditario tipo III.(AU)


Introduction: Hereditary angioedema is a rare genetic disease without any specific treatment. Main symptoms: It is characterized by recurrent episodes of skin and mucous oedema. Main diagnoses: There are three types of angioedema and type III has been related to high-level oestrogen conditions. Therapeutic interventions: We describe the case of a patient with hereditary angioedema type III, who had an episode of angioedema associated with the periovulatory and premenstrual period. Due to this hormonal influence, we used gestagen therapy to attempt to reduce the number of ovulations. Results: After several months of treatment with desogestrel, the patient reports a decrease in the number and severity of episodes. Conclusion: Gestagen therapy seems to be useful for controlling episodes of hereditary angioedema type III.(AU)


Assuntos
Humanos , Feminino , Adulto Jovem , Angioedemas Hereditários , Estrogênios , Angioedema Hereditário Tipo III , Pacientes Internados , Exame Físico , Ginecologia , Alergia e Imunologia , Obstetrícia
3.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 49(3): 100755, Jul - Sep 2022.
Artigo em Espanhol | IBECS | ID: ibc-205913

RESUMO

El objetivo de este artículo ha sido el de analizar las evidencias disponibles sobre la eficacia y la seguridad de un nuevo anticonceptivo oral que contiene estetrol (E4) y drospirenona (DRSP). Para ellos se ha efectuado una revisión de la literatura que ha incluido los estudios publicados sobre esta nueva formulación anticonceptiva. Los ensayos clínicos en fase 2 y fase 3 realizados han puesto de manifiesto que la combinación E4 15mg/DRSP 3mg es eficaz para evitar el embarazo, es bien aceptada por las mujeres y no produce cambios de significado clínico en los parámetros de la coagulación. Para confirmar los resultados obtenidos en los ensayos en fase 2 y 3, es necesario un estudio en fase 4 que ponga de manifiesto el comportamiento de este nuevo anticonceptivo en la vida real.(AU)


The objective of this article was to analyse the available evidence on the efficacy and safety of a new oral contraceptive containing estetrol (E4) and drospirenone (DRSP). We conducted a literature review that included published studies on this new contraceptive formulation. Phase 2 and phase 3 clinical trials have shown that the E4 15mg/DRSP 3mg combination is effective in preventing pregnancy, is well accepted by women, and does not produce clinically significant changes in coagulation parameters. To confirm the results obtained in phase 2 and 3 trials, a phase 4 study is necessary to reveal the behaviour of this new contraceptive in real life.(AU)


Assuntos
Estrogênios , Anticoncepção , Etinilestradiol , Estetrol , Estradiol , Anticoncepcionais Orais , Eficácia , Ginecologia , Obstetrícia , Ensaios Clínicos Fase I como Assunto
4.
J. physiol. biochem ; 78(1): 125-137, feb. 2022.
Artigo em Inglês | IBECS | ID: ibc-215878

RESUMO

Hepatic ischemia reperfusion injury (IRI) occurs in liver transplantation, complex liver resection, and hemorrhagic shock, which causes donor organ shortage and hepatic damage. The burst of reactive oxygen species (ROS) during reperfusion leads to cell apoptosis and necroptosis. It has been reported that estrogen could attenuate hepatic IRI. G protein estrogen receptor (GPER) mediates estrogen effects via nonclassic receptor systems. Here, we investigate whether estrogen protecting liver from hepatic IRI depends on GPER and the influence of GPER activation on hepatocyte necroptosis. We proved that estrogen had a protective effect on both hepatocyte hypoxia re-oxygen (H/R) challenge and mouse hepatic ischemia reperfusion model. However, the application of GPER specific antagonist G15 before estrogen inhibited this beneficial effect. The results of mitochondria functional measurement revealed that estrogen improved hepatocyte mitochondria function by activating GPER, which might benefit from the increased expression of connexin 43 (Cx43) in mitochondria. To investigate the relationship between GPER activation and necroptosis, we used caspase-3/7 inhibitor benzyloxycarbonyl-Asp(OMe)-Glu(OMe)-Val-Asp(OMe)-chloromethylketone (Z-DEVD-FMK) to eliminate the interference of apoptosis. Estrogen showed a protective effect on hepatic IRI after using Z-DEVD-FMK, which could be suppressed by G15. GPER activation decreased the level of receptor interacting protein kinase (RIPK) 3, phosphorylated (p-) RIPK1, and p-mixed lineage kinase domain-like (MLKL). The co-immunoprecipitation result indicated that GPER could bind with RIPK3. GPER is indispensable in estrogen protecting liver from IRI. GPER activation attenuates hepatocyte necroptosis by decreasing the level of RIPK3, p-RIPK1, and p-MLKL. (AU)


Assuntos
Animais , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/prevenção & controle , Fígado/metabolismo , Receptores de Estrogênio/metabolismo , Estrogênios , Proteínas de Ligação ao GTP/metabolismo , Hepatócitos/metabolismo
5.
Gac. sanit. (Barc., Ed. impr.) ; 35(supl. 2): S251-S253, 2021. tab
Artigo em Inglês | IBECS | ID: ibc-220952

RESUMO

Objective: This study was aimed to determine the effect of ginger honey supplementation on cortisol, glutathione, and estrogen levels. The study was conducted on mice that had not yet experienced conception, and prior stress induction was carried out so that they could be continued for human trials at the preconception stage and subjects who experienced mild stress. Method: It was an in vivo study, pretest–posttest control group design. The sample of this study was 2–3 months female Balb/c mice, divided into negative control and ginger honey intervention as much as 28 mg/20 g BW for 14 days—the ELISA method used to examine cortisol hormone, glutathione levels, and estrogen levels. The mice chosen were those that had never experienced conception, and before the intervention, swimming activities were carried out on the mice until they showed symptoms of stress. Results: Results show 42 mg/20 g BW of ginger honey administration for 14 days increased 1.892 ng/dl of cortisol (p = 0.165), increased 2.438 ng/dl of glutathione (p = 0.002), and also increased 22.754 ng/ml estrogen levels in induced stress Balb/c female mice (p = 0.001). Conclusion: Ginger honey did not affect reducing cortisol levels but increasing glutathione and estrogen levels significantly. Ginger honey supplements are the potential to use as complementary therapies. (AU)


Assuntos
Humanos , Animais , Feminino , Camundongos , Glutationa/sangue , Gengibre , Mel , Hidrocortisona/sangue , Estrogênios/sangue , Camundongos Endogâmicos BALB C
6.
Gac. sanit. (Barc., Ed. impr.) ; 35(supl. 2): S571-S575, 2021. tab
Artigo em Inglês | IBECS | ID: ibc-221154

RESUMO

Objective: PMS symptoms can include anxiety, quick temper, excessive strain on the breasts, increased or decreased appetite, nausea, vomiting, acne, low back pain, to faint. This study aimed to determine the effect of estrogen hormone in Adolescent Girls who experienced premenstrual syndrome at Darul Arqam, Makassar. Methods: The research design used the cross-sectional approach using the purposive sampling technique to get the samples of female teenagers who had PMS and another 25 samples of female teenagers who did not have PMS. The respondent who had experienced PMS filled in the daily diary sheets, did the blood taking of five ccs and underwent the examination of estrogen level using ELISA method. The study was conducted for three months, and the data were analyzed using the Mann–Whitney U test. Result: The research result indicated that the mean value of estrogen hormone in adolescent girls who experienced PMS was 148.32 pg/ml higher than the female teenagers who did not experience PMS of 98.00 pg/ml. The analysis result indicated that Ha was accepted, and H0 was rejected since the mean value in PMS teenagers was higher compared to the non-PMS teenagers with the value of p = 0.000 < α = 0.05. This result showed a significant effect of estrogen hormone in adolescent girls who experienced PMS compared to those who did not experience PMS. The adolescent girls who experience mild PMS with the mean value of estrogen hormone were 130.73 pg/dl, while those who experienced severe PMS of 162.14 pg/ml. Conclusion: It was found that the value of p = 0.000 < α = 0.05, which indicated that there was a significant effect of the levels of estrogen hormone between the non-PMS, mild PMS, and severe PMS. (AU)


Assuntos
Humanos , Feminino , Adolescente , Síndrome Pré-Menstrual/epidemiologia , Estrogênios , Indonésia , Inquéritos e Questionários , Ansiedade , Estatísticas não Paramétricas , Estudos Transversais
7.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(4): 151-156, oct.-dic. 2020. ilus
Artigo em Inglês | IBECS | ID: ibc-201068

RESUMO

Female transgender (male to female) is an individual assigned male sex at birth born but who identifies itself and desires to live as female. To achieve and maintain these characteristics, sometimes, it is necessary to undergo hormone therapy and/or surgical treatment. Benign lesions have been described including: fibroadenoma, lobular hyperplasia, pseudoangiomatous stromal hyperplasia, myofibroblastoma, angiolipoma and benign prosthesic reactions. And malignant pathology such as: ductal carcinoma in situ, Paget's disease, infiltrating carcinoma of non-special type (ductal, NOS), secretory adenocarcinoma, malignant phyllodes tumor and breast implant associated anaplastic large cell lymphoma. The described cases of each of these entities are reviewed. In conclusion, hormonal action or prosthesis implantation in female transgender can lead to associated pathologies in the mammary gland that follow a similar pattern to that found in the male breast. Although breast cancer is less frequent than in cisgender women, gynecological control or screening is recommended by some associations


La mujer transgénero (hombre a mujer) es aquella persona nacida varón pero que se identifica y desea vivir como una mujer. Para lograr este objetivo muchas veces precisa de tratamiento hormonal o quirúrgico para alcanzar los atributos sexuales de una mujer. La patología mamaria que estos pacientes pueden presentar es superponible a la patología de la mama masculina, a la patología derivada del tratamiento hormonal y a la relacionada con los implantes mamarios sintéticos. Se han descrito lesiones benignas que incluyen: fibroadenoma, hiperplasia lobulillar, hiperplasia estromal seudoangiomatosa, miofibroblastoma, angiolipoma y reacciones benignas a la prótesis. Y patología maligna como: carcinoma ductal in situ, enfermedad de Paget, carcinoma infiltrante de tipo no especial (ductal, NOS), adenocarcinoma secretor, tumor filoides maligno y linfoma anaplásico de célula grande asociado a prótesis. Se revisan los casos descritos de cada una de estas entidades. En conclusión, la acción hormonal o la implantación de prótesis en las mujeres transgénero pueden llevar asociadas patologías en la glándula mamaria que siguen un patrón similar al de la patología encontrada en la mama del varón. Aunque el cáncer de mama es menos frecuente que en las mujeres cisgénicas, se recomienda un control ginecológico o mediante cribado igual al de estas


Assuntos
Humanos , Feminino , Transexualidade , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Pessoas Transgênero/estatística & dados numéricos , Procedimentos de Readequação Sexual/estatística & dados numéricos , Implantes de Mama/estatística & dados numéricos , Estrogênios/farmacocinética
8.
Acta pediatr. esp ; 78(3/4): e114-e117, mar.-abr. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-202681

RESUMO

La disgenesia gonadal completa 46 XY (46, XY CGD) es un trastorno del desarrollo sexual. Se caracteriza por el cariotipo 46 XY, genitales externos femeninos normales, presencia de estructuras müllerianas y gónadas sin desarrollar. Es un síndrome infrecuente, cuyos pacientes tienen un fenotipo femenino normal y una talla normal o alta, por lo que se diagnostican por retraso puberal o amenorrea primaria. La mayoría de los pacientes con 46, XY CGD muestran un gen SRY normal. Asociado a la presencia de un cromosoma Y, existe un riesgo marcado de tumores gonadales, especialmente después de la pubertad. El gonadoblastoma es el tumor más frecuente y tiene un alto riesgo de malignización hacia disgerminoma. Presentamos el caso de una niña que consulta a los 8 años de edad por talla baja. A la exploración la paciente presenta un fenotipo femenino normal, genitales externos femeninos, con estadio de Tanner I, peso de 21,6 kg (DE -1,43) y talla de 115,4 cm (DE -3,1). El laboratorio reveló test de estimulación con gonadotropina coriónica humana sin respuesta de testosterona y hormona antimülleriana <1 pmol/L. El cariotipo en sangre periférica es informado como 46 XY, con presencia del gen SRY. La resonancia magnética abdominal mostró la presencia de vagina, útero hipoplásico y ausencia de gónadas. Se realiza gonadectomía bilateral laparoscópica. El análisis anatomopatológico confirmó la presencia de gonadoblastoma puro bilateral de ovarios. Los hallazgos permiten confirmar el diagnóstico de 46, XY CGD. La novedad del caso radica en su baja frecuencia de aparición, la edad del diagnóstico y la presentación con una talla baja


Complete gonadal dysgenesis 46 XY (46, XY CGD) is a disorder of sexual development. It is characterized by 46 XY karyotype, normal female external genitalia, presence of Müllerian structures, and undeveloped gonads. It is a rare syndrome, in which patients have normal female phenotype, with normal or increased height, diagnosed by delayed pubertal or primary amenorrhea. The majority of patients with 46, XY CGD show a normal SRY gene. In gonadal dysgenesis associated with the presence of a Y chromosome there is a marked risk of gonadal tumors, especially after puberty. Gonadoblastoma is the most frequent tumor. It has a high risk of malignancy towards dysgerminoma. We present the case of a girl who consulted at age 8 years for short stature. On physical exam, the patient presented normal female phenotype, female external genitalia, with Tanner stage 1. Weight: 21,6 kg (sds -1,43); height: 115,4 cm (sds -3,1). Laboratory tests revealed stimulation test with HCG, did not show testosterone response, antimüllerian hormone <1 pmol/L. Karyotype in peripheral blood showed 46 XY. Genetic analysis of the SRY gene was extended and no deletions were detected. Abdominal MRI showed a normal vagina, hypoplastic uterus and confirmed the absence of gonads. Exploratory laparoscopy was performed. The anatomopathological analysis confirmed the presence of pure bilateral ovarian gonadoblastoma. Thus, the diagnosis of 46, XY CGD was confirmed. The novelty of this case lies in the rarity of the pathology as well as the clinical picture. Diagnosis before puberty as well as short stature are rare in the context of 46, XY CGD


Assuntos
Humanos , Feminino , Criança , Disgenesia Gonadal 46 XY/diagnóstico , Disgenesia Gonadal 46 XY/terapia , Disgenesia Gonadal 46 XY/cirurgia , Disgenesia Gonadal 46 XY/genética , Castração , Hormônio do Crescimento Humano/uso terapêutico , Progestinas/uso terapêutico , Estrogênios/uso terapêutico , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/genética
9.
Allergol. immunopatol ; 47(5): 506-512, sept.-oct. 2019. graf
Artigo em Inglês | IBECS | ID: ibc-186526

RESUMO

Hypersensitivity occurs when the body is stimulated by an antigen, resulting in an immune response, and leads to a physiological disorder or abnormal tissue trauma. Various immune cells, cytokines, and inflammatory mediators are involved in the immune responses related to allergic diseases, which are the core of anaphylaxis. Estrogen receptors are widely distributed in immune cells, which combine with estrogen and participate in allergic responses by affecting immune cells, cytokines, and inflammatory factors. We aimed to summarize the association between estrogen and allergic reactions to provide a scientific basis for understanding and studying the mechanisms of allergic diseases


No disponible


Assuntos
Humanos , Animais , Anafilaxia/metabolismo , Estrogênios/metabolismo , Hipersensibilidade/imunologia , Mastócitos/imunologia , Receptores de Estrogênio/metabolismo , Células Th2/imunologia , Citocinas/metabolismo , Imunidade Celular , Mediadores da Inflamação/metabolismo , Transdução de Sinais
10.
Prog. obstet. ginecol. (Ed. impr.) ; 62(2): 141-148, mar.-abr. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184909

RESUMO

El síndrome genitourinario de la menopausia (SGM) se definió para sustituir al término "atrofia vulvovaginal" como el conjunto de signos y síntomas genitourinarios asociados a la disminución de estrógenos. La primera línea de tratamiento para las manifestaciones vaginales del SGM son los hidratantes (evidencia IA) y lubricantes vaginales (evidencia IIB). Cuando estas medidas no son suficientes, o en casos moderados o intensos, el tratamiento de elección son los estrógenos locales (evidencia IA). Si coexisten síntomas vasomotores que afectan la calidad de vida, la indicación es el tratamiento hormonal sistémico (evidencia IA). Actualmente, se dispone de ospemifeno (evidencia IA), un modulador selectivo de los receptores vaginales de estrógenos (SERM), aprobado en Europa para el tratamiento de los síntomas moderados o graves en mujeres postmenopáusicas que no cumplen los requisitos para recibir estrógenos vaginales. Otros posibles tratamientos del SGM son el láser y la radiofrecuencia. No hay evidencia para indicar el uso de terapias alternativas y complementarias


Genitourinary syndrome of menopause (GSM) was defined to substitute the term "vaginal atrophy" as the signs and symptoms related to reduced circulating oestrogen levels. Vaginal moisturizers (evidence IA) and vaginal lubricants (evidence IIB) are the first-line treatments. If these measures are unsatisfactory, the choice treatment is local oestrogen therapy (evidence IA). In patients with vasomotor symptoms that impair quality of life, systemic hormone replacement therapy (evidence IA) is administered. Currently, a new therapy is available: ospemifene, a selective oestrogen receptor modulator that acts at vaginal level. It is approved in Europe for the treatment of moderate to severe symptoms in postmenopausal women who are not candidate to local oestrogen therapy. Ospemifene improves vaginal histology and physiology, and it has been safe and well tolerated both in clinical trials and in post-marketing surveillance studies. Other therapies for GSM are laser therapy and radiofrequency. Alternative therapies are not recommended


Assuntos
Humanos , Feminino , Vaginite Atrófica/prevenção & controle , Lubrificantes/uso terapêutico , Estrogênios/administração & dosagem , Agentes Molhantes/administração & dosagem , Menopausa , Doenças Urogenitais Femininas/prevenção & controle , Padrões de Prática Médica , Terapia de Reposição de Estrogênios
11.
Hipertens. riesgo vasc ; 35(2): 77-83, abr.-jun. 2018. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-172220

RESUMO

La hipertensión arterial es el mayor factor de riesgo de muerte cardiovascular, afectando al 25% de las mujeres. Los cambios hormonales y la hipertensión arterial tras la menopáusica pueden conducir a mayor daño de órgano blanco y enfermedad cardiovascular, como el incremento de la rigidez arterial, la enfermedad coronaria, la insuficiencia cardíaca crónica y el accidente cerebrovascular. Los mecanismos fisiopatológicos involucrados en el desarrollo de la hipertensión arterial y la enfermedad vascular en la mujer menopáusica son controvertidos. Existen diferencias farmacodinámicas y farmacocinéticas en ambos sexos, la mujer presenta más tos ante los inhibidores de enzima de conversión, más calambres ante los diuréticos tiazídicos y más edema en miembros inferiores con los antagonistas cálcicos. El objetivo de esta revisión es analizar los posibles mecanismos fisiopatológicos involucrados en la hipertensión arterial después de la menopausia y una mayor comprensión de los efectos biológicos que median el envejecimiento vascular en mujeres con la pérdida de los efectos protectores de los estrógenos sobre el sistema vascular (AU)


Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Menopausa , Hipertensão/diagnóstico , Doenças Cardiovasculares/complicações , Fatores de Risco , Insuficiência Cardíaca/complicações , Hipertensão/complicações , Hipertensão/etiologia , Doença das Coronárias/complicações , Acidente Vascular Cerebral/epidemiologia , Hipertensão/fisiopatologia , Estrogênios/uso terapêutico , Pós-Menopausa , Anti-Hipertensivos/uso terapêutico
12.
Prog. obstet. ginecol. (Ed. impr.) ; 61(3): 230-234, mayo-jun. 2018.
Artigo em Inglês | IBECS | ID: ibc-174957

RESUMO

According to the latest data from the medical literature, the Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia [AEEM]) has brought together a group of experts to re-evaluate the use of menopausal hormone therapy so that women can make an informed, evidence-based decision to determine the most appropriate dose, formulation, route of administration, and duration of menopausal hormone therapy. There is some disagreement between scientific evidence on the efficacy and safety of menopausal hormone therapy and how this evidence is perceived by menopausal women and the clinicians who care for them, leading to an unnecessary loss of quality of life in those who reject it or in the unjustified fear of those who choose to use it. A critical review of the most recent available literature was conducted. The review mainly covered randomized clinical trials and epidemiological studies published since January 2015. This paper reviews clinical trials published since then, as well as new information on the potential risks and benefits of HT for the treatment of menopausal symptoms. Decisions about menopausal hormone therapy should be based on a woman’s specific health risks, age, and time since onset of the menopause, as well as on the goals of therapy. The Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia) and the Spanish Society of Gynecology and Obstetrics (Sociedad Española de Ginecología y Obstetricia) updated their position statement on menopausal hormone therapy. This statement updates the clinical practice guidelines on the menopause


Conocidos los últimos datos de la literatura médica, la Asociación Española para el Estudio de la Menopausia ha reunido a un grupobde expertos para reevaluar el uso de la terapia hormonal de la menopausia con el fin de adoptar una decisión informada, basada en la evidencia que determina el tipo más apropiado de dosis, formulación, vía de administración y duración del uso de la terapia hormonal de la menopausia. Existe una discordancia entre las evidencias de carácter científico, sobre la eficacia y la seguridad de la terapia hormonal de la menopausia y la percepción que tienen de ello las mujeres que están en la menopausia y los médicos que las atienden, lo que redunda en una pérdida innecesaria de la calidad de vida en las que lo rechazan o en el temor injustificado de las que optan por su utilización. Se ha realizado una revisión crítica de la literatura disponible más reciente, fundamentalmente de ensayos clínicos aleatorizados y estudios epidemiológicos, publicados desde enero de 2015. El presente documento revisa los nuevos ensayos clínicos publicados desde entonces, así como nueva información sobre los posibles riesgos y beneficios de la terapia hormonal de la menopausia para el tratamiento de los síntomas de la menopausia. Las decisiones sobre la terapia hormonal de la menopausia deben basarse en los riesgos de salud específicos de cada mujer, la edad o el tiempo desde la menopausia y los objetivos de la terapia. La Asociación Española para el Estudio de la Menopausia y la Sociedad Española de Ginecología y Obstetricia actualizaron su posicionamiento con respecto a la terapia hormonal de la menopausia. Dicho posicionamiento de la Asociación Española para el Estudio de la Menopausia/Sociedad Española de Ginecología y Obstetricia actualiza las guías de práctica clínica de menopausia ya publicadas


Assuntos
Humanos , Terapia de Reposição de Estrogênios/métodos , Menopausa , Estrogênios/administração & dosagem , Padrões de Prática Médica/tendências , Segurança do Paciente/estatística & dados numéricos , Medição de Risco , Fogachos/tratamento farmacológico , Osteoporose Pós-Menopausa/prevenção & controle
13.
Rev. toxicol ; 34(2): 143-147, jul.-dic. 2017. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-169825

RESUMO

En este estudio se utilizaron los modelos Allen-Doisy y uterotrópico para estudiar la estrogenicidad de aceites de coco, hígado de bacalao, maíz, pepita de uva y de almendras, en ratas. En el ensayo Allen-Doisy, la actividad estrogénica fue evidenciada por cornificación del epitelio vaginal en ratas adultas ovariectomizadas a las que se administró 300 μl de aceite por tres días consecutivos y por vía subcutánea. La cornificación vaginal se estudió a través de observaciones microscópicas diarias de frotis vaginales. En el ensayo uterotrópico, la estrogenicidad fue evaluada por un incremento en el peso uterino en ratas de 18 días postnatales a las que se administró 300 μl de aceite, subcutaneo, por tres días consecutivos. En el día cuarto, los úteros fueron recolectados y pesados. En ambos ensayos se utilizaron controles negativos (sin tratamiento y suero fisiológico, 300 μl) y controles positivos (estradiol 50 μg/kg y bisfenol A 20 mg/kg). Tanto el aceite de almendras como el de maíz demostraron una respuesta estrogénica estadísticamente significativa, aunque con una potencia bastante menor a la del estradiol y bisfenol A, mientras que los aceites de coco, hígado de bacalao y pepita de uva no indujeron la respuesta. Proponemos que la estrogenicidad del aceite de almendras puede deberse a su contenido relativo en ácidos oleico y linoleico, mientras que la del aceite de maíz a su contenido de factores mitogénicos. El impacto potencial en humanos de estas respuestas en roedores debe ser investigado (AU)


Here we report the use of the Allen-Doisy and the uterotrophic assay in rats to study the estrogenicity of coconut, cod liver, corn, grapeseed and almond oil. In the Allen-Doisy assay, estrogenic activity was evidenced by vaginal epithelium cornification in adult female ovarioctemized rats which were subcutaneously administered 300 μl of oil for three consecutive days. Vaginal cornification was studied by daily observation under a microscope of vaginal smears. In the uterotrophic assay, estrogenicity was evaluated by the increase of uterine weight in 18 day rats administered 300 μl of oil subcutaneously for three consecutive days. On the fourth day, uteri were collected and weighed. An untreated group as well as a saline solution (300 μl subcutaneous) treatment group was included as negative controls while bisphenol A (20 mg/kg) and estradiol (50 􀈝g/kg) were used as positive control in both assays. Our data shows that both corn and almond oil have a strong and statistically significant estrogenic response in the assays although their potency was several orders of magnitude lower tan estradiol, while cod, coconut and grapeseed oils did not induce a response. The potential health impacts of estrogenic components in food oil deserve further attention (AU)


Assuntos
Animais , Ratos , Estrogênios/isolamento & purificação , Óleo de Milho/farmacocinética , Útero , Modelos Animais , Óleos de Plantas/farmacocinética , Prunus dulcis/toxicidade , Composição de Alimentos
16.
Med. clín (Ed. impr.) ; 147(7): 287-292, oct. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-156150

RESUMO

Fundamento y objetivo: El objetivo de este trabajo fue describir la evolución del consumo, la oferta y la prevalencia de uso del tratamiento hormonal sustitutivo (THS) en España durante el período 2000-2014. Métodos: La prevalencia de uso anual bruta en mujeres≥40 años se estimó a partir de datos individuales procedentes de las historias clínicas anonimizadas de la base de datos BIFAP. Para el cálculo del consumo se utilizaron datos agregados de dispensación. El consumo de THS se expresó en dosis diarias definidas dispensadas por cada 1.000 mujeres≥40 años y día (DHD). Resultados: En el año 2000 el consumo de THS fue de 33,12 DHD: estrógenos (19,81 DHD), tibolona (6,88 DHD) y estrógenos asociados a progestágenos (6,44 DHD). En 2014 el consumo de THS fue de 5,32 DHD: estrógenos (1,08 DHD), tibolona (1,61 DHD) y estrógenos combinados con progestágenos (2,62 DHD). Las presentaciones comercializadas se redujeron un 46,9%. La prevalencia de uso de THS en mujeres≥40 años registradas en la base de datos BIFAP ha pasado de un 7,19% (IC 95% 6,97-7,40) en el año 2001 a un 0,21% (IC 95% 0,20-0,22) en 2014. Las mujeres de 40-45 años registraron la mayor prevalencia de uso en 2014: 0,71% (IC 95% 0,66-0,76). Conclusiones: El consumo y la prevalencia de uso de THS ha descendido de manera notable a partir de la publicación de los estudios Women's Health Iniciative, Million Women Study y las medidas reguladoras, siguiendo una tendencia similar a la observada en otros países occidentales (AU)


Background and objective: The objective of the study was to describe the trends of utilization, supply and prevalence of hormone replacement therapy (HRT) in Spain during the period 2000-2014. Methods: Annual prevalence of HRT use including the 95% CI was calculated for women aged≥40 using individual data from the national population-based database BIFAP. Annual and total-period consumptions were expressed in defined daily doses (DDD) per 1,000 inhabitants per day and were obtained from the databases of medications dispensed in community pharmacies and charged through official prescriptions to the Spanish National Health System. Results: In the year 2000, overall HRT consumption was 33.12 DDDs/1000 inhabitans/day: 19.81 for oestrogen only, 6.88 for tibolone and 6.44 for combined oestrogen and progestagen. In 2014 overall HRT consumption was 5.32 DDDs/1000 inhabitans/day: 1.08 for oestrogen only, 1.61 for tibolone and 2.62 for combinations of oestrogen and progestagen. The marketed presentations of HRT decreased by 46.9%. Prevalence of HRT use in women aged≥40 in BIFAP was 7.19% (95% CI 6.97-7.40) in 2001 and 0.21% (95% CI 0.20-0.22) in 2014. Women aged 40-45 registered the highest prevalence of use in 2014: 0.71% (95% CI 0.66-0.76). Conclusions: A sharp decline in the consumption and prevalence of HRT has been observed in Spain since the publication of the Women's Health Initiative and Million Women Study and the regulatory measures taken restricting conditions of use, showing a similar trend to that of other western countries (AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Terapia de Reposição Hormonal , Menopausa , Osteoporose Pós-Menopausa/terapia , Progestinas/uso terapêutico , Antagonistas de Androgênios/uso terapêutico , Estrogênios/uso terapêutico , Norpregnanos/uso terapêutico , Padrões de Prática Médica/tendências , Terapia de Reposição Hormonal/tendências , Estudos Transversais , Espanha , Quimioterapia Combinada , Padrões de Prática Médica/estatística & dados numéricos
18.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 42(5): e33-e37, jul.-ago. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-154513

RESUMO

Muchas mujeres probablemente experimentarán un problema sexual en su vida. La disfunción sexual femenina es un término amplio utilizado para describir 3 categorías de trastornos de naturaleza multifactorial. Existen opciones farmacológicas eficaces pero limitadas para abordar la disfunción sexual femenina. La FDA aprobó recientemente el primer agente para el tratamiento del trastorno del deseo sexual hipoactivo en mujeres premenopáusicas. El uso fuera de indicación de las terapias hormonales, en especial estrógenos y testosterona, son los tratamientos más empleados en la disfunción sexual femenina, particularmente en las mujeres postmenopáusicas. Otros fármacos actualmente en investigación incluyen los inhibidores de la fosfodiesterasa y agentes que modulan los receptores de dopamina o de melanocortina (AU)


Many women will likely experience a sexual problem in their lifetime. Female sexual dysfunction is a broad term used to describe 3 categories of disorders of a multifactorial nature. Effective, but limited pharmacotherapeutic options exist to address female sexual dysfunction. The FDA recently approved the first agent for treatment of hypoactive sexual desire disorder in pre-menopausal women. Off-label use of hormonal therapies, particularly oestrogen and testosterone, are the most widely employed for female sexual dysfunction, particularly in post-menopausal women. Other drugs currently under investigation include phosphodiesterase inhibitors and agents that modulate dopamine or melanocortin receptors (AU)


Assuntos
Humanos , Feminino , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Sexualidade/fisiologia , Disfunções Sexuais Psicogênicas/complicações , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Cremes, Espumas e Géis Vaginais/uso terapêutico , Desenvolvimento Psicossexual , Orgasmo , Orgasmo/fisiologia , Antagonistas da Serotonina/uso terapêutico , Neurotransmissores/uso terapêutico , Testosterona/uso terapêutico , Estrogênios/uso terapêutico , Receptores de Estrogênio/uso terapêutico
19.
Prog. obstet. ginecol. (Ed. impr.) ; 59(3): 134-140, mayo-jun. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-163853

RESUMO

Objetivo: describir y analizar los resultados de un cuestionario diseñado para evaluar diferencias de percepción y actitudes entre los ginecólogos españoles (varones y mujeres) en relación con el abordaje del síndrome genitourinario de la menopausia (SGUM). Material y métodos: estudio transversal mediante una encuesta, cumplimentada por ginecólogos españoles. Se analizan las características basales del ginecólogo, anamnesis proactiva en el SGUM, orientación terapéutica y preventiva y autoprescripción/a la pareja de los ginecólogos varones. Resultados: se analizaron 213 cuestionarios. Son destacables las diferencias entre lo que el ginecólogo preferiría teóricamente prescribir (terapia hormonal asociada a lubricantes), lo que prescribe y lo que estima mejor aceptado por las pacientes (solo hidratantes). Eliminando la influencia de las variables de confusión, no existen diferencias significativas entre los resultados en ginecólogos varones y mujeres, de forma que la variable que condiciona las diferencias es el tipo de actividad del profesional. En la praxis privada se pregunta significativamente más sobre sintomatología vulvovaginal, urinaria y disfunciones sexuales; se dispone de más tiempo para incidir en ella, y mayor uso de probióticos. La terapia autoprescrita mayoritaria es la hormonal, asociada o no a hidratantes (73,1 vs. 63,6% en la pública y privada, respectivamente). Conclusión: la mayoría de los ginecólogos encuestados abordan en su práctica clínica el diagnóstico y tratamiento del SGUM, si bien se identifican diferencias entre los ginecólogos que desarrollan su actividad en el ámbito público frente al privado. Del mismo modo, existe diferencia entre prescripción y autoprescripción, si bien la terapia hormonal asociada o no a hidratantes resulta ser la mayoritaria en todos los subgrupos (AU)


Objective: To describe and analyse the results of a questionnaire designed to evaluate the existence of differences between perceptions and attitudes of Spanish gynaecologists (male and female) regarding the approach of Genitourinary Syndrome of Menopause (GSM). Material and methods: A cross-sectional study was made by means of a survey form completed by Spanish gynaecologists. The gynaecologist’s baseline characteristics, data on proactive history taking about GSM symptom, prevention and therapeutic approach and self-prescription/recommendations to the gynecologist’s couple were analysed. Results: Two hundred-thirteen valid questionnaires were analysed. In that analysis, the significant differences between what the gynaecologists theoretically would prescribe (hormonal therapy associated to moisturizers), what they in the daily practice prescribe and what they think the patients would accept (only lubricants and/or moisturizers). There are no significant differences between male and female gynaecologists in each category or in each age group, excluding the influence of confusion variables. This means that the differences are due to the professional activity area. Thus in private practice is significantly often to be asked about vulvovaginal and urinary symptoms and sexual disfunction, there is more time to inquire about it, the price is less considered when prescribing and there is a better knowledge and greater use of probiotics. The majority self-prescripted therapy was the hormonal therapy associated or not to moisturizers/lubricants (73.1 vs. 63.6% of self-medication in public and private practice respectively). Conclusion: The majority of the asked gynaecologists deal with diagnosis and treatment of GSM in their daily practice, although there are significant differences between the gynaecologists that work mainly at the public practice and the ones that work at the private practice. In the same way, there is a slight difference in prescription and self-prescription, even though hormonal therapy associated or not to moisturizers are the most prevalent products used in all groups (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Conhecimentos, Atitudes e Prática em Saúde , Doenças Urogenitais Femininas/epidemiologia , Doenças Urogenitais Femininas/prevenção & controle , Menopausa , Agentes Molhantes/uso terapêutico , Estrogênios/uso terapêutico , Percepção/fisiologia , Hormônios/uso terapêutico , Inquéritos e Questionários , Estudos Transversais
20.
J. physiol. biochem ; 72(1): 33-44, mar. 2016. graf
Artigo em Inglês | IBECS | ID: ibc-168205

RESUMO

The role of aquaporin-4 (AQP4) and interleukin-6 (IL-6) in the development of brain edema post-traumatic brain injury (TBI) has been indicated. The present study was designed to investigate the effect(s) of administration of progesterone (P) and/or estrogen (E) on brain water content, AQP4 expression, and IL-6 levels post-TBI. The ovariectomized rats were divided into 11 groups: sham, one vehicle, two vehicles, E1, E2, P1, P2, E1 + P1, E1 + P2, E2 + P1, and E2 + P2. The brain AQP4 expression, IL-6 levels, and water content were evaluated 24 h after TBI induced by Marmarou’s method. The low (E1 and P1) and high (E2 and P2) doses of estrogen and progesterone were administered 30 min post-TBI. The results showed that brain water content and AQP4 expression decreased in the E1, E2, P1, and P2-treated groups. The administration of E1 decreased IL-6 levels. Addition of progesterone decreased the inhibitory effect of E1 and E2 on the accumulation of water in the brain. Administration of E1 + P1 and E1 + P2 decreased the inhibitory effect of E1 on the IL-6 levels and AQP4 protein expression. Our findings suggest that estrogen or progesterone by itself has more effective roles in decrease of brain edema than combination of both. Possible mechanism may be mediated by the alteration of AQP4 and IL-6 expression. However, further studies are required to verify the exact mechanism (AU)


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Assuntos
Humanos , Estrogênios/administração & dosagem , Lesões Encefálicas/metabolismo , Edema Encefálico/etiologia , Progesterona/administração & dosagem , Aquaporina 4/metabolismo , Interleucina-6/metabolismo , Lesões Encefálicas/complicações
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