Estrogen-dependent endometrial

Many PAs and SPRMs display antiproliferative effects in the nonhuman primate endometrium where they suppress estrogen-dependent endometrial proliferation and mitotic activity, secretory activity, and reduce endometrial thickness and wet weight [31, 32]. This antiproliferative effect has been described as noncompetitive [31]. 

The effects of pure antiestrogens in the uterus have also been extensively studied, since it is an estrogen-dependent organ and the target of the main side effects of tamoxifen therapy, such as endometrial hyperplasia, hypertrophy of glandular epithelium, or even focal cellular atypia (Sourla et al. 1997). 

Endometriosis is an estrogen-dependent disorder mostly occurring in reproductive-age women characterized by a growth of the endometrium outside the uterine cavity (Oral et al. 1997 Child et al. 2001). Explanations of how the tissue stains this abnormal placement are controversial, although the predominant theory is that retrograde menstruation is the cause (Oral et al. 1997 Child et al. 2001). Additional factors that maybe pivotal in the disease s pathogenesis include immunologic abnormalities, endometrial disorders, and peritoneal dysfunction (Oral et al. 1997 Child et al. 2001). 

Apply patch twice weekly skin irritation. Breast tenderness, headache, edema. Risk of endometrial cancer diminished by concurrent progesterone use. Contraindicated in thromboembolic disorder, breast cancer, or estrogen-dependent malignancy. 

Estrogens can be associated with endometrial carcinoma, liver tumors, and breast tumors they can also promote the further growth of pre-existing estrogen-dependent tumors. 

It is useful to compare the activity profile of a SERM with that of estradiol, particularly in relation to effects seen postmenopausally. During chronic administration of estradiol, the risk of endometrial cancer rises co-ad-ministration of a progestin prevents this effect. Breast cancers occur more frequently, likewise thromboembolic diseases. Estradiol effectively alleviates climacteric hot flashes and sweating. After chronic treatment it reduces the incidence of osteoporotic bone fractures by preventing the loss of an estrogen-dependent portion of bone mass. Nonetheless, estrogens can no longer be recommended for this purpose because of the unfavorable benefit-risk constellation (p.330). 

Inhibition of aromatase may have therapeutic implications in diseases that are estrogen-dependent, such as some types of breast and endometrial cancer in women " " and possibly in benign prostatic hyperplasia in men Several steroidal and nonsteroidal com-... 

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