Estrogen-replacement therapy

The compound shown is diethylstilbestrol (DES) it has a number of therapeutic uses in estrogen replacement therapy DES is not a steroid but can adopt a shape that allows it to mimic estrogens such as estradiol (p 1100) and bind to the same receptor sites Construct molecular models of DES and estradiol that illustrate this similanty in molecular size shape and location of polar groups... 

Hormonal effects on the aging process have been areas of current interest. The intricacies of the interaction of the various hormones are undoubtedly involved in the aging process and hence these hormones could be called antiaging agents. Both androgens and estrogens have been studied. Low level estrogen replacement therapy (ERT) has been used to treat postmenopausal women. 

Anxiety related to diagnosis, useot estrogen replacement therapy, other tadors... 

FIGURE 52-1. This low-dose estrogen transdermal patch, available as the trade name Estraderm (Estradiol Transdermal System), is transparent and about the size of a silver dollar. It releases small amounts of estrogen directly into the bloodstream at a constant and controlled rate to a female requiring estrogen replacement therapy for postmenopausal symptoms. 

CAULEY J A, SEELEY D G, ENSRUD K, ETTINGER B, BLACK D and CUMMINGS S R (1995) EstrOgen replacement therapy and fractures in older women. Ann Intern Med 122, 9-16. 

Observational studies have suggested possible favourable effects of estrogen replacement therapy (ERT) on the risk of coronary heart disease in postmenopausal women. Since elevated plasma cholesterol has been identified as the primary risk factor for cardiovascular disease, investigations have focused on the inverse association between plasma cholesterol concentration and soy protein consumption. The cholesterol-lowering properties of soy have been demonstrated, and a good correlation has been found in... 

WAGNER J D, CEFALU W T, ANTHONY M S, LITWAK K N, ZHANG L and CLARKSON T B (1997) Dietary soy protein and estrogen replacement therapy improve cardiovascular risk factors and decrease aortic cholesteryl ester content in ovariectomized cynomolgus monkeys. ... 

Drug therapy Estrogen-containing oral contraceptive pills Estrogen replacement therapy SERMs HIT... 

Long-term use of hormone-replacement therapy and concurrent use of progestins appear to contribute to breast cancer risk.7 The use of postmenopausal estrogen-replacement therapy in women with a history of breast cancer generally is considered contraindicated. However, most experts believe that the safety and benefits of low-dose oral contraceptives currently outweigh the potential risks and that changes in the prescribing practice for the use of oral contraceptives are not warranted. Oral contraceptives are known to reduce the risk of ovarian cancer by about 40% and the risk of endometrial cancer by about 60%. 

CRTT Certified Respiratory Therapy Technician ERT Estrogen-replacement therapy... 

Diesner JW (1998). A review of estrogen replacement therapy use in the prevention and treatment of Alzheimer disease. Primary Care Update for OB/GYNS, 5, 50-53. 

Women >55 years or premature menopause without estrogen-replacement therapy Family history of premature CHD (definite myocardial infarction or sudden death before 55 years of age in father or other male first-degree relative or before 65 years of age in mother or other female first-degree relative) Cigarette smoking... 

The beneficial role of estrogen replacement therapy (ERT) to prevent bone loss has been largely demonstrated (Nelson et al. 2002 Wells et al. 2002). Re-... 

Bar J, Tepper R, Fuchs J, Pardo J, Goldberger S, Ovadia J (1993) The effect of estrogen replacement therapy on platelet aggregation and adenosine triphosphate release in postmenopausal women. Obstet Gynecol 81 261-264... 

Jokela H, Dastidar P, Rontu R, Salomaki A, Teisala K, Lehtimaki T, Punnonen R (2003) Effects of long-term estrogen replacement therapy versus combined hormone replacement therapy on nitric oxide-dependent vasomotor function. J Clin Endocrinol Metab 88 4348-4354... 

Holbert TR (1997) Transvaginal ultrasonographic measurement of endometrial thickness in postmenopausal women receiving estrogen replacement therapy. Am J Obstet Gynecol 176 1334-1339... 

Zee RF, Trivedi MA (2002) The effects of estrogen replacement therapy on neuropsychological functioning in postmenopausal women with and without dementia a critical and theoretical review. Neuropsychol Rev 12 65-109... 

Kawas C, Resnick S, Morrison A, Brookmeyer R, Corrada M, Zonderman A, Bacal C, Lingle DD, Metter E. (1997). A prospective study of estrogen replacement therapy and the risk of developing Alzheimer s disease the Baltimore longitudinal study of aging. Neurology. 48(6) 1517-21. 

Isolated soy protein, rich in phytoestrogen, enhances vascular reactivity in female monkeys with atherosclerosis, an effect similar to that observed with estrogen replacement therapy. The effect appears dependent on the phytoestrogen content of soy and is not observed when animals are fed soy protein devoid of its phytoestrogen content (Honore et al., 1997). One in vitro study... 

Synthetic steroids, especially estrogenic drugs, are used extensively in estrogen-replacement therapy and oral contraceptives, in veterinary medicine for growth enhancement, and in athletic performance enhancement. In general, large portions... 

Calcium is recommended in doses of 1,500 mg/day for men older than 65 years of age and for postmenopausal women not taking estrogen replacement therapy. 

Hypercoagulability Some studies have shown that women taking estrogen replacement therapy have hypercoagulability, primarily related to decreased antithrombin activity. This effect appears dose- and duration-dependent and is less pronounced than that associated with OC use. 

Positive risk factors for CHD (other than high LDL) include Age (men 45 years of age or older women 55 years of age or older or women who go through premature menopause without estrogen replacement therapy) family history of premature CHD smoking hypertension (greater than 140/90 mm Hg) low HDL cholesterol (less than 35 mg/dL) obesity (more than 30% overweight) and diabetes mellitus. 

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