Estrogens long-term effects

Based on limited epidemiologic evidence, fluoride supplements, with or without calcium, estrogen and vitamin D, are used by clinicians for the treatment of osteoporosis. However, knowledge of the effects of fluoride on calcium and phosphorus metabolism in normal animals is limited although Spencer et al. (32) reported that ingestion of fluoride by three osteoporotic men did not affect calcium absorption but caused a decrease in urinary excretion. Moreover, there is a need to determine the long-term effects of fluoride treatment on bone strength and on soft tissues ( ). 

Estrogen replacement therapy was until recently widely recommended for the prevention of osteoporosis in middle-aged and older women (1). Long-term estrogen therapy also reduces the incidence of ischemic heart disease in such women (2). However, it has always been difficult to know in which women such prophylactic use is likely to be needed, and this dilemma is compounded by the prospect of adverse reactions, which can include any of the acute effects listed in the estrogen monograph, but also in some cases long-term effects such as tumors. 

Itoi H, Minakami H, Iwasaki R, Sato I. Comparison of the long-term effects of oral estriol with the effects of conjugated estrogen on serum lipid profile in early menopausal women. Maturitas 2000 36(3) 217-22. 

Lipophilic hormones The principle mode of action for Upophitic hormones is to penetrate cells where they interact with the intracellular receptors, which mediate their long-term effects. These in turn penetrate the nucleus to provoke specific mRNA synthesis by binding to promoter elements on DNA. Steroid hormones (e.g. glucocorticoids, androgens, estrogens, progestins) and thyroxine. 

Riggs, B L, et al., "Short- and Long-Term Effects of Estrogen and Synthetic Anabolic Hormone in Postmenopausal Osteoporosis," lournal of Clinical Investigation, Vol. 51,1972, p 1659. 

SUI. Systemic estrogen therapy also carries numerous short- and long-term side effect risks (mastodynia, uterine bleeding, nausea, thromboembolism, cardiac and cerebrovascular ischemic events, and enhanced breast and endometrial cancer risks). If estrogens are to be used in SUI management, only locally-administered products should be used (Table 50-4). 

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... 

Hsu S, Cheng WCh, Jang MW, Tsai KS (2001) Effects of long-term use of raloxifene, a selective estrogen receptor modulator, on thyroid function test profiles. Clin Chem 47 1865-1867... 

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