Oestrogen therapy

Stevens HP, Ostlere LS, Black CM, Jacobs HS, Rustin MH (1993) Cyclical psoriatic arthritis responding to anti-oestrogen therapy. Br J Dermatol 129 458-460... 

Coope J Is oestrogen therapy effective in the treatment of menopausal depression. 

Oestrogen replacement therapy (see Post-menopausal oestrogen therapy)... 

Iversen P. Orchidectomy and oestrogen therapy revisited. Eur Urol 1998 34(Suppl 3) 7-ll. 

Henriksson P, Blomback M, Bratt G, Edhag O, Eriksson A, Vesterqvist O. Effects of oestrogen therapy and orchidectomy on coagulation and prostanoid synthesis in patients with prostatic cancer. Med Oncol Tumor Pharmacother 1989 6(3) 219-25. 

Q18 Comment on the use of prolonged oestrogen therapy in post-menopausal women. 

Adverse oestrogen effects can include abdominal cramps, nausea, vomiting, headache, dizziness, depression, mood changes, hypertension, headache and fluid retention. Some major problems can occur with oestrogen therapy, including thromboembolism, seizures and risk of stroke. There is some evidence of a small increased incidence of breast, ovarian and endometrial cancer, which is related to the duration of HRT use. 

One patient was withdrawn from the study because of a significant rise in AST (three times above baseline) and ALT (five times above baseline) levels. No change in ALP or bilirubin was observed. Upon withdrawal of treatment AST and ALT returned to baseline levels within three months. The authors concluded that, in the absence of other factors, oestrogen therapy was the likely cause of this [14]. 

Narayanan Menon KV, Angulo P, Boe GM, et al. (2003) Safety and efficacy of oestrogen therapy in preventing bone loss in primary biliary cirrhosis. Am... 

Contraindications to oestrogen therapy include women who may have an oestrogen-dependent neoplasm, e.g. breast cancer, who may be pregnant, or have a disposition to thromboembolism. Hypertension, liver disease or gallstones, migraine, diabetes, uterine fibroids or endometriosis may all be made worse by oestrogen. These are not necessarily absolute contraindications, and HRT should not for instance be denied to a poly-symptomatic woman with mild hypertension. If necessary, it may be permissible to treat both the hypertension and the postmenopausal symptoms with separate drugs. 

Oestrogen deficiency in postmenopausal women. This leads to thinning of the endometrial tissue with increased susceptibility to irritation and trauma and cystitis-like symptoms. It can be corrected by hormone replacement or topical oestrogen therapy. Vaginal lubricants can be used if symptoms are caused by intercourse. Honeymoon cystitis may occur in younger women as a consequence of increased sexual activity. 

Cherry N, Gilmour K, Hannaford P, et al. Oestrogen therapy for prevention of reinfarction in postmenopausal women A randomized, placebo-controlled trial. Lancet 2002 360 2001-2008. 

Bajpayee [41] had suggested that the well-known sex difference (female to male ratio 2 1) in populations of arthritic patients may have accounted for elevated levels of Cu and Cp due to the oestrogen-mediated increase in plasma Cu concentration in the female subgroup of his RA population. However, his data did not show that women, who were not known to be on oestrogen therapy, had significantly different levels of Cu or Cp from men. Also, the TS Cu concentrations for patients with active disease [25,40] were found to be much greater than the reported [41] estrogen-induced increase in TSCu. 

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