ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
Ru
En

Hormones and Vessels: Pros and Cons

DOI:10.31550/1727-2378-2020-19-6-85-90
Bibliography link: Kuznetsov M.R., Papysheva O.V., Orlov B.B., Sorokina I.V. Hormones and Vessels: Pros and Cons. Doctor.Ru. 2020; 19(6): 85–90. (in Russian) DOI: 10.31550/1727-2378-2020-19-6-85-90
23 July 17:30

Objective of the Review: To describe the current understanding of menopausal hormone therapy (MHT) as a means to prevent perimenopausal and postmenopausal disorders.

Key Points: MHT provides extremely powerful protection against atherosclerosis, diabetes mellitus, abdominal obesity, and vascular and degenerative dementia.

Oral MHT is four to five times more effective than transdermal MHT. A therapeutic window of no more than five-ten years after the onset of menopause should be respected in prescribing MHT. Minimal doses of natural estrogen are preferable for reducing the risk of venous thromboembolic events, while dydrogesterone is the safest gestagen.

Conclusion: MHT, initiated in a timely fashion, prevents many life-threatening disorders, and the correct choice of medications significantly reduces the risk of thrombotic events.

Contributions: Dr. M.R. Kuznetsov contributed to writing the article (section about vascular and degenerative dementia) and approved the final version of the manuscript submitted for publication. Dr. O.V. Papysheva contributed to writing the article (introduction and sections about impairment in lipid and carbohydrate metabolism and ischemic heart disease). Dr. B.B. Orlov contributed to writing the article (section about venous thromboembolic events). Dr. I.V. Sorokina selected published source materials.

Conflict of interest: The authors declare that they do not have any conflict of interests.

M.R. Kuznetsov (Corresponding author) — I.M. Sechenov First Moscow State Medical University (Sechenov University) (a Federal Government Autonomous Educational Institution of Higher Education), Russian Federation Ministry of Health; 8 Trubetskaya St., Bldg. 2, Moscow, Russian Federation 119991. S.S. Yudin City Clinical Hospital (a Government-funded Healthcare Institution), Moscow City Department of Health; 4 Kolomensky Proyezd, Moscow, Russian Federation 115446. eLIBRARY.RU SPIN: 7146-1348. ORCID: https://orcid.org/0000-0001-6926-6809. E-mail: mrkuznetsov@mail.ru

O.V. Papysheva — S.S. Yudin City Clinical Hospital (a Government-funded Healthcare Institution), Moscow City Department of Health; 4 Kolomensky Proyezd, Moscow, Russian Federation 115446. E-mail: viulen@mail.ru

B.B. Orlov — S.S. Yudin City Clinical Hospital (a Government-funded Healthcare Institution), Moscow City Department of Health; 4 Kolomensky Proyezd, Moscow, Russian Federation 115446. E-mail: bborlov@mail.ru

I.V. Sorokina — S.S. Yudin City Clinical Hospital (a Government-funded Healthcare Institution), Moscow City Department of Health; 4 Kolomensky Proyezd, Moscow, Russian Federation 115446. E-mail: innamir22@yandex.ru

Доктор.ру

Table 1
The leading causes of death in postmenopausal women [2]

t13_1.jpg 

Table 2
Changes in concentrations of cerebral neurotransmitters during menopause and menopausal hormone therapy (MHT)

t13_2.jpg

Received: 28.04.2020
Accepted: 03.06.2020

23 July 17:30
LITERATURE
  1. Federal State Statistics Service. Reproductive health of the Russian population: Report Summary, 2011. URL: https://www.gks.ru/free_doc/new_site/population/zdrav/zdravo-2011.pdf (Accessed April 1, 2020). (in Russian)
  2. Van Dijk G.M., Kavousi M., Troup J., Franco O.H. Health issues for menopausal women: the top 11 conditions have common solutions. Maturitas. 2015; 80(1): 24–30. DOI: 10.1016/j.maturitas.2014.09.013
  3. Davis S.R., Lambrinoudaki I., Lumsden M., Mishra G.D., Pal L., Rees M. et al. Menopause. Nat. Rev. Dis. Primers. 2015; 1: 15004. DOI: 10.1038/nrdp.2015.4
  4. Davis S.R., Castelo-Branco C., Chedraui P., Lumsden M.A., Nappi R.E., Shah D. et al.; Writing Group of the International Menopause Society for World Menopause Day 2012. Understanding weight gain at menopause. Climacteric. 2012; 15(5): 419–29. DOI: 10.3109/13697137.2012.707385
  5. Samal S., Panigrahi P., Dutta A. Social epidemiology of excess weight and central adiposity in older Indians: analysis of Study on global AGEing and adult health (SAGE). BMJ Open. 2015; 5(11): e008608. DOI: 10.1136/bmjopen-2015-008608
  6. Levine J.A. Poverty and obesity in the U.S. Diabetes. 2011; 60(11): 2667–8. DOI: 10.2337/db11-1118
  7. Kinge J.M., Strand B.H., Vollset S.E., Skirbekk V. Educational inequalities in obesity and gross domestic product: evidence from 70 countries. J. Epidemiol. Community Health. 2015; 69(12): 1141–6. DOI: 10.1136/jech-2014-205353
  8. Kolb R., Sutterwala F.S., Zhang W. Obesity and cancer: inflammation bridges the two. Curr. Opin. Pharmacol. 2016; 29: 77–89. DOI: 10.1016/j.coph.2016.07.005
  9. Kalantaridou S.N., Naka K.K., Papanikolaou E., Kazakos N., Kravariti M., Calis K.A. et al. Impaired endothelial function in young women with premature ovarian failure: normalization with hormone therapy. J. Clin. Endocrinol. Metab. 2004; 89(8): 3907–13. DOI: 10.1210/jc.2004-0015
  10. Kodama M., Komura H., Kodama T., Nishio Y., Kimura T. Estrogen therapy initiated at an early age increases bone mineral density in Turner syndrome patients. Endocr. J. 2012; 59(2): 153–9. DOI: 10.1507/endocrj.ej11-0267
  11. Cartwright B., Robinson J., Seed P.T., Fogelman I., Rymer J. Hormone replacement therapy versus the combined oral contraceptive pill in premature ovarian failure: a randomized controlled trial of the effects on bone mineral density. J. Clin. Endocrinol. Metab. 2016; 101(9): 3497–505. DOI: 10.1210/jc.2015-4063
  12. Salpeter S.R., Walsh J.M., Ormiston T.M., Greyber E., Buckley N.S., Salpeter E.E. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes Obes. Metab. 2006; 8(5): 538–54. DOI: 10.1111/j.1463-1326.2005.00545.x
  13. Godsland I.F., Manassiev N.A., Felton C.V., Proudler A.J., Crook D., Whitehead M.I. et al. Effects of low and high dose oestradiol and dydrogesterone therapy on insulin and lipoprotein metabolism in healthy postmenopausal women. Clin. Endocrinol. (Oxf.). 2004; 60(5): 541–9. DOI: 10.1111/j.1365-2265.2004.02017.x
  14. Slopien R., Wender-Ozegowska E., Rogowicz-Frontczak A., Meczekalski B., Zozulinska-Ziolkiewicz D., Jaremek J.D. et al. Menopause and diabetes: EMAS clinical guide. Maturitas. 2018; 117: 6-10. DOI: 10.1016/j.maturitas.2018.08.009
  15. Walsh B.W., Schiff I., Rosner B., Greenberg L., Ravnikar V., Sacks F.M. Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins. N. Engl. J. Med. 1991; 325(17): 1196–204. DOI: 10.1056/NEJM199110243251702
  16. Duncan A.C., Lyall H., Roberts R.N., Petrie J.R., Perera M.J., Monaghan S. et al. The effect of estradiol and a combined estradiol/progestagen preparation on insulin sensitivity in healthy postmenopausal women. J. Clin. Endocrinol. Metab. 1999; 84(7): 2402–7. DOI: 10.1210/jcem.84.7.5836
  17. Barrett-Connor E., Laakso M. Ischemic heart disease risk in postmenopausal women: effects of estrogen on glucose and insulin levels. Arteriosclerosis. 1990; 10(4): 531–4. DOI: 10.1161/01.atv.10.4.531
  18. Stevenson J.C., Rioux J.E., Komer L., Gelfand M. 1 and 2 mg 17beta-estradiol combined with sequential dydrogesterone have similar effects on the serum lipid profile of postmenopausal women. Climacteric. 2005; 8(4): 352–9. DOI: 10.1080/13697130500345190
  19. Cieraad D., Conradt C., Jesinger D., Bakowski M. Clinical study comparing the effects of sequential hormone replacement therapy with oestradiol/dydrogesterone and conjugated equine oestrogen/norgestrel on lipids and symptoms. Arch. Gynecol. Obstet. 2006; 274(2): 74–80. DOI: 10.1007/s00404-006-0132-4
  20. Anagnostis P., Bitzer J., Cano A., Ceausu I., Chedraui P., Durmusoglu F. et al. Menopause symptom management in women with dyslipidemias: an EMAS clinical guide. Maturitas. 2020; 135: 82–8. DOI: 10.1016/j.maturitas.2020.03.007
  21. Özdemir B.C., Dotto G.P. Sex hormones and anticancer immunity. Clin. Cancer Res. 2019; 25(15): 4603–10. DOI: 10.1158/1078-0432.CCR-19-0137
  22. Panevina A.S., Smetneva N.S., Vasilenko A.M., Shestakova M.V. The effects of menopausal hormone therapy on proinflammatory cytokines and immunoglobulins in perimenopausal patients with type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD). Therapeutic archive. 2018; 10: 79–83. (in Russian)
  23. Tuomikoski P., Lyytinen H., Korhonen P., Hoti F., Vattulainen P., Gissler M. et al. Coronary heart disease mortality and hormone therapy before and after the Women's Health Initiative. Obstet. Gynecol. 2014; 124(5): 947–53. DOI: 10.1097/AOG.0000000000000461
  24. Reslan O.M., Khalil R.A. Vascular effects of estrogenic menopausal hormone therapy. Rev. Recent. Clin. Trials. 2012; 7(1): 47–70. DOI: 10.2174/157488712799363253
  25. Brinton R.D., Yao J., Yin F., Mack W.J., Cadenas E. Perimenopause as a neurological transition state. Nat. Rev. Endocrinol. 2015; 11(7): 393–405. DOI: 10.1038/nrendo.2015.82
  26. Weber M.T., Rubin L.H., Maki P.M. Cognition in perimenopause: the effect of transition stage. Menopause. 2013; 20(5): 511–7. DOI: 10.1097/GME.0b013e31827655e5
  27. Rocca W.A., Grossardt B.R., Maraganore D.M. The long-term effects of oophorectomy on cognitive and motor aging are age dependent. Neurodegener. Dis. 2008; 5(3–4): 257–60. DOI: 10.1159/000113718
  28. Archer J.S. NAMS/Solvay Resident Essay Award. Relationship between estrogen, serotonin, and depression. Menopause. 1999; 6(1): 71–8.
  29. Matyi J.M., Rattinger G.B., Schwartz S., Buhusi M., Tschanz J.T. Lifetime estrogen exposure and cognition in late life: the Cache County Study. Menopause. 2019; 26(12): 1366–74. DOI: 10.1097/GME.0000000000001405
  30. Baber R.J., Panay N., Fenton A.; IMS Writing Group. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016; 19(2): 109–50. DOI: 10.3109/13697137.2015.1129166
  31. Henderson V.W. Action of estrogens in the aging brain: dementia and cognitive aging. Biochim. Biophys. Acta. 2010; 1800(10): 1077–83. DOI: 10.1016/j.bbagen.2009.11.005
  32. Fuente-Martin E., Garcia-Caceres C., Morselli E., Clegg D.J., Chowen J.A., Finan B. et al. Estrogen, astrocytes and the neuroendocrine control of metabolism. Rev. Endocr. Metab. Disord. 2013; 14(4): 331–8. DOI: 10.1007/s11154-013-9263-7
  33. Imtiaz B., Tuppurainen M., Rikkonen T., Kivipelto M., Soininen H., Kröger H. et al. Postmenopausal hormone therapy and Alzheimer disease: a prospective cohort study. Neurology. 2017; 88(11): 1062–8. DOI: 10.1212/WNL.0000000000003696
  34. Canonico M. Hormone therapy and risk of venous thromboembolism among postmenopausal women. Maturitas. 2015; 82(3): 304–7. DOI: 10.1016/j.maturitas.2015.06.040
  35. Raffetto J.D., Qiao X., Beauregard K.G., Khalil R.A. Estrogen receptor-mediated enhancement of venous relaxation in female rat: implications in sex-related differences in varicose veins. J. Vasc. Surg. 2010; 51(4): 972–81. DOI: 10.1016/j.jvs.2009.11.074
  36. Vinogradova Y., Coupland C., Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ. 2019; 364: k4810. DOI: 10.1136/bmj.k4810
Новости мировой медицины! Свежие статьи из журнала! Будьте в курсе!

Похожие статьи

Similar article
19 April 00:00, Interview
Interview
Doctor.Ru Pediatrics. Vol. 20, No. 3 (2021)
19 April 00:00, Paediatrics
A.V. Aksenov, E.A. Ivanovskaya
Successful Use of Tocilizumab in a Child with Systemic Juvenile Idiopathic Arthritis
Doctor.Ru Pediatrics. Vol. 20, No. 3 (2021)

News