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Estrone (E1) constitutes the primary component in oral conjugated equine estrogens (CEEs) and serves as the principal estrogen precursor in the female circulation in the post-menopause. E1 induces endothelium-dependent vasodilation and activate PI3K/NO/cGMP signaling. To assess whether E1 mitigates vascular dysfunction associated with postmenopause and explore the underlying mechanisms, we examined the vascular effects of E1 in ovariectomized (OVX) rats, a postmenopausal experimental model. Blood pressure was measured using tail-cuff plethysmography, and aortic rings were isolated to assess responses to phenylephrine, acetylcholine (ACh), and sodium nitroprusside. Responses to ACh in rings pre-incubated with superoxide dismutase (SOD), catalase (CAT), or apocynin were also evaluated. Protein expression of SOD, CAT, NOX1, NOX2, and NOX4 was determined by Western blotting. E1 treatment resulted in decreased body weight and retroperitoneal fat, increased uterine weight, and prevented elevated blood pressure in the OVX group. Furthermore, E1 improved endothelium-dependent ACh vasodilation, activated compensatory antioxidant mechanisms - i.e. increased SOD and CAT antioxidant enzymes activity, and decreased NOX4 expression. This, in turn, helped prevent oxidative stress and endothelial dysfunction in OVX rats. Additionally, E1 treatment reversed the increased total LDL cholesterol observed in the OVX group. The findings underscore protective effects of E1 on the cardiovascular system, counteracting OVX-related oxidative stress and endothelial dysfunction in Wistar rats. E1 exhibits promising therapeutic benefits for managing cardiovascular health, particularly in postmenopausal conditions.

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It has been observed that plasmatic concentrations of estrogens, progesterone, or both correlate with symptoms in asthmatic women. Fluctuations in female sex steroid concentrations during menstrual periods are closely related to asthma symptoms, while menopause induces severe physiological changes that might require hormonal replacement therapy (HRT), that could influence asthma symptoms in these women. Late-onset asthma (LOA) has been categorized as a specific asthmatic phenotype that includes menopausal women and novel research regarding therapeutic alternatives that might provide relief to asthmatic women suffering LOA warrants more thorough and comprehensive analysis. Therefore, the present review proposes phytoestrogens as a promising HRT that might provide these females with relief for both their menopause and asthma symptoms. Besides their well-recognized anti-inflammatory and antioxidant capacities, phytoestrogens activate estrogen receptors and promote mild hormone-like responses that benefit postmenopausal women, particularly asthmatics, constituting therefore a very attractive potential therapy largely due to their low toxicity and scarce side effects.

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Evaluar los efectos de la terapia hormonal (TH) con Drospírenona (DRSP)/17 ß -estradiol (E2), sobre los parámetros del Síndrome Metabólico (SM) en pacientes postmenopáusicas. Métodos: Investigación comparativa y aplicada, con diseño cuasi experimental, de casos y controles a simple ciego, prospectivo y de campo; realizada en la Consulta de Ginecología. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. Participaron 120 mujeres separadas al azar para recibir la combinación DRSP/E2 (Grupo A) o un placebo (Grupo B). Se evaluaron los componentes del SM antes y posterior a 6 meses de haber recibido la TH. Resultados: Se encontró una alta prevalencia de SM en ambos grupos antes de recibir el tratamiento (53,3% y 48%; grupo A y B respectivamente). Posterior al tratamiento, DRSP/E2 al compararse con un placebo, redujo significativamente tanto la prevalencia del SM como el riesgo de padecerlo (21,7% versus 48,3%, OR [IC95%]= 0,29 [0,13-0,65]; p < 0.001), con reducción significativa (p< 0.001) de la hipertensión arterial, glicemia basal alterada, hipertrigliceridemia y obesidad central; además de una reducción significativa de los síntomas vasomotores, síntomas psicológicos e incontinencia urinaria (p< 0.001). En el grupo B la prevalencia del SM se mantuvo sin cambios, salvo para la glicemia basal alterada y los síntomas vasomotores y psicológicos que mostraron una reducción significativa (p< 0.001). Conclusión: DRSP/E2 (2mg/1 mg) demostró ser eficaz luego de 6 meses de tratamiento tanto para el control de los parámetros que definen al SM; con pocos y leves efectos indeseados(AU)

To assess the effects of hormone therapy (HT) with drospirenone (DRSP)/17 ß -estradiol (E2) on the parameters of the metabolic syndrome (MS) in postmenopausal patients. Methods: We performed a comparative and applied research, with quasiexperimental, case-control, single-blind, prospective and field design. The study was realized in the Gynecology consultation. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. 120 women were included, they were separated to receive either the combination DRSP/E2 (Group A) or placebo (Group B). We assess MS components before and ather 6 months of receiving HT. Results: We found a high prevalence in both groups before receiving treatment (53.3% and 48%, group A and B respectively). A ther treatment, DRSP/E2 when compared to placebo, significantly reduced both the prevalence of MS as the risk of setting it (21.7% versus 48.3%, OR [95%] = 0.29 [0.13-0.65] p <0.001), with a significant reduction (p <0.001) of hypertension, impaired fasting glucose, hypertriglyceridemia, central obesity; and a significant reduction in vasomotor symptoms, psychological symptoms and urinary incontinence (p <0.001). In group B the prevalence of MS was unchanged, except for impaired fasting glycemia and vasomotor and psychological symptoms showed a significant reduction (p <0.001). Conclusion: DRSP/E2 (2mg /1mg), proved to be effective a ther 6 months of treatment both for the control of the parameters that define the SM, with few and mild side effects(AU)

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Enquanto aumenta a expectativa de vida, também cresce a preocupação com a qualidade de vida na velhice. Para muitos, o envelhecimento está associado a aspectos negativos como inatividade, doenças, necessidade de cuidados, além de não encontrarem significado nessa fase da vida. Rudolf Steiner considerava que as mesmas forças vitais empenhadas no crescimento e desenvolvimento orgânicos são as que dão sustentação ao pensamento. Assim, a antroposofia considera que há uma metamorfose das forças que promovem o crescimento em forças do pensamento. Da mesma forma, há uma metamorfose no processo do envelhecimento: as forças vitais se desprendem paulatinamente dos órgãos e ficam disponíveis para o desenvolvimento ou o fortalecimento de algumas habilidades. O exemplo do sentido da audição, metamorfoseado em percepção da verdade é citado. De modo marcante, as ondas de calor no climatério (fogachos) caracterizam forças vitais que se desprendem dos ovários e não encontram destino ou utilidade, causando mal-estar à mulher nessa fase da vida. Mas as mulheres descendentes dos maias, no Yucatán (México), não têm a experiência dos fogachos após a menopausa. Para essa sociedade, envelhecer significa evoluir, ganhar posição superior no status social. Além disso, elas tecem e bordam desde jovens e assim continuam a criar, mesmo após o término do período fértil, usando as forças vitais que se desprendem dos ovários. Ao usar a terapia de reposição hormonal, a mulher terá suas forças vitais artificialmente presas aos órgãos, impedindo que a metamorfose citada aconteça. Então, trata-se de uma necessidade de nossa época encontrar uma nova perspectiva para o envelhecimento, pautada pela compreensão da metamorfose das forças vitais no ser humano.(AU)

While the life expectancy increases, there is also a growing concern about the quality of life in old age. For many, aging is associated with negative aspects such as inactivity, illness, need for care and lack of meaning in this stage of life. Rudolf Steiner considered that the same vital forces engaged in organic growth and development, are those that support the thought. Thus, anthroposophy considers that there is a metamorphosis of growth forces into thinking forces. In the same way, there is a metamorphosis in the process of aging: the vital forces gradually detach from the organs and they become available for the development or the strengthening of some abilities. The example of the sense of hearing, metamorphosed into the perception of truth is cited. Significantly, the hot flushes in the climacteric characterize vital forces that are released from the ovaries and do not find a destiny or a utility, causing discomfort to the woman in this phase of life. But the women descendants of the Maya, in the Yucatán (Mexico), do not experience the hot flashes after the menopause. For this society, aging means to progress, to gain a superior position in social status. In addition, they weave and embroider since youth and thus they continue to create, even after the end of the fertile period, using the vital forces that are released from the ovaries. The hormone replacement therapy artificially attaches the vital forces to the organs, and impedes the event of the mentioned metamorphosis. Therefore, finding a new perspective for aging is a necessity of our time, based on the understanding of vital forces metamorphosis in the human being.(AU)

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Se realizó un estudio descriptivo y transversal, a fin de describir las principales manifestaciones clínicas del síndrome climatérico en 341 mujeres de edad mediana que asistieron a la consulta especializada para la atención al climaterio y la menopausia del Hospital "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde enero de 2009 hasta mayo de 2012. La edad promedio de las pacientes en la etapa perimenopáusica fue de 47,2 años, mientras que en las posmenopáusicas resultó ser de 49,4 años. Se aplicó la escala climatérica cubana, desde un enfoque médico social. En la posmenopausia artificial, los síntomas fueron muy molestos para 69,1 % de las afectadas; asimismo, los sofocos predominaron en 88,2 %, seguidos de las sudoraciones nocturnas en 82,7 % de ellas. La depresión y el insomnio figuraron entre los síntomas psicológicos más relevantes, con 84,7 y 78,0 %, respectivamente. La medicina natural y la terapia hormonal de reemplazo constituyeron las principales modalidades de tratamiento.

A descriptive and cross-sectional study was conducted in order to describe the main clinical manifestations of the climacteric syndrome in 341 middle-aged women, who attended the specialized care for climacteric and menopause of "Dr. Juan Bruno Zayas Alfonso" Hospital in Santiago de Cuba, from January 2009 to May 2012. The average age of patients in the perimenopausal stage was 47.2 years, while in postmenopausal women was found to be 49.4 years. The Cuban climacteric scale was applied from a social medical approach. In the artificial postmenopause, the symptoms were very bothersome for 69.1 % of those affected; also, hot flashes prevailed in 88.2 %, followed by the night sweats in 82.7 % of them. Depression and insomnia were among the most significant psychological symptoms, with 84.7 and 78.0 %, respectively. Natural medicine and hormone replacement therapy were the main treatment modalities.

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Antecedentes: El avance de la medicina ha incrementado la esperanza de vida al nacer y el crecimiento de la población mayor a 60 años, siendo cada vez mayor las mujeres en etapa de menopausia. Objetivo: Estudiar la calidad de vida (CV) en pacientes menopáusicas con y sin terapia de reemplazo hormonal. Método: Se estableció una investigación de tipo comparativa y aplicada, con diseño no experimental, contemporáneo transeccional y de campo, donde se incluyo una muestra de 200 pacientes con diagnóstico de menopausia. Se les aplicaron los cuestionario de CV SF-36 y el Menopause Rating Scale (MRS). Resultados: Hubo diferencias significativas (p<0,05) en cuanto al dolor físico y altamente significativas (p<0,01), respecto a los síntomas somáticos, psicológicos y urogenitales en las pacientes no tratadas vs las del grupo que recibió TRH. Conclusión: Las pacientes bajo TRH perciben una mayor CV específica respecto a las pacientes que no la reciben, presentando síntomas somáticos o psicológicos menos severos.

Background: The medicine's advance has increased the life expectancy when being born and the growth of the greater population of 60 years, being increasing the women in menopause stage. Objective: To study the quality of life (QL) in menopause's women with and without hormonal therapy. Method: An investigation of comparative and applied type was settle down, with nonexperimental, contemporary transeccional and field design, where was included a sample of 200 patients with diagnosis of menopause. To these patients was be applied a questionnaire of QL, SF-36 and the Menopause Rating Scale (MRS). Results: It was a significant differences (p<0.05) in the presence of physical pain and highly significant differences (p<0.01) respect to the somatic, psychological and urogenitals symptoms in the nontreated patients when comparing them with those who received TRH. Conclusion: Patient under TRH perceives a greater specific QL with respect to the patients who do not receive it, presenting less severe somatic or psychological symptoms.

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A menopausa e uma fase da vida em que as gonadas femininas cessam a producao de estrogenio e ocorre entao o ultimo sangramento ciclico. A idade media para ocorrencia do climaterio e de 51 anos mas, em alguns casos, ele pode acontecer precocemente decorrente de varios outros fatores.O hipoestrogenismo que ocorre nesta etapa altera consideravelmente o organismo, deixando as mulheres vulneraveis aos disturbios causadospela deficiencia de estrogenos. Esta diminuicao dos niveis hormonais pode gerar alteracoes ginecologicas e extra-ginecologicas. Uma das maneiras mais comuns utilizadas atualmente para controle desta oscilacao hormonal e o uso da terapia de reposicao hormonal(TRH), a qual ja foram agregados diversos riscos e beneficios para a sua utilizacao. Quando a opcao para reducao da sintomatologia do climaterio e o uso de suplementacao de TRH, deve-se levar em conta que todas as mulheres tem historicos medicos diferentes e que a resposta ao tratamento e individual, o que resulta na necessidade de diferentesdoses de TRH. Assim, devemos chamar atencao para o fato de que a reposicao hormonal, quando realizada, deve sempre ser individualizada, nao sendo possivel a padronizacao de qualquer tratamento utilizado. Portanto, a decisao de opcao pelo tratamento de reposicao hormonal, dependera da aceitacao da paciente, sendo que ela deve ser esclarecida sobre as consequencias da deplecao estrogenica no climaterio, seus riscos e beneficios, efeitos colaterais e contra-indicacoes da mesma.

The menopause is a moment in life where the female gonads stop producing estrogen and then occurs the last cyclic bleeding. Usually it occurs in the age of 51, but in a few cases it happens before due to many others factors. The hypoestrogenism at this time takes to many changes in women’s organism, and it makes women vulnerable to some disturbs caused by estrogens deficiency. Lower hormonal levels can lead to gynecological e non-gynecological modifications. One of the most common w ays currently used to control the hormonal levels is the Replacement Hormone Therapy, and are alreadyknown many risks and benefits related to it. When the option to reduce the symptoms of the climaterium is the Replacement Hormone Therapy, we have to pay attention to the fact that every woman has a different medical history and that the response to the treatment is individual, what results in the necessity of different doses of hormones, it should always be individualized, so it is not possible to patronize any treatment utilized.Therefore, the option for the Replacement Hormone Therapy depends on the patient acceptance, always with the explanation about consequences of the lower levels of estrogen at the climaterium, risks and benefits, side effects and contraindications.

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Objetivo: avaliar por meio de histeroscopia e biópsia dirigida a influência do uso da terapia de reposição hormonal (TRH) sobre o endométrio de mulheres menopausadas com sangramento uterino. Material e métodos: Foram estudadas 469 pacientes com sangramento uterino na pós-menopausa e submetidas à histeroscopia no Setor de Histeroscopia da Faculdade de Medicina do ABC (FMABC). As pacientes foram divididas em grupos: Grupo I, mulheres que faziam uso de TRH após a menopausa há mais de seis meses (n=174) e Grupo II, mulheres que nunca fizeram TRH(n=295). Para análise estatística utilizou-se o teste χ2. Resultados: os achados histeroscópicos mais frequententemente encontrados foram pólipo endometrial e endométrio atrófico tanto no Grupo I como no Grupo II. Não houve diferença significativa nos achados malignos, benignos e negativos nos dois grupos estudados. Conclusões: A TRH não influenciou os achados histeroscópicos e de biópsia de endométrio em mulheres após amenopausa.

Purpose: to evaluate by hysteroscopy the role of hormonal replacement therapy (HRT) on the endometrial findings in women with postmenopausal bleeding. Material and methods: a sample of 469 patients with postmenopausal bleeding who underwent hysteroscopy procedure at Hysteroscopy Section of Faculdade de Medicina do ABC (FMABC). The patients were divided in groups: Group I, the ones with hormonal replacement therapy (HRT) (n=174) and Group II, the ones without it (n=295). For statistical analysis, the test of χ2 was used. Results: hysteroscopy revealed in both groups the same diagnosis: endometrial polyps and endometrial atrophy. No differences were observed in the comparison of results found on the Groups Iand II for incidence of malignant, benign pathology and even for the endometrium without abnormality. Conclusions: The HRT did not influence the endometrium hysteroscopic and biopsies findings in postmenopausal women.

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Estetrol es un esferoide estrogénico sintetizado exclusivamente por el hígado fetal, que traspasa a la circulación materna por la placenta. Descrito por primera vez por Diczfalusy en 1965. Desde esa fecha se han realizado diversas investigaciones preclínicas. En los últimos años, el interés por el estetrol ha aumentado, dado el logro de su síntesis en el laboratorio y la demostración de su buena biodisponibilidad y larga vida media al administrarlo por vía oral a mujeres. Se presenta una revisión de su síntesis, metabolismo y de la información científica existente de sus diferentes efectos en los tejidos estrógeno sensibles en distintos modelos animales.

Estetrol is an estrogenic steroid synthesized exclusively by the fetal liver. It crosses over from the placenta to the maternal circulation. It was first described in 1965 by Diczfalusy and from this date onwards, several preclinical investigations have been carried out. In recent years, the interest for estetrol has been growing due to its laboratory synthesis and the demonstration of its good bioavailability together with its long half life, when administered orally to women. A review of its synthesis, metabolism and existing scientific information on its different effects on estrogen sensitive tissues, in a variety of animal models, is here presented.

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A menopausa é um período de transição caracterizado por diversas mudanças na composição corporal, incluindo perda de massa magra e aumento e redistribuição da adiposidade. O objetivo deste estudo foi analisar os efeitos do treinamento concorrente (TC), aeróbio e com pesos, sobre indicadores de força muscular e composição corporal em mulheres na pósmenopausa. Participaram 18 mulheres menopausadas, com e sem terapia de reposição hormonal (TRH) e clinicamente saudáveis. Foram subdivididas em dois grupos: com TRH (n=8, idade =50,12 ± 3,8), e sem TRH (n=10, idade=56,3 ± 7,4). O TC teve duração de 10 semanas, com freqüência semanal de três dias e duração média de 60 min/sessão. Para o treinamento com pesos foram propostos nove exercícios para os principais grupamentos musculares e para o treino aeróbio, caminhadas e corridas com duração de 30 min. O treino aeróbio foi sempre realizado após o treinamento com pesos. Análise de variância (ANOVA) foi empregada para as comparações entre os grupos, para analisar os efeitos do treinamento e o post hoc de Scheffé para comparações múltiplas. Os resultados encontrados mostraram que o TC foi eficiente para melhorias principalmente nos indicadores de força, porém não encontramos diferenças significantes para os componentes da composição corporal. Ambos os grupos mostraram respostas semelhantes quanto ao efeito do TC. Dessa forma, concluímos que se faz necessário mais estudos utilizando ou não a TRH, para verificar seus benefícios ou prejuízos para a saúde da mulher.

The menopause is a transitional period characterized by several changes in body composition, including lean mass loss and increase and redistribution of fat. The purpose of this study was to analyze the effects of concurrent training (CT), aerobic and strength on indicators neuromuscular and body composition indicators in postmenopausal women. Participated 18 clinically healthy menopausal women with and without Hormone Replacement Therapy (HRT). They were divided into two groups: with HRT (n = 8, age = 50.12 ± 3.8), and without HRT (n = 10, age = 56.3 ± 7.4). The TC lasts 10 weeks, three days a week and mean duration of 60 min per session. For the strength training were proposed nine exercises for the major muscle groups and for the aerobic training was done walks and running for about 30 minutes. The aerobic training was always done after strength training. Analysis of variance (ANOVA) was used for comparison between groups, to analyze the effects of the training. It was used the post hoc of Scheffé for multiple comparisons. The results showed the efficiency of the CT mainly to improvements in strength indicators, but did not find significant differences in the body composition components. Both groups showed similar responses to the TC. So more studies are needed to a better knowledge about the importance of using HRT, as its benefits or harms to the women health.

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A terapia de reposição hormonal (TRH) tem sido muito usada para alívio de sintomas climatéricos. Porém, como se sabe, os hormônios esteróides, principalmente os estrogênios, exercem ação promotora na carcinogênese mamária, a segurança da TRH em termos de risco de câncer de mama pode ser questionada. Nesta revisão de literatura, os autores concluíram que a TRH eleva discretamente o risco relativo de câncer de mama, podendo ser considerada quando as vantagens superarem as desvantagens. Mas, para mulheres com antecedente pessoal de câncer de mama ou com fatores predisponentes de alto risco, a TRH deve ser evitada, preferindo-se alternativas não-hormonais.

Hormonal replacement therapy (HRT) has been widely used for the 1llanagement of climateric symptoms. As it is known that steroid hormones, mainly estrogens, are promoting factors for mammary carcinogenesis, the safety of HRT in terms of risk for breast cancer may be cause of concern. In this review literature the authors concluded that HRT increases slightly the relative risk of breast cancer, and may by tailoring considered when the advantages exceed the disadvantages. Neverthless HRT should be avoided in women with personal history of breast cancer or presenting high risk predisposing factors, to whom non-hormonal alternatives are preferred.

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OBJETIVO: Existe coincidência entre os sintomas do climatério e o aparecimento acentuado dos sinais de envelhecimento da pele. Estudos, em modelos animais, mostraram que o estrógeno é uma espécie de mediador crítico na cicatrização de feridas. Os autores apresentam um estudo da influência da terapia de reposição hormonal (TRH) em anastomoses de cólon, feitas em ratas. MÉTODOS: Utilizam 3 grupos de ratas Wistar, um grupo de ooforectomizadas com TRH feita com 50mg de estrógeno e 2 mg de acetato de medroxiprogesterona, um de ooforectomizadas e sem TRH e um de ratas laparotomizadas e não ooforectomizadas. Realizaram a ooforectomia e a confirmação da condição hormonal após 28 dias. Em seguida instituíram a TRH ou de solução fisiológica, diariamente. Após 2 meses fizeram uma colotomia esquerda com anastomose término-terminal e estudaram a resistência e a densidade de colágeno com 7 e 14 dias. RESULTADOS: As anastomoses dos cólons das ratas sem TRH eram menos resistentes do que as do grupo controle tanto no 7.º dia (p=0,0488) como no 14.º dia (p=0,0115). A densidade de colágeno foi menor no 7.º dia (p=0,0210) com menor presença de colágeno I (p=0,0023) e de colágeno III (p=0,0470). No 14.º dia estas diferenças permaneceram significantes. Nas anastomoses dos cólons das ratas com TRH as diferenças, em relação ao grupo controle, não foram significantes. CONCLUSAO: A falta dos hormônios ovarianos leva à menor resistência e atrasa a maturação de anastomoses do cólon, em ratas e estas deficiências são compensadas pela TRH. (AU)

PURPOSE: The symptoms of the climacteric coincide with the marked appearance of signs of skin aging. Studies on animal models have shown that estrogen is a critical mediator in wound healing. The authors report a study of the influence of hormonal replacement therapy (HRT) on colon anastomoses performed in female rats.METHODS: Three groups of Wistar rats were used: one submitted to oophorectomy and receiving HRT with 50 mg estrogen and 2 mg medroxyprogesterone acetate, one submitted to oophorectomy without HRT, and one of laparotomized but not oophorectomized rats. Hormonal condition was confirmed 28 days after oophorectomy and HRT or physiological saline was then administered daily. Left colotomy was performed after 2 months with end-to-end anastomosis, and resistance and collagen density were determined after 7 and 14 days.RESULTS: the anastomoses of the colons of rats receiving no HRT were less resistant than those of the control group both on the 7th (p=0.0488) and 14th (p=0.0115) day. Collagen density was lower on the 7th day (p=0.0210), with a lower presence of collagen I (p=0.0023) and collagen III (p=0.0470), and these differences continued to be significant on the 14th day. The colon anastomoses of rats receiving HRT did not differ significantly from control.CONCLUSION: The lack of ovarian hormones leads to a lower resistance and delays the maturation of colon anastomosis in rats and these deficiencies are compensated for by HRT.

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