Evolution of the goals of menopausal hormone therapy. From treatment for hot flushes to the new horizons of cardiometabolic protection
Female diseases associated with natural aging occur on average 10 years after the onset of menopause. The risk of cardiovascular diseases increases at the menopause. According to the latest scientific data, estrogens play an important role in maintaining the functional and morphological parameters of the vascular wall. The findings suggest that menopausal hormone therapy (MHT) provides a certain level of cardioprotection when MHT is performed in early postmenopause. A new concept of eu-estrogenemia (Eu-E) is proposed: that is the optimal concentration of estrogens, which provides/maintains the normal functioning of estrogen receptors (ERs) (the so-called functional density) in non-productive target organs. Chronic hypoestrogenemia leads to a primary ER functional defect with a further decline in the number of functioning ERs. (There is a reduced functional density). The concept of Eu-E makes it critical to estimate the timing of hormonal therapy initiation, at which there can be a protective effect on the vascular wall and the central nervous system.Yureneva S.V., Dubrovina A.V.
Keywords
eu-estrogenemia
estrogens
postmenopause
menopausal hormone therapy
cardiovascular diseases
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Received 06.04.2018
Accepted 20.04.2018
About the Authors
Svetlana V. Yureneva, doctor of medical sciences, leading research assistant of gynecological endocrinology department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79161797400. E-mail: syureneva@gmail.com
Anastasiya V. Dubrovina, postgraduate student of the 3rd year of the gynecological endocrinology department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79663877888. E-mail: a.dubrovina@list.ru
For citations: Yureneva S.V., Dubrovina A.V. Evolution of the goals of menopausal hormone therapy. From treatment for hot flushes to the new horizons of cardiometabolic protection. Clinical data. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (6): 18-24. (in Russian)
https://dx.doi.org/10.18565/aig.2018.6.18-24
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