title: Menopause, estrogens and frailty.
abstract: The controversy surrounding the results from the Women's Health Initiative (WHI) trials published a decade ago caused a significant decline in the use of menopausal hormone replacement therapy. However, these results have been vehemently contested and several lines of evidence suggest that in perimenopausal and non-obese women, estrogen therapy may indeed be of benefit. There is ample proof that menopause causes a loss of musculoskeletal tissue mass and quality, thereby causing a loss of health and quality of life. There is also solid evidence that hormone replacement therapy in itself prevents most of these effects in connective tissue in itself. Besides the independent, direct effects on the musculoskeletal tissues, estrogen deficiency also reduces the ability to adequately respond and adapt to external mechanical and metabolic stressors, e.g. exercise, which are otherwise the main stimuli that should maintain musculoskeletal integrity and metabolic function. Thus, normophysiological estrogen levels appear to exert a permissive effect on musculoskeletal adaptations to loading, thereby likely improving the outcome of rehabilitation following critical illness, musculoskeletal trauma or orthopedic surgical therapy. These effects add to the evidence supporting the use of estrogen therapy, particularly accelerated gain of functional capacity and independence following musculoskeletal disuse.
authors: Nordic Bioscience - Biomarkers and Research (Part of CCBR Group), Herlev, Copenhagen, Denmark. afn@nordicbioscience.com
authors: Anders
authors: A
authors: Nedergaard
authors: Kim
authors: K
authors: Henriksen
authors: Morten Asser
authors: MA
authors: Karsdal
authors: Claus
authors: C
authors: Christiansen
mesh_terms: D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000502:physiology*; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology*; D009142:Musculoskeletal Physiological Phenomena
chemical_list: D004967:Estrogens