[Association of estrogens and selective estrogens receptors modulators: towards a renewal of the hormonal treatment?].
The life expectancy of women has risen in the past century from 48years to more than 80. The decline of endogenous estrogen production (in particular, the principal circulating physiological hormone, 17β-estradiol) at menopause (which occurs at an average of 51years) is often accompanied by a series of functional disorders that affect quality of life (QoL). This estrogen deficiency affects different tissues and results in an increase in the prevalence of various disorders, including but not limited to osteoporosis and cardiovascular disease. Hormone therapy for menopause is a relatively recent biomedical challenge, which underwent a downturn after the Women Health Initiative study of older postmenopausal women. We will summarize the WHI findings in the first part of this article. At Inserm unit 1048, we are working on understanding the protective effects of estrogen against the development of atherosclerosis and type 2 diabetes in murine models. We have also focused in recent years on modeling the impact of estrogen in thrombosis models, to attempt to clarify the complex relation between estrogen and thrombotic risk. In part II of this article, we will describe a new strategy of hormone therapy for menopause, combining estrogens and selective estrogen receptor modulators (SERM). We review the scientific underpinnings of this strategy, which may enable the renewal of hormone therapy for menopause.
CHU de Toulouse, université Toulouse III, service d'odontologie, Inserm U1048, I2MC, 31059 Toulouse, France.
Marie-Cécile
MC
Valéra
CHU de Toulouse, université Toulouse III, service de chirurgie gynécologique, Inserm U1048, I2MC, 31059 Toulouse, France.
Elodie
E
Chantalat
CHU de Toulouse, université Toulouse III, service d'odontologie, Inserm U1048, I2MC, 31059 Toulouse, France.
Alexia
A
Vinel
CHU de Toulouse, université Toulouse III, service d'urologie, Inserm U1048, I2MC, 31059 Toulouse, France.
Thibaut
T
Benoit
CHU de Toulouse, université Toulouse III, service d'explorations fonctionnelles physiologiques, Inserm U1048, I2MC, 31059 Toulouse, France.
Maeva
M
Guillaume
CHU de Toulouse, université Toulouse III, service d'urologie, Inserm U1048, I2MC, 31059 Toulouse, France.
Xavier
X
Game
CHU de Toulouse, université Toulouse III, service de diabétologie, Inserm U1048, I2MC, 31059 Toulouse, France.
Pierre
P
Gourdy
CHU de Toulouse, université Toulouse III, centre de la ménopause, Inserm U1048, I2MC, 31059 Toulouse, France.
Florence
F
Trémollières
CHU de Toulouse, université Toulouse III, laboratoire d'hématologie, Inserm U1048, I2MC, 31059 Toulouse, France.
Bernard
B
Payrastre
CHU de Toulouse, université Toulouse III, service d'explorations fonctionnelles physiologiques, Inserm U1048, I2MC, 31059 Toulouse, France. Electronic address: Jean-Francois.Arnal@inserm.fr.
Jean-François
JF
Arnal
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000379:methods* / Q000639:trends*; D004967:Estrogens / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology / Q000517:prevention & control; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage* / Q000009:adverse effects
D004967:Estrogens; D020845:Selective Estrogen Receptor Modulators