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2003, Number 2

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Rev Endocrinol Nutr 2003; 11 (2)

Menopause: New evidences, new enigmas

Manuel MJ

Language: Spanish
References: 126
Page: 61-72
PDF size: 148.31 Kb.


ABSTRACT

Recent advances on menopause are reviewed. Menopause is considered as an adaptation related with grandmothers’ role on children’s survival. A tendency toward a later age at menopause appears in industrialized, but not in developing countries. Postmenopausal obese women may have significant estrogen exposure resulting from peripheral conversion of androgens. The complex interaction of estrogens deprivation with the metabolic syndrome probably results in a neutral effect on insulin resistance. The influence of hormone replacement in cardiovascular risk is reported to be beneficial in cross-sectional as well as in prospective observational studies. In prospective randomized studies, however, increased risk is reported. The estrogen-progestin arm of the Women’s Health Initiative Study was stopped because of increased cardiovascular and breast cancer risk. However, women in the study had a mean age of 63, and were asymptomatic. The effect of hormone therapy on markers of inflammation is not consistent. At postmenopause physical and emotional symptoms depend on estrogen deprivation, and on other biological, social and environmental factors. Estrogen treatment provides relief for physical symptoms, but are useful to control emotional symptoms only in selected cases. Androgens are another therapeutic alternative. For osteoporosis, the polymorphysms of estrogen receptor, osteoproteregin, and the aromatase gene have interesting perspectives to identify women at risk. It was concluded that the risk-benefit balance for treatment at this stage of women’s life, depend on careful evaluation of factors in each case.


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