Hypoestrogenism: Difference between revisions
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* [[Menopause]] |
* [[Menopause]] |
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| ⚫ | * [[Premature ovarian failure]] due to varying causes, such as radiation therapy, chemotherapy, or a natural decline. This can often lead to infertility.<ref>{{Cite web|last=Nelson|first=Lawrence M.|date=2009|title=Primary Ovarian Insufficiency|url=https://www.nejm.org/doi/pdf/10.1056/NEJMcp0808697|url-status=live|archive-url=|archive-date=|access-date=2020-07-30|website=http://dx.doi.org/10.1056/NEJMcp0808697|language=EN|doi=10.1056/nejmcp0808697|pmc=PMC2762081|pmid=19196677}}</ref> |
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* [[Premature ovarian failure]] |
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* Certain medications (e.g., [[aromatase inhibitor]]s, [[CYP17A1 inhibitor]]s) |
* Certain medications (e.g., [[aromatase inhibitor]]s, [[CYP17A1 inhibitor]]s) |
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* [[ |
* [[Gonadotropin insensitivity]] |
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* [[ |
* [[Inborn errors of steroid metabolism]] (e.g., [[aromatase deficiency]], [[17α-hydroxylase deficiency]], [[17,20-lyase deficiency]], [[3β-hydroxysteroid dehydrogenase deficiency]], and [[lipoid congenital adrenal hyperplasia|cholesterol side-chain cleavage enzyme or steroidogenic acute regulatory protein deficiency]]) |
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* Natural menopause |
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* Functional amenorrhea |
* Functional amenorrhea |
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| ⚫ | * |
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* |
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== Pathophysiology == |
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Under hypoestrogenic conditions, the vaginal epithelium becomes thinner, its barrier function is lost, the vaginal folding decreases, the elasticity of the tissues decreases, and the secretory activity of the Bartholin glands decreases, which lead to traumatization of the vaginal mucosa and painful sensations.<ref>{{Cite journal|last=Naumova|first=Iuliia|last2=Castelo-Branco|first2=Camil|date=2018|title=Current treatment options for postmenopausal vaginal atrophy|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074805/|journal=International Journal of Women's Health|volume=10|pages=387–395|doi=10.2147/IJWH.S158913|issn=1179-1411|pmc=6074805|pmid=30104904|via=}}</ref> |
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==Diagnosis== |
==Diagnosis== |
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Revision as of 18:59, 30 July 2020
 | This article needs additional citations for verification. (February 2018) |
| Hypoestrogenism | |
|---|---|
| Other names | Estrogen deficiency |
 | |
| Lower level of estrogen exist in this condition | |
| Specialty | Gynecology |
Hypoestrogenism, or estrogen deficiency, refers to a lower than normal level of estrogen, the primary sex hormone in women. In general, lower levels of estrogen may cause differences in the breasts, genitals, urinary tract, and skin.
Hypoestrogenism is most commonly found in women who are postmenopausal, have premature ovarian failure, or are suffering from amenorrhea; however, it is also associated with hyperprolactinemia and the use of gonadotropin-releasing hormone (GnRH) analogues in treatment of endometriosis.[1] It has also been linked to scoliosis and young women with type 1 diabetes mellitus.
Signs and symptoms
Symptoms of hypoestrogenism can manifest in a variety of mild signs and symptoms in the body including:
Vasomotor symptoms[2]
- Diminished sleep quality, irritability, difficulty concentrating, sleep disturbances, mood changes
- Presentations of low estrogen levels include hot flashes, headaches, and breast atrophy.
Genitourinary symptoms[3]
- Genital dryness, burning, irritation, lowered libido
- Hypoestrogenism is also considered one of the major risk factors for developing uncomplicated urinary tract infections (UTIs) in postmenopausal women who do not take hormone replacement therapy.
- Low levels of estrogen can lead to dyspareunia and limited genital arousal because of changes in the four layers of the vaginal wall.[4]
- atrophic changes such as pH change in the vagina[5] is also linked to hypoestrogenism.
Bone Mineral Density
- Reduced bone density leading to secondary osteoporosis
Causes
Hypogonadotropic hypogonadism
Hypogonadotropic hypoganadism is a condition where
hyperandrogenism, lactation, certain medications (e.g., androgens/anabolic steroids, progestogens, prolactin releasers, GnRH analogues), pituitary gland/hypothalamus damage, or isolated hypogonadotropic hypogonadism (e.g., Kallmann syndrome, CHARGE syndrome, GnRH insensitivity)
Hypergonadotropic hypogonadism
Hypergonadotropic hypogonadism
- Menopause
- Premature ovarian failure due to varying causes, such as radiation therapy, chemotherapy, or a natural decline. This can often lead to infertility.[6]
- Certain medications (e.g., aromatase inhibitors, CYP17A1 inhibitors)
- Gonadotropin insensitivity
- Inborn errors of steroid metabolism (e.g., aromatase deficiency, 17α-hydroxylase deficiency, 17,20-lyase deficiency, 3β-hydroxysteroid dehydrogenase deficiency, and cholesterol side-chain cleavage enzyme or steroidogenic acute regulatory protein deficiency)
- Functional amenorrhea
Pathophysiology
Under hypoestrogenic conditions, the vaginal epithelium becomes thinner, its barrier function is lost, the vaginal folding decreases, the elasticity of the tissues decreases, and the secretory activity of the Bartholin glands decreases, which lead to traumatization of the vaginal mucosa and painful sensations.[7]
Diagnosis
![[icon]](/wiki/File:Wiki_letter_w_cropped.svg){kind=small} | This section is empty. You can help by adding to it. (November 2017) |
Treatment
Hormone replacement therapy (HRT) is an effective therapy for the treatment of hypoestrogenism and menopause related symptoms . HRT has been used with estrogen can be used to treat hypoestrogenism both in premenopausal and postmenopausal women. Low dose estrogen, approved by the FDA for treatment of menopause-related symptoms, can be used with or without a pro-gestational agent to improve symptoms such as hot flashes, sweating, insomnia, and vaginal dryness and discomfort.
- Treatments for hypoestrogenism vasomotor symptoms include:
- Conjugated equine estrogens (0.3 to 0.625 mg)
- Micronized 17β-estradiol (0.5 to 1 mg)
- Transdermal estradiol (14 to 100 μg)
- Ethinyl estradiol (0.01 to 0.02 mg)
- Vaginal estrogenic preparations (estradiol ring)
See also
- Aromatase deficiency
- Estrogen insensitivity syndrome
- Aromatase excess syndrome
- Hypogonadism
- Hyperestrogenism
- Hypoandrogenism
- Hypergonadism
- Hyperandrogenism
References
- ^ Meczekalski, Blazej; Podfigurna-Stopa, Agnieszka; Genazzani, Andrea Riccardo (2010-09-01). "Hypoestrogenism in young women and its influence on bone mass density". Gynecological Endocrinology. 26 (9): 652–657. doi:10.3109/09513590.2010.486452. ISSN 0951-3590.
- ^ Warren, Michelle P.; Shu, Aimee R.; Dominguez, Jennifer E. (2000), Feingold, Kenneth R.; Anawalt, Bradley; Boyce, Alison; Chrousos, George (eds.), "Menopause and Hormone Replacement", Endotext, South Dartmouth (MA): MDText.com, Inc., PMID 25905278, retrieved 2020-07-30
- ^ Portman, David J.; Gass, Margery L. S.; Panel, on behalf of the Vulvovaginal Atrophy Terminology Consensus Conference (2014). "Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and The North American Menopause Society". Menopause. 21 (10): 1063–1068. doi:10.1097/GME.0000000000000329. ISSN 1530-0374.
- ^ Lara, L. A.; Useche, B; Ferriani, R. A.; Reis, R. M.; De Sá, M. F.; De Freitas, M. M.; Rosa e Silva, J. C.; Rosa e Silva, A. C. (2009). "The effects of hypoestrogenism on the vaginal wall: Interference with the normal sexual response". The Journal of Sexual Medicine. 6 (1): 30–9. doi:10.1111/j.1743-6109.2008.01052.x. PMID 19170834.
- ^ Sartori, M. G.; Feldner, P. C.; Jarmy-Di Bella, Z. I.; Aquino Castro, R; Baracat, E. C.; Rodrigues De Lima, G; Castello Girão, M. J. (2011). "Sexual steroids in urogynecology". Climacteric. 14 (1): 5–14. doi:10.3109/13697137.2010.508542. PMID 20839956.
- ^ Nelson, Lawrence M. (2009). "Primary Ovarian Insufficiency". http://dx.doi.org/10.1056/NEJMcp0808697. doi:10.1056/nejmcp0808697. PMC 2762081. PMID 19196677. Retrieved 2020-07-30.
{{cite web}}: External link in|website= - ^ Naumova, Iuliia; Castelo-Branco, Camil (2018). "Current treatment options for postmenopausal vaginal atrophy". International Journal of Women's Health. 10: 387–395. doi:10.2147/IJWH.S158913. ISSN 1179-1411. PMC 6074805. PMID 30104904.
{{cite journal}}: CS1 maint: unflagged free DOI (link)
External links
- Gonadotropin-releasing hormone agonist-induced hypoestrogenism and blood flows in cerebral arteries.
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