Long-term use of estrogens: benefit or risk

COMMENTARY ON THE LAW

Long-term use of estrogens: benefit or risk

Bogusława Pietrzak 1 , Ewelina Wlaźlak 1 , Ewa Zwierzyńska 1

1. Zakład Farmakodynamiki Uniwersytetu Medycznego w Łodzi

Published: 2015-03-05
DOI: 10.5604/17322693.1142582
GICID: 01.3001.0009.6502
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2015; 69 : 285-293

 

Abstract

Estrogens are widely used in hormone replacement therapy, gynecology, urogynecology and rarely in dermatology. Non-therapeutic use of estrogens is very widespread. Estrogens are used as contraceptives, which cause a lot of serious side effects. A common clinical problem is skin hyperpigmentation (melasma), occurring mainly in women who take contraceptives with high doses of estrogens. But low doses of estrogens may also cause skin side effects. The mechanism of melasma development is very complicated and not fully understood. It is very likely that UV radiation and genetic background can affect melasma development. Effective therapy should lead to prevention or alleviation of relapses. Treatment should also reduce the area of lesions and improve the appearance of skin. There is no effective and universal pattern of treatment, in which only one substance or method is used. A combination of different methods is used to optimize the therapy. An important role is attributed to prevention, especially protection from UV radiation.

References

  • 1. Cayce K.A., McMichael A.J., Feldman S.R.: Hyperpigmentation:an overview of the common afflictions. Dermatol. Nurs., 2004; 16:401-416
    Google Scholar
  • 2. Cody J.D., Jacobs M.L., Richardson K., Moehrer B., Hextall A.:Oestrogen therapy for urinary incontinence in post-menopausalwomen. Cochrane Database Syst. Rev., 2012; 10: CD001405
    Google Scholar
  • 3. Collaborative Group on Epidemiological Studies of Ovarian Cancer:Ovarian cancer and oral contraceptives: collaborative reanalysisof data from 45 epidemiological studies including 23257 womenwith ovarian cancer and 87303 controls. Lancet, 2008; 371: 303-314
    Google Scholar
  • 4. Costin G.E., Hearing V.J.: Human skin pigmentation: melanocytesmodulate skin color in response to stress. FASEB J., 2007; 21: 976-994
    Google Scholar
  • 5. Członkowska A., Ciesielska A., Joniec I.: Influence of estrogens onneurodegenerative processes. Med. Sci. Monit., 2003; 9: RA247-RA256
    Google Scholar
  • 6. Dickinson B.D., Altman R.D., Nielsen N.H., Sterling M.L., Councilon Scientific Affairs, American Medical Association: Drug interactionsbetween oral contraceptives and antibiotics. Obstet. Gynecol.,2001; 98: 853-860
    Google Scholar
  • 7. Drukała J., Bobis S., Żabińska-Płazak E., Wojas-Pelc A.: Molekularnepodłoże zaburzeń pigmentacji w chorobach skóry. Przegl. Lek.,2009; 66: 145-149
    Google Scholar
  • 8. Fang H., Tong W., Shi L.M., Blair R., Perkins R., Branham W., HassB.S., Xie Q., Dial S.L., Moland C.L., Sheehan D.M.: Structure-activityrelationships for a large diverse set on natural, synthetic, and environmentalestrogens. Chem. Res. Toxicol., 2001; 14: 280-294
    Google Scholar
  • 9. Goldberg D.J., Berlin A.L., Phelps R.: Histologic and ultrastructuralanalysis of melasma after fractional resurfacing. Lasers Surg.Med., 2008; 40: 134-138
    Google Scholar
  • 10. Grimes P.E., Yamada N., Bhawan J.: Light microscopic, immunohistochemicaland ultrastructural alterations in patients withmelasma. Am. J. Dermatopathol., 2005; 27: 96-101
    Google Scholar
  • 11. Gupta A.K., Gover M.D., Nouri K., Taylor S.: The treatment ofmelasma: a review of clinical trials. J. Am. Acad. Dermatol., 2006;55: 1048-1065
    Google Scholar
  • 12. Hesson J.: Cumulative estrogen exposure and prospective memoryin older women. Brain Cogn., 2012; 80: 89-95
    Google Scholar
  • 13. Ingber A.: Hyperpigmentation and melasma. W: Obstetric Dermatology:A Practical Guide, red.: A. Ingber, M. Lebwohl. Heidelberg:Springer, Berlin 2009, 7-18
    Google Scholar
  • 14. Jadotte Y.T., Schwartz R.A.: Melasma: insights and perspectives.Acta Dermatovenerol. Croat., 2010; 18: 124-129
    Google Scholar
  • 15. Jian D., Jiang D., Su J., Chen W., Hu X., Kuang Y., Xie H., Li J., ChenX.: Diethylstilbestrol enhances melanogenesis via cAMP-PKA-mediatingup-regulation of tyrosinase and MITF in mouse B16 melanomacells. Steroids, 2011; 76: 1297-1304
    Google Scholar
  • 16. Kang W.H., Yoon K.H., Lee E.S., Kim J., Lee K.B., Yim H., Sohn S.,Im S.: Melasma: histopathological characteristics in 56 Korean patients.Br. J. Dermatol., 2002; 146: 228-237
    Google Scholar
  • 17. Kauvar A.N.: Successful treatment of melasma using a combinationof microdermabrasion and Q-switched Nd:YAG lasers. LasersSurg. Med., 2012; 44: 117-124
    Google Scholar
  • 18. Kim E.H., Kim Y.C., Lee E.S., Kang H.Y.: The vascular characteristicsof melasma. J. Dermatol. Sci., 2007; 46: 111-116
    Google Scholar
  • 19. Kim Y.J., Uyama H.: Tyrosinase inhibitors from natural and syntheticsources: structure, inhibition mechanism and perspective forthe future. Cell. Mol. Life Sci., 2005; 62: 1707-1723
    Google Scholar
  • 20. Kuhl H.: Pharmacology of estrogens and gestagens. W: Menopause- Andropause: Hormone replacement therapy through theages. New cognition and therapy concepts, red.: F. Fischl. Krause &Pachernegg GesmbH, Gablitz 2001, 33-50
    Google Scholar
  • 21. Kuhl H.: Pharmacology of estrogens and progestogens: influence ofdifferent routes of administration. Climacteric, 2005; 8 (Suppl. 1): 3-63
    Google Scholar
  • 22. Markou A., Duka T., Prelevic G.M.: Estrogens and brain function.Hormones, 2005; 4: 9-17
    Google Scholar
  • 23. Męczekalski B., Czyżyk A.: Konwencjonalna hormonalna terapiazastępcza w leczeniu osteoporozy. Pol. Merkur. Lekarski, 2009;27: 72-76
    Google Scholar
  • 24. Nemere I., Pietras R.J., Blackmore P.F.: Membrane receptors forsteroid hormones: signal transduction and physiological significance.J. Cell. Biochem., 2003; 88: 438-445
    Google Scholar
  • 25. Otręba M., Rok J., Buszman E., Wrześniok D.: Regulacja melanogenezy:rola cAMP i MITF. Postępy Hig. Med. Dośw., 2012; 66: 33-40
    Google Scholar
  • 26. Persson I., Weiderpass E., Bergkvist L., Bergström R., Schairer C.:Risk of breast and endometrial cancer after estrogen and estrogenprogestinreplacement. Cancer Causes Control, 1999; 10: 253-260
    Google Scholar
  • 27. Piechota E., Baranowski W.: Estetrol – potencjalne zastosowaniaw ginekologii i onkologii ginekologicznej. Prz. Menopauzalny,2009; 8: 84-86
    Google Scholar
  • 28. Rendon M., Berneburg M., Arellano I., Picardo M.: Treatmentof melasma. J. Am. Acad. Dermatol., 2006; 54 (Suppl. 2): S272-S281
    Google Scholar
  • 29. Rodriguez C., Patel A.V., Calle E.E., Jacob E.J., Thun M.J.: Estrogenreplacement therapy and ovarian cancer mortality in a large prospectivestudy of US women. JAMA, 2001; 285: 1460-1465
    Google Scholar
  • 30. Sarkar R., Puri P., Jain R.K., Singh A., Desai A.: Melasma in men:a clinical, aetiological and histological study. J. Eur. Acad. Dermatol.Venereol., 2010; 24: 768-772 32 Sheth V.M., Pandya A.G.: Melasma: a comprehensive update:part I. J. Am. Acad. Dermatol., 2011; 65: 689-697 [31] Sheth V.M., Pandya A.G.: Melasma: a comprehensive update:part II. J. Am. Acad. Dermatol., 2011; 65: 699-714 [33] Shweta K., Khozema S., Meenu R., Anupama S., Singh S.K., NeelimaS.: A systemic review on melasma. Int. J. Curr. Biol. Med. Sci.,2011; 1: 63-68 34 Sintim-Damoa A., Lambert W.C., Schwartz R.A.: Ostuda: nowe poglą-dy na temat zaburzeń barwnikowych. Dermat. Estet., 2006; 46: 258-264 35 Sobjanek M., Sokołowska-Wojdyło M., Barańska-Rybak W., NowickiR., Włodarkiewicz A.: Rola czynników hormonalnych w etiopatogeneziei terapii trądziku pospolitego. Post. Dermatol. Alergol.,2006; 23: 266-272 36 Sobstyl M., Tkaczuk-Włach J., Jakiel G.: Farmakologiczne leczenieendometriozy. Prz. Menopauzalny, 2010; 3: 194-197 37 Świtalska M., Strządała L.: Niegenomowe działanie estrogenów.Postępy Hig. Med. Dośw., 2007; 61: 541-547 38 Thornton M.J.: The biological actions of estrogens on skin. Exp.Dermatol., 2002; 11: 487-502 39 Ting P.T., Barankin B.: Can you identify this condition? Melasma.Can. Fam. Physician, 2005; 51: 353-355 40 Urban M., Banks E., Egger S., Canfell K., O’Connell D., Beral V., SitasF.: Injectable and oral contraceptive use and cancers of the breast,cervix, ovary, and endometrium in black South African women: casecontrolstudy. PLoS Med., 2012; 9: e1001182 41 Victor F.C., Gelber J., Rao B.: Melasma: a review. J. Cutan. Med.Surg., 2004; 8: 97-102 42 Zoccali G., Piccolo D., Allegra P., Giuliani M.: Melasma treatedwith intense pulsed light. Aesthetic Plast. Surg., 2010; 34: 486-493
    Google Scholar

Full text

Skip to content