In studies in which postmenopausal women received the testosterone analogue methyltestosterone, alone or in combination with estrogens, a dose of 10 mg/day induced virilizing signs such as acne and hirsutism in a sizeable proportion of the women.
When used in combination with estrogens in postmenopausal replacement therapy, progesterone reduced the excess risk for endometrial cancer found with estrogen alone but did not alter the increased risk for breast cancer.
4.2.2 Human carcinogenicity 22.214.171.124 Breast cancer The relationship between estrogen use and breast cancer risk is of paramount importance because of the frequency of this neoplasm, of which there are approximately 800 000 new cases per year worldwide, representing 21% of all cancers in women (Parkin et al., 1999).
Oral administration is the most popular route, although percutaneous methods are becoming commoner; use of injections, the first form of postmenopausal estrogen therapy, has been declining.
Information on the relationship between postmenopausal estrogen therapy and the risk for breast cancer is available from many epidemiological studies (Colditz, 1998; IARC, 1999).
Gillies GE and McArthur S (2010) Estrogen actions in the brain and the basis for differential action in men and women: a case for sex‐specific medicines. Pharmacological Reviews 62: 155–198.
National Institutes of Health (2005) State‐of‐the‐Science Conference statement: management of menopause‐related symptoms. Annals of Internal Medicine 142: 1003–1013.
Gadducci A, Biglia N, Cosio S, Sismondi P and Genazzani AR (2009) Progestagen component in combined hormone replacement therapy in postmenopausal women and breast cancer risk: a debated clinical issue. Gynecological Endocrinology 25: 807–815.
Rapp SR, Espeland MA, Shumaker SA et al. (2003) Effect of estrogen plus progestin on global cognitive function in postmenopausal women: the Women's Health Initiative Memory Study: a randomized controlled trial. Journal of the American Medical Association 289: 2663–2667.
Shumaker SA, Legault C, Kuller L et al. (2004) Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative Memory Study. Journal of the Americal Medical Association 291: 2947–2958.
Native Americans have used pumpkin seeds for centuries to improve bladder and prostate health. Pumpkin is also one of the few natural remedies to be tested in clinical trials: in one six-week study of postmenopausal women suffering from overactive bladder, almost 60% of participants showed marked improvement.
Palmetto is commonly used throughout Europe to treat the symptoms of benign enlarged prostate. Its precise mechanism of action is unclear but it has anti-inflammatory properties and is known to reduce the activity of enzymes linked to prostate problems. Clinical studies have proved that it reduces urinary frequency. But palmetto has some mild estrogenic effects; for that reason, women who are pregnant, breastfeeding, taking birth control pills or undergoing hormone therapy should avoid it.
While its symptoms and many non-invasive treatments are similar to those for overactive bladder, its underlying cause is quite different: it due to a weakening of the pelvic musculature which in men can occur following a prostatectomy and among women is a common aftermath to childbirth among women (exacerbated when estrogen levels decrease in the week before menstruation or following menopause.)
Anastrozole (inhibits the enzyme responsible for biosynthesis of oestrogens) in postmenopausal women with hormone sensitive Ductal Carcinoma In Situ (DCIS).
McLean Estradiol-17ß Explanation Biological data Absorption, distribution, and elimination Biotransformation Hydroxylation Conjugation Biochemical parameters Synthesis Mechanism of action Toxicological studies Acute toxicity Short-term studies of toxicity Long-term studies of toxicity and carcinogenicity Genotoxicity Reproductive toxicity Special studies on mechanism of action Observations in humans Therapeutic use Estradiol-related genetic markers of carcinogenicity Progesterone Explanation Biological data Absorption, distribution, and excretion Biotransformation Biochemical parameters Synthesis Mechamism of action Toxicological studies Acute toxicity Short-term studies of toxicity Long-term studies of toxicity and carcinogencity Genotoxicity Reproductive toxicity Observations in humans Testosterone Explanation Biological data Absorption, distribution, and elimination Biotransformation Biochemical parameters Synthesis Mechamism of action Toxicological studies Acute toxicity Short-term studies of toxicity Long-term studies of toxicity and carcinogenicity Genotoxicity Reproductive toxicity Observations in humans Epidemiological studies of women exposed to postmenopausal estrogen therapy and hormonal contraceptives Methods Postmenopausal oestrogen therapy Exposure Human carcinogenicity Breast cancer Endometrial cancer Cervical cancer Ovarian cancer Cancers of the liver and biliary tract Colorectal cancer Cutaneous malignant melanoma Thyroid cancer Summary and conclusions Cardiovascular disease Osteoporosis Overall mortality Hormonal contraceptives Exposure Human carcinogenicity Breast cancer Endometrial cancer Cervical cancer Ovarian cancer Cancers of the liver and biliary tract Colorectal cancer Cutaneous malignant melanoma Thyroid cancer Summary and conclusions Cardiovascular disease Acute myocardial infarct Stroke Venous thromboembolism Overall mortality Meat intake and cancer risk Comments and evaluation Estradiol-17ß Progesterone Testosterone References The purpose of this monograph is to provide a review and summary of the scientific information relative to a toxicological assessment of the safety of three endogenous hormones, estradiol-17ß, progesterone, and testosterone, with emphasis on information published since the review of the Committee at its thirty-second meeting (Annex 1, reference 80).