Lecture 23

Question 1

steroid hormone production

Answer 1

male and female gonards release sex steroid hormones which bind to steroid receptors. There are nuclear (slow) and membrane (fast) steroid receptors.

Question 2

hormone deprivation

Answer 2

androgen and estrogen receptors are found in muscles and bones. Hormone deprivation decreases bioavailability of ligands able to bind to receptors. Increases risk osteoporosis, sarcopenia, fracture risk. Not only side effects.

Question 3

Women’s health initiative

Answer 3

> 27000 participants on HRT’s effects on coronary heart disease from 1992-2007. Postmenopausal women received conjugated equine estrogens with/without MPA. stopped in 2004 due to increase coronary events and memory decline though it decreased fractures. Other studies found starting HRT early in menopause is beneficial.

Question 4

Estrogen treatment in men

Answer 4

Oral estrogen was common treatment for prostate cancer until 1980s. Replaced with LHRH agonists in 1980s due to increase in CVD deaths. Hepatic metabolism of oral estrogens increases clotting factor, increase thromboembolism risk. Non-oral estrogens have similar CVD risks as LHRH agonists in prostate cancer patients.

Question 5

Benefits of HRT

Answer 5

decrease risk of bone fractures in post menopausal women, transdermal estradiol treatments preserve bone mineral density in androgen-deprived men. Estradiol decreases fracture risk in androgen-deprived men.

Question 6

Benefit of HRT on muscle health

Answer 6

HRT does not increase lean muscle mass in postmenopausal women, it increases muscle strength. Testosterone RT increases muscle mass in middle-aged/older men (more effective with intramuscular injections) and increase muscle strength in older hypogonadal men

Question 7

HRT and osteoarthritis

Answer 7

Unknown impact on OA in post-menopausal women