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Estrogen is a hormone associated with female sex and is responsible for the development of female sexual characteristics.
There are three major endogenous estrogens, that have estrogenic hormonal activity: estrone, estradiol , and estriol. Estradiol, is the most potent and prevalent.
The effects of estrogens on the body:
Breast: Estrogen is responsible for developing breast and mammary gland tissue.
It causes breast development during puberty in females.
Estrogen is also responsible for the development of mammary ducts during puberty and pregnancy, functions to secrete breast milk in postpartum lactation.
Estrogens thickening the endometrial lining in preparation for pregnancy.
Vagina: Estrogen supports the proliferation of epithelial mucosa cells of the vagina and the vulva. In the absence of estrogen, the vaginal and vulvar mucosal epithelium becomes thin and presents with symptoms of dryness known as vulvovaginal atrophy.
During puberty, estrogen aids in the development of long bones and fusion of the epiphyseal growth plates. Estrogen protects bones by inactivating osteoclast activity, preventing osteoporosis in both estrogen-deficient and postmenopausal women.
Cardiovascular: Estrogen affects plasma lipids by increasing high-density lipoproteins (HDL) and triglyceride levels while decreasing low-density lipoproteins (LDL) and total plasma cholesterol and reduce the risk of coronary artery disease in early use in postmenopausal women.
The FDA has approved estrogen for hormone replacement therapy in the treatment of symptoms of menopause.
Ethinyl estradiol is a commonly used synthetic estrogen to prevent pregnancy as a component of the oral contraceptive pill approved by the FDA.
Estrogen or estradiol is the most common form of estrogen hormone for FDA-approved treatment as hormone replacement therapy
Clinically, the use of estrogen includes the following FDA-approved indications:
Primary ovarian insufficiency,
Female hypogonadism,
Symptoms associated with menopause including vulvovaginal atrophy, dyspareunia, hot flashes and night sweats, and prevention of osteoporosis,
Oral contraceptive pill (OCP) to prevent pregnancy,
Moderate acne vulgaris,
Prostate cancer with advanced forms of metastasis.
Estrogens are in male body also. While estrogen levels are significantly lower in males than in females, estrogens nevertheless have important physiological roles in males.
The balance of two steroid hormones, androgen and estrogen, plays an important role in male reproductive organs, and is essential for normal prostate development and prostatic homeostasis. However, estrogen signaling also plays a role in maintaining the male reproductive system. ERα is expressed in prostatic tissues during fetal development.
Estrogens are Steroidal hormone, which means it reaches cell nucleus and induce DNA transcription.
Natural estrogen and synthetic estrogen may cause the following common adverse effects: breast tenderness, nausea, vomiting, bloating, stomach cramps, headaches, weight gain, hyperpigmentation of the skin, hair loss, vaginal itching, abnormal uterine bleeding, also known as breakthrough bleeding, and anaphylaxis.
Weight gain may be a reported adverse effect of the oral contraceptive pill (OCP) containing ethinyl estradiol, but studies conducted on short-term and long-term use of OCPs resulted in no weight gain association.
More severe but rare side effects of estrogen include: hypertension, cerebrovascular accident, myocardial infarction, venous thromboembolism, pulmonary embolism, exacerbation of epilepsy, irritability, exacerbation of asthma, galactorrhea and nipple discharge, hypocalcemia, gallbladder disease, hepatic hemangioma and adenoma, pancreatitis, breast hypertrophy, endometrial hyperplasia, vaginitis, vulvovaginal candidiasis (intravaginal preparations), enlargement of uterine fibroids, and risk of cervical cancer and breast cancer.
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