The Impact of Estrogen Decline on Other Noncommunicable Diseases
摘要
The widespread distribution of estrogen receptors (ER) conditions that the decline in the circulating levels of estrogens with menopause has a series of effects. Some of them may influence the risk to some noncommunicable diseases (NCD) or, if not attaining sufficient impact to modify the risk for disease, unless some level of organ dysfunctions. This chapter summarizes some remarkable changes on the central nervous system (CNS), the vasculature, and the bone joints, specifically osteoarthritis. The actions on the CNS are analyzed following a stepwise procedure so that the effect of estrogen deprivation on experimental models, from culture cells to live animals, is followed by the review of clinical studies. Both cognitive functions and mood are analyzed. The same strategy, experimental models followed by clinical data, is reproduced to revise vascular actions. The effect of estrogen deprivation on vascular physiology is reviewed along with the increased risk of diseases, such as diabetes or hyperlipidemia, which have been related to increased cardiovascular risk. The risk of atherosclerosis is therefore increased, something that is analyzed together with a concomitant clinical impact. This is more evident in the case of surgical or premature menopause. Osteoarthritis is presented, again, in a perspective in which experimental data are contrasted with clinical studies. The discrepancies between studies remain unresolved so that the loss of estrogen support, despite being frequently associated with joint pain, does not seem to be clearly related to an obvious deleterious action on cartilage function.