Low Estrogen Research Articles

Gut microbiota and butyrate contribute to nonalcoholic fatty liver disease in premenopause due to estrogen deficiency.

The incidence of nonalcoholic fatty liver disease (NAFLD) in postmenopausal women has increased significantly. Estrogen plays a very important role in NAFLD, but whether NAFLD in premenopausal women was caused by estrogen deficiency was unknown. Thus, it is of great clinical significance to explore the mechanism of NAFLD in premenopausal women. Gut microbiota and its metabolites short chain fatty acids (SCFA) have been shown to play important roles in the development of NAFLD. In this study, we investigated the impact of gut microbiota and SCFA in NAFLD patients and mice caused by estrogen deficiency. We showed that premenopause NAFLD patients had much lower estrogen levels. Estrogen deficient mice, due to ovariectomy (OVX), suffered more severe liver steatosis with an elevated body weight, abdominal fat weight, serum triglycerides and deterioration in hepatic steatosis. Altered gut microbiota composition and decreased butyrate content were found in NAFLD patients and in OVX mice. Furthermore, fecal microbiota transplantation (FMT) or supplementing with butyrate alleviated NAFLD in OVX mice. The production of antimicrobial peptides (AMP) Reg3ɣ, β-defensins and the expression of intestinal epithelial tight junction, including ZO-1 and Occluding-5, were decreased in the OVX mice compared to control mice. Upregulation of PPAR-ɣ and VLDLR, downregulation of PPAR-ɑ indicated that OVX mice suffered from abnormal lipid metabolism. These data indicate that changes in the gut microbiota and SCFA caused by estrogen reduction, together with a disorder in AMP production and lipid metabolism, promote NAFLD, thus provide SCFAs derived from microbiota as new therapeutic targets for the clinical prevention and treatment of NAFLD.

Low testosterone concentrations and risk of ischaemic cardiovascular disease in ageing: not just a problem for older men

Coronary heart disease, myocardial infarction, and ischaemic stroke increase sharply in prevalence with age in both men and women.1 The understanding that such diseases are more likely to occur in women after the menopause has motivated research into the cardiovascular effects of low blood oestrogen concentrations. By contrast, it is less well appreciated that blood testosterone concentrations also decrease gradually with age in women, although these concentrations can rise again at the start of the seventh decade.

Abstract WP252: Tamoxifen Treatment Worsens Astrocyte Activation And Mitochondrial Stress From Oxygen Glucose Deprivation

Introduction: Tamoxifen (TAM), a selective estrogen receptor modifier, is a first-line treatment option for hormone receptor positive breast cancer. TAM inhibits the downstream estrogen receptor signaling in tumor cells. Stroke risk is increased in women with low estrogen levels, such as early-onset menopause, and doubles in women after the age of 55, which corresponds with the average age of menopause. Women with breast cancer who were treated with tamoxifen had an increased risk for ischemic stroke (82%). Since stroke severity is associated with increased blood brain barrier (BBB) damage, we investigated the effects of tamoxifen on activation and mitochondrial stress in astrocytes, which is a cellular component of the BBB. Methods: Cultured female human astrocytes were treated with tamoxifen (1uM), 17ß-estradiol (10nM), or vehicle (DMSO) for 24 hours. Cells were separated into two groups: normoxic (21% O2, 25mM glucose) or oxygen and glucose deprivation (OGD) conditions 6 hours before analysis. ROS production was measured using the Cellular ROS Assay Kit (Red) and aquaporin-4 levels were visualized via immunocytochemistry. Mitochondrial function was assessed by using a Seahorse XFe96 Analyzer. Results: Tamoxifen treatment increased Aquaporin-4 protein levels (p <0.0001) in cultured astrocytes after OGD compared to both vehicle (DMSO) and 17ß-estradiol treatment. While there was no significant effect, tamoxifen treated cells showed a trend toward (p =0.0732) increased ROS production after OGD compared to vehicle. Additionally, tamoxifen reduced oxygen consumption rate (p =0.0197) and basal respiration under normoxic conditions in astrocytes when compared with DMSO or 17ß-estradiol treatment. Conclusions: Tamoxifen treatment altered the expression of a water channel protein and decreased the ability to respond to oxidative stress in astrocytes. Aquaporin-4, when localized to the astrocytic end feet, facilitates edema after stroke, and ischemic stroke by definition puts brain tissue under oxidative stress. Our findings suggest tamoxifen may increase edema, which is known to impair stroke recovery. These data suggest a mechanism by which breast cancer treatment may increase the risk for severe ischemic stroke. Supported by RFAG042189 to FS

POS-981 PREMATURE OVARIAN FAILURE SECONDARY TO LOW DOSE INTRAVENOUS CYCLOPHOSPHAMIDE IN A YOUNG WOMAN WITH RELAPSED LUPUS NEPHRITIS

Cyclophosphamide (CYC) is a nonspecific cell cycle cytotoxic antiproliferative agent that is used in inducing remission in lupus nephritis (LN) and it also possesses a wide spectrum of toxicities, particularly premature ovarian failure (POF) in woman. Ovarian damage often manifests with amenorrhoea, low estrogen level and increased follicle stimulating hormone (FSH) and luteinizing hormone (LH), which resemble the hormonal changes seen at menopausal woman.

Postmenopausal Vaginal Microbiome and Microbiota.

The ovulatory cycle has a significant influence on the microbial composition, according to the action of estrogen and progesterone on the stratified squamous epithelium, due to an increase in epithelial thickness, glycogen deposition, and influence on local immunology. The 16S rRNA gene amplification and pyrosequencing study demonstrated that healthy women have community state types (CST), classified as; type “L,” with a predominance of Lactobacillus crispatus, type II, with a predominance of Lactobacillus gasseri, type III, where Lactobacillus iners predominates, and type V with a predominance of Lactobacillus jensenii. Type IV does not identify lactobacilli but a heterogeneous population of bacteria. There seems to be a relationship between increased vaginal bacterial diversity and poverty of lactobacilli with the complaining of vaginal dryness. With menopause, there appears to be a reduction in lactobacilli associated with higher serum levels of follicle-stimulating hormone (FSH) and lower estrogen levels. The evaluation of Gram-stained vaginal smears in postmenopause women must take into account the clinical-laboratory correlation. We should observe two meanly possibilities, atrophy with few bacterial morphotypes, without inflammatory, infiltrate (atrophy without inflammation), and atrophy with evident inflammatory infiltrate (atrophy with inflammation or atrophic vaginitis). The relationship between the microbiome and postmenopausal vulvovaginal symptoms seems to be related to the bacterial vaginal population. However, more robust studies are needed to confirm this impression.

Salt Sensitivity of Blood Pressure and Aldosterone: Interaction Between the Lysine-specific Demethylase 1 Gene, Sex, and Age.

Salt sensitivity of blood pressure (SSBP) is associated with increased cardiovascular risk, especially in individuals of African descent, although the underlying mechanisms remain obscure. Lysine-specific demethylase 1 (LSD1) is a salt-sensitive epigenetic regulator associated with SSBP and aldosterone dysfunction. An LSD1 risk allele in humans is associated with SSBP and lower aldosterone levels in hypertensive individuals of African but not European descent. Heterozygous knockout LSD1 mice display SSBP and aldosterone dysregulation, but this effect is modified by age and biological sex. This might explain differences in cardiovascular risk with aging and biological sex in humans. This work aims to determine if LSD1 risk allele (rs587618) carriers of African descent display a sex-by-age interaction with SSBP and aldosterone regulation. We analyzed 297 individuals of African and European descent from the HyperPATH cohort. We performed multiple regression analyses for outcome variables related to SSBP and aldosterone. LSD1 risk allele carriers of African (but not European) descent had greater SSBP than nonrisk homozygotes. Female LSD1 risk allele carriers of African descent had greater SSBP, mainly relationship-driven by women with low estrogen (postmenopausal). There was a statistically significant LSD1 genotype-sex interaction in aldosterone response to angiotensin II stimulation in individuals aged 50 years or younger, with female carriers displaying decreased aldosterone responsiveness. SSBP associated with LSD1 risk allele status is driven by women with a depleted estrogen state. Mechanisms related to a resistance to develop SSBP in females are uncertain but may relate to an estrogen-modulating effect on mineralocorticoid receptor (MR) activation and/or LSD1 epigenetic regulation of the MR.

Lifelong exposure to pyrethroid insecticide cypermethrin at environmentally relevant doses causes primary ovarian insufficiency in female mice

Pyrethroids are a class of widely used insecticides. Our recent epidemiological study of Chinese women reported that pyrethroid exposure was positively associated with the risk of primary ovarian insufficiency (POI). In this study, we utilized cypermethrin (CP), the most frequently detected pyrethroid in the environment, to recognize how lifelong and low-dose exposure to pyrethroids affects ovarian functions and the underlying mechanism(s). Female mice were exposed to CP at doses of human dietary intake of 6.7 μg/kg/day, an acceptable daily intake (ADI) of 20 μg/kg/day, or the chronic reference dose (RfD) of 60 μg/kg/day, starting from gestational day 0.5 until 44-week-old. We assessed effects on fertility, serum hormone levels, ovarian follicular development and ovarian transcriptomic profiles. Chronic exposure to CP at doses of ADI and RfD caused a significant reduction in the size of the primordial follicle pool on postnatal day (PND) 5 and the number of all types of follicles in 44-week-old mice, lower estrogen and higher gonadotropin levels, as well as decreased fertility. Significant increase in apoptosis and decrease in cell proliferation were observed in CP-exposed ovarian follicles from PND 5 and 44-week-old mice. Ovarian transcriptomic data showed that the pro-apoptotic protein BMF and the cell cycle inhibitor p27 were significantly up-regulated in CP-exposed ovaries. Cyp17a1, Cyp19a1 and Hsd17b1 genes involved in the key steps of steroidogenesis were down-regulated in the ovaries of female mice exposed to CP. This study first reported that lifelong exposure to CP at doses of ADI or RfD caused an ovarian phenotype similar to human POI in female mice and provided a mechanistic explanation. Our findings suggest that lifelong exposure to pyrethroids of low doses, which are recommended as ‘safe’ dosages, may have a significant impact on the ovarian health of female mammals and humans.

The regulative effect of Urtica dioica on sex hormones imbalance: elevated follicle-stimulating hormone/luteinizing hormone ratio ≥4.5 is associated with low performance in aged breeder quails

The age-related reproductive disorders are the main concerns in old birds. It was suggested that a drop in egg production and reproductive performance, towards the end of their laying period was caused partly by a decrease in the baseline concentration of plasma LH. Urtica dioica (nettle) is a plant with natural aromatase inhibitors. Steroid hormone levels are regulated by inhibition of the aromatase enzyme. Few studies have examined the effect of nettle on the egg production in adult hens. The aim of this study was to investigate the effects of diet supplemented with nettle powder (NP) in aged quails. One hundred and forty-52-week-old Japanese quails were randomly assigned to four treatments consisting of seven replicates (n = 5; four females and one male) and fed with diets containing NP at 0% (control group), 0.5, 1.0, and 1.5% (treatment groups). At 62 week of age, our results indicated the NP improved egg production, feed conversion ratio, eggshell thickness and Haugh unit (p < .05). Notably, fertility and hatchability of fertile eggs were significantly increased, while total embryonic mortality decreased significantly by supplementing diet with nettle powder (p < .05). Higher luteinizing hormone, lower oestrogen, malondialdehyde and total cholesterol and triglyceride concentrations were associated with percent of the nettle powder in diet (p ≤ .05). Elevated follicle-stimulating hormone/luteinizing hormone ratio ≥4 is associated with low egg production in control group and nettle supplementation can balance FSH/LH ratio to ≤2.7. It is concluded that nettle powder could be used as a worthwhile feed additive at the late laying period of aged quails. HIGHLIGHTS Nettle powder can be used as a food additive with aged quails at late laying period. Addition of 1 and 1.5% nettle powder improves egg production, FCR, egg shell thickness. Nettle enhances reproductive performances, such as fertility, hatchability, weight of ovary, and weight of follicles by balancing reproductive hormones at late laying period.

Effects of Low Estrogens: Vaginal Atrophy

Estrogens are the group of hormones which makes a woman a woman. Girls at menarche start making it and under normal conditions sufficient levels are maintained in the women's body until menopause. During perimenopause, menopause and postmenopause the hormone levels start fluctuating and if maintained low for a longer period, it starts giving various problems. Fluctuating levels of estrogen causes, hot flashes, night sweats, vaginal dryness, depression, and mood swings. Sleep disturbances brain fog and may be heart disease, osteoporosis, obesity and the appearance of unwanted facial hair. These problems can be overcome by supplementing with phytoestrogens or hormone replacement therapy.

Biological effect and chemical monitoring of Watch List substances in European surface waters: Steroidal estrogens and diclofenac - Effect-based methods for monitoring frameworks.

Three steroidal estrogens, 17α-ethinylestradiol (EE2), 17β-estradiol (E2), estrone (E1), and the non-steroidal anti-inflammatory drug (NSAID), diclofenac have been included in the first Watch List of the Water Framework Directive (WFD, EU Directive 2000/60/EC, EU Implementing Decision 2015/495). This triggered the need for more EU-wide surface water monitoring data on these micropollutants, before they can be considered for inclusion in the list of priority substances regularly monitored in aquatic ecosystems. The revision of the priority substance list of the WFD offers the opportunity to incorporate more holistic bioanalytical approaches, such as effect-based monitoring, alongside single substance chemical monitoring. Effect-based methods (EBMs) are able to measure total biological activities (e.g., estrogenic activity or cyxlooxygenase [COX]-inhibition) of specific group of substances (such as estrogens and NSAIDs) in the aquatic environment at low concentrations (pg/L). This makes them potential tools for a cost-effective and ecotoxicologically comprehensive water quality assessment. In parallel, the use of such methods could build a bridge from chemical status assessments towards ecological status assessments by adressing mixture effects for relevant modes of action. Our study aimed to assess the suitability of implementing EBMs in the WFD, by conducting a large-scale sampling and analysis campaign of more than 70 surface waters across Europe. This resulted in the generation of high-quality chemical and effect-based monitoring data for the selected Watch List substances. Overall, water samples contained low estrogenicity (0.01-1.3ng E2-Equivalent/L) and a range of COX-inhibition activity similar to previously reported levels (12-1600ng Diclofenac-Equivalent/L). Comparison between effect-based and conventional analytical chemical methods showed that the chemical analytical approach for steroidal estrogens resulted in more (76%) non-quantifiable data, i.e., concentrations were below detection limits, compared to the EBMs (28%). These results demonstrate the excellent and sensitive screening capability of EBMs.

Deficiency of Wnt10a causes female infertility via the β-catenin/Cyp19a1 pathway in mice.

Wnt signaling is relevant for a wide range of biological processes, including reproductive function. The function of Wnt10a in female fertility, however, remains obscure. In the present study, we explored the structure and function of the female reproductive organs in Wnt10a knockout (KO) mice. The expression of β-catenin signaling was significantly lower in the ovaries of the Wnt10a KO mice compared with wild-type (WT) mice. In addition, the estrous cycles were disrupted, ovarian follicles were diminished, and endometria were thinner, accompanied by lower serum estrogen levels, and higher testosterone and progesterone levels in Wnt10a KO mice. The expression of the ovarian cytochrome P450 family 19 subfamily A member 1 (Cyp19a1) was significantly lower in Wnt10a KO mice. We detected no significant changes in the levels of the gonadotropins between WT and KO mice. Together, our findings indicate that deficiency of Wnt10a causes female infertility through β-catenin and Cyp19a1signaling pathways in mice.

Low estrogen level in aged mice leads to abnormal oogenesis affecting the quality of surrounded nucleolus-type immature oocytes.

With aging, various problems in the reproductive system emerge, especially in females. However, our understanding of reproductive aging in livestock and humans is limited. We aimed to investigate reproductive changes between young and aged mice. Eight- to ten-week-old female mice were used as the young group, and 10-month-old mice were studied as the aged group. Reproductive changes were investigated from physiological, histological, cytological, and epigenetic perspectives. The estrus cycle was shortened (P <0.0001), and the estradiol (E2) concentration was lower in aged mice (P <0.01), whereas the progesterone (P4) concentration did not differ between young and aged mice (P >0.05). The histological results revealed a lower number of antral follicles in the ovary and disordered epithelial tissue structures in the oviducts in aged mice. During oogenesis, the surrounded nucleolus (SN)-type oocytes in aged mice exhibited increased mitochondrial agglutination (P <0.05) and cellular apoptosis (P <0.01) as well as decreased H3K36 triple-methylation (P <0.001). Although many defects existed, the oocytes from aged mice could normally support cellular reprogramming after somatic cell nuclear transfer. Our results indicate that the reduced levels of reproductive hormones in aged females lead to shorter estrus cycles and reduced follicular development, leading to abnormal oogenesis, particularly in SN-type immature oocytes. These results provide new insight that enhance our understanding and improve the reproductive ability of aged females.

Oral cavity status in menopausal and postmenopausal women

The purpose of this review was to analyze and summarize the available literature data on changes of oral tissues in menopausal/postmenopausal women. We searched for the relevant references in Pubmed database using appropriate key words. We had revealed about 3,500 references on these topics and analyzed the most relevant. Postmenopausal women have an increased risk of the decrease of bone mineral density due to estrogen deficiency. Estrogens induce osteoclast apoptosis and intensity of this protective mechanism decreases after the cessation of menstruation. Most cross-sectional radiographic studies have confirmed an association between age-related osteoporosis and decreased alveolar bone height. It has been established that postmenopausal women with generalized chronic periodontitis are characterized by severe destruction of the periodontium, which progresses in parallel to a decrease in bone mineral density. Sex hormones maintaining bone integrity and strength, involved in regulating the proliferation, differentiation, and growth of keratinocytes and fibroblasts of the gums. The effect of low estrogen levels on keratinization of the gum epithelium and decreased salivation can lead to menopausal gingivostomatitis. Estrogen deficiency also adversely affects the microenvironment of gingival sulcus, including the composition and circulation of crevicular fluid. Postmenopausal women have lower salivary pH and lower salivation, which is associated with deterioration of periodontal tissues. In addition, the postmenopausal period is characterized by the changes in the microbial composition of the oral cavity, IgG decreases in the crevicular fluid and prooxidant changes of saliva. Conclusions. The oral cavity status in menopausal and postmenopausal women undergoes significant changes: a decrease in bone mineral density, dryness of mucous membranes, microbiome changes, and activation of oxidative and immune processes. These changes necessitate regular examinations, timely treatment and application of all measures of preventive dentistry. There is also a need for randomized clinical trials and create standardized guidelines for the management of postmenopausal patients with periodontal disease.

ESTROGEN AND IDIOPATHIC CONDYLAR RESORPTION IN ORTHODONTICS-A REVIEW ARTICLE

Idiopathic condylar resorption (ICR) is a condition with no specific cause. Condylar resorption occurs more frequently in women because of the pathogenesis of sex hormones. Cone-beam computed tomography and magnetic resonance imaging are vital imaging methods for diagnosis of Idiopathic condylar resorption.The symptoms of ICR overlap with osteoarthritis, inflammatory arthritis, physiologic resorption/remodeling, congenital disorders affecting the mandible.Thus a thorugh medical and physical history is essential in understanding the pathogenesis of idiopathic condylar resorption.Idiopathic condylar resorption can be active or passive.. This review provides an early glimpse of low estrogen and idiopathic condylar resorption.

GnRH-a-Induced Perimenopausal Rat Modeling and Black Cohosh Preparations' Effect on Rat's Reproductive Endocrine.

GnRH-a-Induced Perimenopausal Rat Modeling and Black Cohosh Preparations' Effect on Rat's Reproductive Endocrine.

The Rational Use of Hormone Replacement Therapy in Older Adults

Multiple hormone levels are lower in older compared to younger adults, but the clinical implications are controversial. Lower thyroid hormone, testosterone, estrogen and vitamin D are variously associated with metabolic syndrome, sarcopenia, low bone density and cognitive decline, for which treatment has been recommended in the past. However, evidence from the T Trials of testosterone therapy failed to show benefit for endpoints other than sexual function. In the Women’s Health Initiative, a large RCT of estrogen replacement in older women, found evidence of an interaction between estrogen therapy and metabolic risk factors such as diabetes that actually exacerbates risk of cognitive decline. Longitudinal observation of thyroid hormone and thyrotropin patterns in the Baltimore Longitudinal Study of Aging demonstrate heterogeneity that might account for a lack of benefit in studies of treatment for subclinical hypothyroidism in older adults. At the same time, new data suggest the need for a more aggressive threshold for vitamin D in older adults, with a lower threshold associated with a drop in physical function compared to younger adults. Complexity in the regulation of hormonal pathways and the downstream effects on target tissues means multiple individuals with similar hormone levels may have different underlying physiology, with divergent clinical needs. Changes in activity and diet common during aging, and exacerbated by the pandemic, lead to physical and mood changes associated with hormonal dysfunction in popular culture and patient requests for evaluation. The ultimate goal should be personalized treatment decisions based on comprehensive evaluation and pathophysiology.

Relationship between second to fourth digit ratio (2D:4D) and academic performance among students in Nigeria.

The second to fourth digit ratio (2D:4D), is a sexually dimorphic trait, with males on the average having lower ratios than females 2D:4D. It had been correlated with several psychosocial features. The present study is primarily aimed at investigating the existence of the association between digit ratio (2D:4D) with academic performance of 205 secondary school students (110 males and 95 females) in Kano State, Nigeria. Academic performance of the students was measured from the terminal examinations results in three key subjects (Maths, English and Biology) and these results were obtained from the schools managements. A significantly low 2D:4D (a correlate of high prenatal testosterone and low prenatal oestrogen) was observed in male students compared to females and the differences in digit size measurments between male and female students were also statistically significant (P&lt;0.05). Female students performed significantly better in all the 3 subjects, but there was no correlation between the performance and any of the 3 subjects or their cumulative average with 2D:4D ratio of the right or left hand in the current study. However, a positive but negative correlation between the sizes of the left and right digits, with academic performance in all subjects in males and two subjects (English and Biology) in females were observed. It is therefore sufficient to conclude that 2D:4D ratio was not associated with better performance in the current study.

Research Progress on the Treatment of Premature Ovarian Failure Using Mesenchymal Stem Cells: A Literature Review

Premature ovarian failure (POF) has become one of the main causes of infertility in women of childbearing age and the incidence of POF is increasing year by year, seriously affecting the physical and mental health of patients and increasing the economic burden on families and society as a whole. The etiology and pathogenesis of POF are complex and not very clear at present. Currently, hormone replacement therapy is mainly used to improve the symptoms of low estrogen, but cannot fundamentally solve the fertility problem. In recent years, stem cell (SC) transplantation has become one of the research hotspots in the treatment of POF. The results from animal experiments bring hope for the recovery of ovarian function and fertility in patients with POF. In this article, we searched the published literature between 2000 and 2020 from the PubMed database (https://pubmed.ncbi.nlm.nih.gov), and summarized the preclinical research data and possible therapeutic mechanism of mesenchymal stem cells (MSCs) in the treatment of POF. Our aim is to provide useful information for understanding POF and reference for follow-up research and treatment of POF.

AACE2021-A-1026: Premature Ovarian Insufficiency: Epidemiology, Aetiopathology, and Diagnostic Evaluation at Sultan Qaboos University Hospital

Premature ovarian insufficiency (POI) affects women younger than 40 years and is described by the loss of ovarian functions. This study aim is to identify the incidence of POI, describe the epidemiological characteristic of patients and their presenting symptoms, determine biochemical features, identify radiological features of POI, and describe the treatment option in patients of POI at Sultan Qaboos Hospital (SQUH). A retrospective observational study was designed to identify the incidence of POI at SQU in the period between January 2015 and January 2020 on women with POI who aged between 13 and 40 years old and came with amenorrhea, infertility, low estrogen levels, and with or without small ovaries under pelvis ultrasound radiography. Data were obtained from the Hospital Information System by TrakCare system which includes demographic, clinical, biochemical, radiological features and medications which were described at SQUH to women with POI. SPSS was used for data analysis. 143 patients were collected from a database with POI in 5 years. The median age was 33 years, the mean of ages was 30.8 ± 7.07 years, and the range of ages was between 16-39 years. Most of the patients who were diagnosed with POI at SQUH were from Muscat governorate. 79% of patients came with amenorrhea whereas 21% came with menstrual irregularity. The most common cause within patients was post-BMT and chemotherapy by 45% of patients. As a radiological feature, pelvis ultrasound (US) was shown the abnormal size of ovaries in 41% of patients. Oral contraceptive (OCP) drugs were described in 53% of patients. The majority of cases had POI due to chemotherapy and bone marrow transplantation (BMT) and presented with amenorrhea. Almost all cases of POI suffer from infertility. Hormone replacement therapy (HRT) is a treatment that is used in most cases of POI.

Influence of Menopausal Hormone Therapy on the Breast: Counseling Your Patients Before You Prescribe.

Menopausal hormone therapy (HT) aims to improve a woman's quality of life by treating bothersome menopausal symptoms associated with low estrogen levels. Although HT is prescribed to millions of women worldwide, its breast-related adverse effects have always been a concern. Some of the common adverse effects of HT are breast fullness, increased breast density, and increased breast cancer (BC) risk. Health care professionals need to be aware of the influence of HT on breast tissue to provide appropriate counseling as part of informed decision making. Our review summarizes the influence of HT on breast symptoms, breast density, mammograms, and BC risk.