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Merzel Šabović EK, Kocjan T, Zalaudek I. Treatment of menopausal skin - A narrative review of existing treatments, controversies, and future perspectives. Post Reprod Health 2024; 30:85-94. [PMID: 38379168 DOI: 10.1177/20533691241233440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Menopause is a state of estrogen deficiency that affects numerous estrogen-dependent tissues in the female body. Skin is one of the most affected organs. Many consider menopausal skin changes to be merely an aesthetic problem; however, they can significantly affect women's quality of life. Currently, there are no approved effective treatments to prevent or alleviate skin changes associated with estrogen deficiency. Standard systemic hormone replacement therapy used to treat menopausal symptoms may be effective to some degree for skin treatment. In addition, compounded bioidentical hormone replacement therapy, selective estrogen receptor modulators, and phytoestrogens could also be used for skin treatment, although this is only hypothetical due to lack of data. Many questions therefore remain unanswered. On the other hand, topical, low-dose estrogen that would act only on the skin without systemic effects could be a possible option, as could be skin-only acting topical phytoestrogens. Such topical products without systemic effects could play a role in the treatment of menopausal skin. However, they are not currently approved because there is insufficient data on their safety and efficacy. A healthy lifestyle could have a positive effect on the menopausal skin. In this review, we provide an overview of the characteristics of menopausal skin, an outlook on the future treatment of menopausal skin with estrogens and other approaches, and the associated controversies and speculations. Overall, the importance of menopausal skin changes should not be neglected, and high-quality research is needed to gain new insights into the treatment of menopausal skin.
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Affiliation(s)
- Eva K Merzel Šabović
- Department of Dermatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tomaž Kocjan
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Endocrinology, Diabetes, and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Iris Zalaudek
- Department of Dermatology, Maggiore Hospital, University of Trieste, Trieste, Italy
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Lephart ED, Naftolin F. Factors Influencing Skin Aging and the Important Role of Estrogens and Selective Estrogen Receptor Modulators (SERMs). Clin Cosmet Investig Dermatol 2022; 15:1695-1709. [PMID: 36017417 PMCID: PMC9397534 DOI: 10.2147/ccid.s333663] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022]
Abstract
The narrative for this overview focuses on updating the factors that influence skin aging and the important role estrogens and selective estrogen receptor modulators (SERMs) play in this process (mainly utilizing journal reports and reviews from the last four years). Estrogens have been known and studied for over a century. For many years, it has been recognized that estrogens are important in the maintenance of human skin. Women seek cosmetic and medical treatments to improve dermal health and physical characteristics to enhance their self-perception and inhibit skin aging, particularly in highly visible body areas. The goal: to retain estrogen’s positive benefits while aging and especially at/after menopause where estrogen-deficient skin contributes to the dramatic decline in skin health. In this overview, both background information and recent novel findings are included that cover aging (general mechanisms), skin aging, and factors that influence skin aging (intrinsic, extrinsic, skin microbiome and gut microbiome.) Plus, estrogen’s general role in maintaining skin health is presented through the classical estrogen receptors alpha (α) and beta (β) and non-classical (or non-genomic) estrogen receptor (G protein-coupled seven transmembrane receptor). More importantly, the various benefits of 17β-estradiol in skin health are examined (ie, skin collagen and elastin profiles that follow 17β-estradiol levels during aging and at/after menopause). Finally, a revision of information for estrogenic skin topical applications involving isoflavonoid compounds that act as SERMs, but are classified as endocrine disruptors, and a topical estrogen analog are explored to update the known and unknown characteristics of these treatments. Further study is warranted to understand the biological and molecular mechanisms by which estrogens support and enhance dermal health and wellbeing.
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Affiliation(s)
- Edwin D Lephart
- Department of Cell Biology, Physiology and The Neuroscience Center, Brigham Young University, Provo, UT, USA
| | - Frederick Naftolin
- Department of Research and Development, e-Bio Corporation, Woodbridge, CT, USA
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Lephart ED, Naftolin F. Estrogen Action and Gut Microbiome Metabolism in Dermal Health. Dermatol Ther (Heidelb) 2022; 12:1535-1550. [PMID: 35752663 PMCID: PMC9276867 DOI: 10.1007/s13555-022-00759-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/08/2022] [Indexed: 01/14/2023] Open
Abstract
Emerging scientific advances in microbial research linking estrogens and the gut-skin microbiome in reference to dermal health are featured in this narrative review of journal reports and reviews from January 2018 through February 2022. Background information on advances in microbial research along with defining the microbiota and microbiome is presented in brief. The development of and factors that influence the gut microbiome in health and disease as well as the intrinsic and extrinsic factors influencing the skin microbiome and skin aging are summarized. New information on the development and changes of organ microbiomes have exposed similarities between skin and gut structure/function, microbial components/diversity/taxonomy and how they impact the immune response for combating disease and enhancing wellness. Estrogens promote health and support homeostasis in general and directly impact dermal health. Moreover, the gut, based upon the level of the microbial enzyme β-glucuronidase, which regulates estrogen’s enterohepatic recirculation, constitutes a gut-skin microbial axis. This axis revolves around the systemically available estrogen to support immune function, counteract inflammation and oxidative stress, and decrease the risk of hormone-dependent skin cancers. These data support the direct effect of estrogens on skin health and the interaction of diet on dermal health via effects on the gut microflora. Finally, the potential for bioactive botanicals containing phytoestrogens or selective estrogen receptor modulators (SERMs) to evade the effects of gut β-glucuronidase expressing flora is proposed that may have a positive impact on skin.
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Affiliation(s)
- Edwin D. Lephart
- Department of Cell Biology, Physiology and The Neuroscience Center LS 4005, College of Life Sciences, Brigham Young University, Provo, UT 84602 USA
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Zhu M, Lee TXY, Hsieh YW, Lai LF, Condello G, Donnelly CJ, Smith M, Hamzah SH, Lim BH, Huang CY, Chi NF, Kuo CH. Vascular function in the aging human brain during muscle exertion. Aging (Albany NY) 2022; 14:3910-3920. [PMID: 35500246 PMCID: PMC9134944 DOI: 10.18632/aging.204052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/08/2022] [Indexed: 11/25/2022]
Abstract
To determine how brain oxygenation is stably maintained during advancing age, cerebral oxygenation and hemoglobin were measured real-time at 10 Hz using near-infrared spectroscopy (NIRS) at rest (30 seconds) and during a 10-repeated handgrip strength test (30 seconds) for 834 adults (M/F = 45/55%) aged 20-88 y. The amplitude of cerebral hemodynamic fluctuation was reflected by converting 300 values of % oxygen saturation and hemoglobin of each 30-second phase to standard deviation as indicatives of brain oxygenation variability (BOV) and brain hemodynamic variability (BHV) for each participant. Both BOV (+21-72%) and BHV (+94-158%) increased during the maximal voluntary muscle exertions for all age levels (α < 0.05), suggesting an increased vascular recruitment to maintain oxygen homeostasis in the brain. Intriguingly, BHV was >100 folds for both resting and challenged conditions (α < 0.001) in >80% of adults aged above 50 y despite similar BOV compared with young age counterparts, indicating a huge cost of amplifying hemodynamic oscillation to maintain a stable oxygenation in the aging brain. Since vascular endothelial cells are short-lived, our results implicate a hemodynamic compensation to emergence of daily deficits in replacing senescent endothelial cells after age 50 y.
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Affiliation(s)
- Maijian Zhu
- Laboratory of Exercise Biochemistry, University of Taipei, Taipei City 11153, Taiwan, ROC
| | - Tania Xu Yar Lee
- Laboratory of Exercise Biochemistry, University of Taipei, Taipei City 11153, Taiwan, ROC
| | - Yu-Wen Hsieh
- Laboratory of Exercise Biochemistry, University of Taipei, Taipei City 11153, Taiwan, ROC
| | - Li-Fan Lai
- Laboratory of Exercise Biochemistry, University of Taipei, Taipei City 11153, Taiwan, ROC
| | - Giancarlo Condello
- Laboratory of Exercise Biochemistry, University of Taipei, Taipei City 11153, Taiwan, ROC.,Department of Medicine and Surgery, University of Parma, Via Gramsci, Parma 43126, Italy
| | - Cyril J Donnelly
- Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore
| | - Marc Smith
- Body Composition Technologies, Pty Ltd., South Perth, Western Australia, Australia
| | - Sareena Hanim Hamzah
- Centre for Sport and Exercise Sciences, University Malaya, Kuala Lumpur 50603, Malaysia
| | - Boon-Hooi Lim
- Centre for Sport and Exercise Sciences, University Malaya, Kuala Lumpur 50603, Malaysia
| | - Chih-Yang Huang
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan, ROC.,Center of General Education, Buddhist Tzu Chi Medical Foundation, Tzu Chi University of Science and Technology, Hualien 970, Taiwan, ROC.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404, Taiwan, ROC.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan, ROC
| | - Nai-Fang Chi
- Department of Neurology, National Yang Ming Chiao Tung University School of Medicine, Taiwan, ROC.,Department of Neurology, Taipei Veterans General Hospital, Taiwan, ROC
| | - Chia-Hua Kuo
- Laboratory of Exercise Biochemistry, University of Taipei, Taipei City 11153, Taiwan, ROC
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Lephart ED, Naftolin F. Menopause and the Skin: Old Favorites and New Innovations in Cosmeceuticals for Estrogen-Deficient Skin. Dermatol Ther (Heidelb) 2021; 11:53-69. [PMID: 33242128 PMCID: PMC7859014 DOI: 10.1007/s13555-020-00468-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Indexed: 12/14/2022] Open
Abstract
Estrogen is a pivotal signaling molecule; its production is regulated by the expression of the aromatase (CYP19A1) gene from ovarian and peripheral tissue sites, and it is transmitted via estrogen receptors to influence many important biological functions. However, the narrative for this overview focuses on the decline of 17β-estradiol levels from ovarian sites after menopause. This estrogen-deficient condition is associated with a dramatic reduction in skin health and wellness by negatively impacting dermal cellular and homeostatic mechanisms, as well as other important biological functions. The changes include loss of collagen, elastin, fibroblast function, vascularity, and increased matrix metalloproteinase(s) enzymatic activities, resulting in cellular and extracellular degradation that leads to dryness, wrinkles, atrophy, impaired wound healing/barrier function, decreased antioxidant capacity [i.e., defense against reactive oxygen species (ROS) and oxidative stress], decreased attractiveness and psychological health, and increased perception of aging. While topical estrogen may reverse these changes, the effects of today's low-dose systemic hormone treatments are not well established, raising the need for more concentrated local administration of hormones or newer cosmeceutical agents such as selective estrogen receptor modulators (SERMs), including phytoestrogens that have become major active ingredients for skin care products, especially when addressing estrogen-deficient skin. Two example compounds are presented, an analog of resveratrol (i.e., 4'-acetoxy resveratrol) and the isoflavonoid equol, both of which are involved in a variety of biochemical/molecular actions and mechanisms, as demonstrated via in vitro and clinical studies that enhance human dermal health, especially in estrogen-deficient skin.
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Affiliation(s)
- Edwin D Lephart
- Department of Physiology, Developmental Biology and The Neuroscience Center, College of Life Sciences, Brigham Young University, Provo, UT, USA.
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Palacios OM, Cortes HN, Jenks BH, Maki KC. Naturally occurring hormones in foods and potential health effects. TOXICOLOGY RESEARCH AND APPLICATION 2020. [DOI: 10.1177/2397847320936281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Hormones and hormone-like substances, for example, phytoestrogens, are food components that can be endogenously produced by a food source or occur secondary to farming practices. The hormone content of foods has been studied for decades, and safety evaluations in the United States and Europe indicate that naturally occurring hormones found in foods are safe for human consumption. More recent studies have focused on the role of certain hormones found in specific foods (e.g. dairy or soy) and their potential health effects. However, limited summaries exist on food content of hormones and hormone-like phytoestrogens in the context of a comprehensive US diet and implications, if any, of their daily consumption for overall health. This review provides an outline of hormone biosynthesis and functions in the body; discusses the more commonly studied, naturally occurring hormones in food and their biological role within food; estimates relative dietary contribution and when available, bioavailability, of naturally occurring food hormones; and summarizes the potential health associations of their intake in food. Based on the review of the scientific literature, the hormone content of typical serving sizes of commonly consumed foods is undetectable or in quantities that fall well within safety guidelines without any evidence for adverse effects on health.
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Affiliation(s)
- Orsolya M Palacios
- Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Addison, IL, USA
| | | | - Belinda H Jenks
- Belinda H. Jenks Consulting, Sunshine Terrace, Studio City, CA, USA
| | - Kevin C Maki
- Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Addison, IL, USA
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
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Bjerregaard-Olesen C, Ghisari M, Bonefeld-Jørgensen EC. Activation of the estrogen receptor by human serum extracts containing mixtures of perfluorinated alkyl acids from pregnant women. ENVIRONMENTAL RESEARCH 2016; 151:71-79. [PMID: 27451001 DOI: 10.1016/j.envres.2016.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/22/2016] [Accepted: 07/01/2016] [Indexed: 05/20/2023]
Abstract
Humans are exposed to a wide variety of perfluorinated alkyl acids (PFAAs). Several studies have found xenoestrogenic activity of single PFAAs. Studies on mixture effects of the PFAAs are however sparse. In the present study, we aimed to determine the xenoestrogenic activity in human serum extracts containing mixtures of PFAAs. Recently we developed a method to extract the PFAAs from human serum with simultaneous removal of endogenous hormones and interfering steroid metabolites. We used this method to extract the PFAAs from serum of 397 Danish nulliparous pregnant women followed by analysis of estrogen receptor (ER) transactivation using MVLN cells carrying an estrogen response element luciferase reporter vector. Using 17β-estradiol (E2) concentration-transactivation curves, we calculated the estradiol equivalents (EEQ) for the extracts containing the PFAAs. Fifty-two percent of the PFAA serum extracts agonized the ER transactivation, and 46% enhanced the E2-induced ER transactivation. We found positive linear concentration-response associations between the ER transactivation and the PFAA serum levels. For the relatively few PFAA extracts that antagonized the ER in the presence of 24 pM E2 (n=38, 10%), we found inverse linear associations between the ER transactivation and the PFAA serum levels. The results indicated that the serum extracts induced the ER in a non-monotonic concentration dependent manner. The median EEQ of the extracts containing the PFAAs corresponds to the effect of 0.5pg E2 per mL serum. In conclusion, we observed that most of the extracts containing the PFAA mixtures from pregnant women's serum agonized the ER and enhanced the E2-induced effects in non-monotonic concentration-dependent manners.
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Affiliation(s)
- Christian Bjerregaard-Olesen
- Centre for Arctic Health & Unit of Cellular and Molecular Toxicology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Mandana Ghisari
- Centre for Arctic Health & Unit of Cellular and Molecular Toxicology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Eva C Bonefeld-Jørgensen
- Centre for Arctic Health & Unit of Cellular and Molecular Toxicology, Department of Public Health, Aarhus University, Aarhus, Denmark.
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Loja-Chango R, Pérez-López FR, Simoncini T, Escobar GS, Chedraui P. Increased mood symptoms in postmenopausal women related to the polymorphism rs743572 of the CYP17 A1 gene. Gynecol Endocrinol 2016; 32:827-830. [PMID: 27117436 DOI: 10.1080/09513590.2016.1177015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Menopausal and depressive symptoms are highly prevalent after the menopause; but may vary from one population to another and genetics play a key role. OBJECTIVE To analyze the intensity of these symptoms in relation to the genetic variants of the rs743572 polymorphism of the CYP17 A1 gene in postmenopausal women. METHODS DNA was extracted from the whole blood of 168 natural postmenopausal women (40-65 years) and tested for the rs743572 polymorphism of the CYP17 A1 gene. Intensity of menopausal (Menopause Rating Scale, MRS) and depressive symptoms (Hospital Anxiety and Depressive Scale, HADS) were correlated to polymorphism genotypes. RESULTS Women with the GG genotype of the rs743572 polymorphism displayed significantly higher scores for the MRS (items 5 and 6 [irritability and anxiety] and the psychological subscale) and the HADS (total and subscales). CONCLUSION The intensity of menopausal symptoms related to mood was found higher among postmenopausal women presenting the GG genotype of the rs743572 polymorphism of the CYP17 A1 gene. There is a need for more research in this regard.
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Affiliation(s)
- Rita Loja-Chango
- a Facultad de Ciencias Médicas , Institute of Biomedicine, Research Area for Women's Health, Universidad Católica de Santiago de Guayaquil, Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador
| | - Faustino R Pérez-López
- b Department of Obstetrics and Gynecology , Facultad de Medicina, Universidad de Zaragoza, Lozano Blesa University Hospital , Zaragoza , Spain , and
| | - Tommaso Simoncini
- c Department of Clinical and Experimental Medicine , Division of Obstetrics and Gynecology, University of Pisa , Pisa , Italy
| | - Gustavo S Escobar
- a Facultad de Ciencias Médicas , Institute of Biomedicine, Research Area for Women's Health, Universidad Católica de Santiago de Guayaquil, Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador
| | - Peter Chedraui
- a Facultad de Ciencias Médicas , Institute of Biomedicine, Research Area for Women's Health, Universidad Católica de Santiago de Guayaquil, Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador
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Abyar F, Farrokhpour H. Symmetry adapted cluster–configuration interaction calculation of the photoelectron spectra of famous biological active steroids. J Mol Struct 2014. [DOI: 10.1016/j.molstruc.2014.07.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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