Tailored local estrogen therapies for GSM

madman

Super Moderator
Local estrogen therapy (LET) is the standard treatment for urogenital symptoms. Various formulations and molecules have been used with similar results. Low-dose LET is preferred for minimal systemic absorption. Patient preference is crucial, but dissatisfaction exists. Breast cancer survivors and high-risk populations require special consideration. Studies focusing on quality of life, sexual function, and genitourinary conditions are needed for tailored treatment.




Take Home Points:
  • Early use of LET, alone or combined with MHT, is crucial in managing urogenital aging in postmenopausal women with high GSM symptom severity.
  • Tailored LET treatment should be based on the patient's profile, preferences, and treatment goals to prevent the negative impact of GSM on quality of life and sexual well-being.
  • While there is a documented class effect of LET, different products may have specific benefits that need further exploration based on age, symptom type and severity, and clinical conditions.
  • Poor compliance and treatment adherence among LET users can be attributed to efficacy and safety concerns.
  • Studies focusing on the specific effects of LET on quality of life, sexual function, and genitourinary conditions are necessary, with a patient-tailored approach.
 

Attachments

Figure 1. Main formulations of local estrogen therapy (LET) available worldwide. Created in BioRender.com.
Screenshot (25561).webp
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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