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The increasing awareness on the varied consequences of hypogonadism in
distinct organs and systems has supported the notion of estrogens as systemic
agents. This observation is congruent with the variety of tissues affected by estrogens
when used in hormone therapy formulations on hypogonadic women.
Apart from the genital tract and the breast, recognized as traditional targets
for estrogens, the skeleton, the vascular tree, or the central nervous system, are
good examples of territories that have demonstrated sensitivity to estrogens.
This evidence has created great interest, as shown by the great amount of literature
that has been produced on the benefits and risks associated with the use
of estrogens.
In parallel to the clinical interest, basic research has improved our knowledge
on the complexities involved in estrogen action at the molecular level.
Together with effects mediated through specific receptors, a concept that has
been the mainstay of the interpretation of estrogen action for years, there
is enough evidence to hold the notion of receptor-independent effects. The
substantial advances in modern technology applied to research have helped
in enlightening the particulars of this versatile action of estrogens. This more
detailed knowledge on the sophisticated mechanism of action of estrogens has
nourished the emergence of multiple hypotheses speculating with the possibility
of manipulating estrogen action. The notion that a widely extended
regulatory system of cell function, as it is the estrogen receptor machinery,
might be modulated at wish has arisen as an attractive, although still elusive
postulate. |
