The menopause is associated with a relatively abrupt decline in the ovarian production
of estrogen that results in a state of estrogen deficiency. This estrogen deficiency
state is associated with an accelerated expression of cardiovascular disease, osteoporosis,
urogenital atrophy, dermal aging, an increased expression of colorectal cancer, an
alteration in the expression of breast cancer which results in more malignant forms
of the disease, and the loss of neurons from the brain that is associated with a more
rapid decline in cognitive function, balance, and an earlier expression of Alzheimer's
disease. Macular degeneration and cataract formation may be additional consequences
of the estrogen deficiency state. Thus the estrogen deficiency state may be characterized
as a state of accelerated aging. The abrupt transition from the reproductive state
of multiple estrogen-dependent neural systems within the brain may affect their function
as manifested by the typical menopausal symptoms of hot flashes, mood changes, sleep
disturbance, and cognitive impairment. This transition may trigger a cascade of events
that contributes to the acceleration of brain aging and the expression of neurodegenerative
processes as Alzheimer's disease. This article discusses the use of estrogen to prevent
these age-related changes (Box 1).
Box 1
The age-related consequences of the estrogen deficiency state
-
Osteoporosis
-
Acceleration of cardiovascular disease
-
Accelerated aging of the skin
-
Increased expression of colon cancer
-
Accelerated decline in cognitive function
-
Accelerated expression of Alzheimer's disease
-
Expression of more malignant forms of breast cancer
-
Tooth loss
-
Cataract formation
-
Macular degeneration
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