Titre du document / Document title

Rauchen, Estradiolstoffwechsel und Hormonsubstitution = Smoking, estradiol metabolism and hormone replacement therapy

Auteur(s) / Author(s)

MUECK A. O. ⁽¹⁾ ; SEEGER H. ⁽¹⁾ ; WALLWIENER D. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Universitäts-Frauenklinik Tübingen, ALLEMAGNE

Résumé / Abstract

In the recent discontinued Women's Health Initiative (WHI) 50% of the 8500 women on HRT had smoked before or continued to smoke during the study - thus the question as to whether smoking may influence estradiol metabolism is of special relevance. Smoking can reduce or completely cancel the efficacy of orally administered estrogens depending on the type, duration and intensity of nicotine consumption. Not only does smoking diminish the beneficial effects of estrogen on hot flashes, urogenital symptoms, lipid metabolism and osteoporosis prevention, but smoking also may influence positive estrogenic effects on the vasculature. Main cause seems to be a dose-dependent elevated hepatic clearance, partially in conjunction with lower estrogen levels. Compensation by increasing the estrogen dose in smokers should be avoided as this might result in the production of toxic, even potentially mutagenic estrogen metabolites - compounds recently associated with a higher risk of breast cancer. The favorable effects of estrogens are not lost in smokers when they are treated transdermally. This route enables low dosage and also avoids the formation of unphysiological metabolites by bypassing the liver. Women who continue to smoke despite all warnings should therefore be treated via the transdermal route.

Revue / Journal Title

Geburtshilfe und Frauenheilkunde   ISSN 0016-5751   CODEN GEFRA2 

Source / Source

2003, vol. 63, n^o3, pp. 213-222 [10 page(s) (article)] (77 ref.)

Langue / Language

Allemand

Editeur / Publisher

Thieme, Stuttgart, ALLEMAGNE  (1939) (Revue)

Mots-clés anglais / English Keywords

Ovarian hormone ; Sex steroid hormone ; Estrogen ; Female ; Human ; Influence ; Statistical analysis ; Comparative study ; Replacement therapy ; Metabolism ; Estradiol ; Tobacco ; Smoker ;

Mots-clés français / French Keywords

Hormone ovarienne ; Hormone stéroïde sexuelle ; Oestrogène ; Femelle ; Homme ; Influence ; Analyse statistique ; Etude comparative ; Traitement substitutif ; Métabolisme ; Estradiol ; Tabac ; Fumeur ;

Mots-clés espagnols / Spanish Keywords

Hormona ovárica ; Hormona esteroide sexual ; Estrógeno ; Hembra ; Hombre ; Influencia ; Análisis estadístico ; Estudio comparativo ; Tratamiento sustitutivo ; Metabolismo ; Estradiol ; Tabaco ; Fumador ;

Localisation / Location

INIST-CNRS, Cote INIST : 4872, 35400011093888.0020