Oestrogens are steroid hormones that act through specific receptors in the brain to influence sexual behaviour, as well as mood and cognition. Oestrogen actions include alterations of neuronal excitability, neurotransmitter synthesis and metabolism, neuronal circuitry and neuronal survival, one or all of which may contribute to their effects on mood and cognition. Oestrogens act on a wide variety of peripheral tissues such as breast, bone, liver and heart tissues. Although they have found widespread use for the management of menopausal symptoms, the current consensus is that oestrogen replacement therapy should be used at the lowest possible doses, for a limited duration and with careful consideration of the individual woman's treatment goals and risks. Oestrogens regulate gene transcription, resulting in long‐lasting biochemical changes that can impact adversely on health. The development of improved selective oestrogen receptor modulators that target specific tissues may eventually help circumvent some of the undesired effects of oestrogens.
Key Concepts:
Oestrogens serve important physiological roles in the brain and in peripheral organ systems.
Oestrogens and oestrogen‐like compounds bind to oestrogen receptors; oestrogen receptors occur as two isoforms, known as oestrogen receptor, ERα and ERβ
Oestrogens modulate gene activity, cellular structure and function and ultimately, regulate complex behaviours after binding to specific oestrogen receptors in the brain.
Oestrogen secretion starts during early development, varies cyclically from puberty onwards, and gradually diminishes with age (menopause in women).
Oestrogen‐like compounds that raise health issues are increasingly found in our modern environment as well as in plants; the potency and safety of the latter, especially as dietary supplements, is however questionable.
The therapeutic use of oestrogens in menopausal women should be tailored to an individual woman's needs and should be limited in order to avoid health‐related reductions in quality of life.