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Comment
. 2009 Aug;150(8):3443-5.
doi: 10.1210/en.2009-0449.

Understanding estrogen action during menopause

Jameel Iqbal  1 , Mone Zaidi
Affiliations
Comment

Understanding estrogen action during menopause

Jameel Iqbal et al. Endocrinology. 2009 Aug.
No abstract available

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Figures

Figure 1
Figure 1
Estrogen action on the kidneys, heart, and bone. The anterior pituitary hormone FSH acts on the ovaries to induce production of estrogens in premenopausal women; estrogens serve to inhibit FSH production through feedback mechanisms that include inhibins (28). During the perimenopausal period, ovarian failure is sensed by the pituitary, which dramatically increases its production of FSH in an attempt to keep levels of estrogens within normal limits. Menopause is heralded by the failure of estrogenic output from the ovaries. A, Estrogens act in the kidney to augment activation of vitamin D and induce PTHrP production; PTHrP, in turn, augments the growth of and calcium reabsorption by the renal tubular cells. During menopause, the lack of estrogens causes decreases in circulating PTH and may affect renal PTHrP production (21); these effects may ultimately lead to calcium wasting. B, Estrogens act on the heart to chronically stimulate NO production, which in turn stimulates PTHrP production; chronically produced PTHrP, as well as ischemia-triggered PTHrP, serve to augment recovery after an ischemic insult. During menopause, a decrease in chronic NO production may cause a dramatic decrease in basal PTHrP production. For reasons that remain unclear, ischemically triggered PTHrP no longer serves to augment recovery from an insult but rather is detrimental. C, Estrogens act on osteoblasts to directly augment their formation and matrix-producing capacity. It remains unclear whether there is a connection between the action of estrogens on osteoblasts/osteocytes and PTHrP. Cyclically injected PTH1-34 or PTHrP augment osteoblastic bone formation through yet unclear mechanisms. During the perimenopausal period, high circulating FSH induces increases in osteoclastic bone resorption (14,15). During menopause, decreases in estrogens negatively impact osteoblast function.
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