Coelingh Bennink Herjan J T, Prowse Amanda, Egberts Jan F M, Debruyne Frans M J, Huhtaniemi Ilpo T, Tombal Bertrand
Pantarhei Bioscience, 3700 AL Zeist, The Netherlands.
Terminal 4 Communications, 1217 SK Hilversum, The Netherlands.
J Endocr Soc. 2024 Jun 4;8(7):bvae107. doi: 10.1210/jendso/bvae107. eCollection 2024 May 23.
The role of estradiol (E2; an estrogen) in men needs to be more appreciated. In this review, we address the clinical situations that allow the study of the clinical consequences of E2 deficiency in men and discuss the effects of restoration of levels of this reproductive steroid hormone. In men with advanced prostate cancer (PCa) undergoing androgen deprivation therapy (ADT), E2 is suppressed along with testosterone, leading to side effects affecting the quality of life. These include hot flashes, arthralgia, fatigue, mood changes, cognition problems, weight gain, bone loss, and increased risk of cardiovascular disease. Transdermal E2 alone for ADT has shown equivalent testosterone suppression compared to gonadotropin-releasing hormone (GnRH) agonists while also preventing estrogen-deficiency side effects, including hot flashes and bone loss. Co-treatment of ADT with fetal estrogen estetrol (E4) has shown significant improvements of estrogen-deficiency symptoms. These observations emphasize the need to raise awareness of the importance of estrogens in men among clinicians and the lay public.
雌二醇(E2;一种雌激素)在男性中的作用需要得到更多重视。在本综述中,我们探讨了有助于研究男性E2缺乏临床后果的临床情况,并讨论了恢复这种生殖类固醇激素水平的影响。在接受雄激素剥夺治疗(ADT)的晚期前列腺癌(PCa)男性中,E2与睾酮一同被抑制,从而导致影响生活质量的副作用。这些副作用包括潮热、关节痛、疲劳、情绪变化、认知问题、体重增加、骨质流失以及心血管疾病风险增加。单独使用经皮E2进行ADT已显示出与促性腺激素释放激素(GnRH)激动剂相当的睾酮抑制效果,同时还能预防雌激素缺乏的副作用,包括潮热和骨质流失。ADT与胎儿雌激素雌三醇(E4)联合治疗已显示出雌激素缺乏症状有显著改善。这些观察结果强调,临床医生和普通大众都需要提高对雌激素在男性中重要性的认识。