Estrogenic treatment and liver functions

Czech version

Authors: Jiří Slíva
Authors‘ workplace: Ústav farmakologie, 3. LF UK, Praha
Published in: Ceska Gynekol 2024; 89(6): 501-503
Category:
doi: https://doi.org/10.48095/cccg2024501

Overview

Estrogens are key hormones that play a vital role in the physiology of the reproductive system in women. However, their therapeutic use in hormonal treatment, contraception, and the treatment of hormone-dependent diseases may be associated with a number of side effects, especially on the liver. This article focuses on the mechanisms of action of estrogens and their potential hepatotoxic effects, as well as risk factors and possible differences between representatives.

Keywords:

side effects – estradiol – Safety – Estrogens – liver – estetrol – ethinyl estradiol

Sources

1. Tsuchiya Y, Nakajima M, Yokoi T. Cytochrome P450-mediated metabolism of estrogens and its regulation in human. Cancer Lett 2005; 227 (2): 115–124. doi: 10.1016/j.canlet.2004.10.007.

2. Zhang H, Cui D, Wang B et al. Pharmacokinetic drug interactions involving 17alpha--ethinylestradiol: a new look at an old drug. Clin Pharmacokinet 2007; 46 (2): 133–57. doi: 10.2165/00003088-200746020-00003.

3. Rodrigues AD. Drug interactions involving 17a-ethinylestradiol: considerations beyond cytochrome P450 3A induction and inhibition. Clin Pharmacol Ther 2022; 111 (6): 1212–1221. doi: 10.1002/cpt.2383.

4. Rose DP, Goldman M, Connolly JM et al. High--fiber diet reduces serum estrogen concentrations in premenopausal women. Am J Clin Nutr 1991; 54 (3): 520–525. doi: 10.1093/ajcn/54.3.520.

5. Raps M, Helmerhorst F, Fleischer K et al. Sex hormone-binding globulin as a marker for the thrombotic risk of hormonal contraceptives. J Thromb Haemost 2012; 10 (6): 992–997. doi: 10.1111/j.1538-7836.2012.04720.x.

6. Odlind V, Milsom I, Persson I et al. Can changes in sex hormone binding globulin predict the risk of venous thromboembolism with combined oral contraceptive pills? Acta Obstet Gynecol Scand 2002; 81 (6): 482–490. doi: 10.1034/j.1600-0412.2002.810603.x.

7. Mawet M, Maillard C, Klipping C et al. Unique effects on hepatic function, lipid metabolism, bone and growth endocrine parameters of estetrol in combined oral contraceptives. Eur J Contracept Reprod Health Care 2015; 20 (6): 463–475. doi: 10.3109/13625187.2015.1068934.

8. Klipping C, Duijkers I, Mawet M et al. Endocrine and metabolic effects of an oral contraceptive containing estetrol and drospirenone. Contraception 2021; 103 (4): 213–221. doi: 10.1016/j.contraception.2021.01.001.

9. Kluft C, Zimmerman Y, Mawet M et al. Reduced hemostatic effects with drospirenone-based oral contraceptives containing estetrol vs. ethinyl estradiol. Contraception 2017; 95 (2): 140–147. doi: 10.1016/j.contraception.2016.08.018.

10. Douxfils J, Klipping C, Duijkers I et al. Evaluation of the effect of a new oral contraceptive containing estetrol and drospirenone on hemostasis parameters. Contraception 2020; 102 (6): 396–402. doi: 10.1016/j.contraception. 2020.08.015.

11. Arnal JF, Scarabin PY, Trémollières F et al. Estrogens in vascular biology and disease: where do we stand today? Curr Opin Lipidol 2007; 18 (5): 554–560. doi: 10.1097/MOL.0b013e3282ef3bca.

12. Hodgin JB, Krege JH, Reddick RL et al. Estrogen receptor a is a major mediator of 17b-estradiol’s atheroprotective effects on lesion size in Apoe-/- mice. J Clin Investig 2001; 107 (3): 333–340. doi: 10.1172/JCI11320.

13. Coelingh Bennink HJ, Verhoeven C, Zimmerman Y et al. Pharmacodynamic effects of the fetal estrogen estetrol in postmenopausal women: results from a multiple-rising-dose study. Menopause 2017; 24 (6) : 677– 685. doi: 10.1097/ GME.0000000000000823.

ORCID autora

J. Slíva 0000-0003-2690-1889

doc. MU Dr. Jiří Slíva, Ph.D.

Ústav farmakologie

3. LF UK

Ruská 2411/ 87

100 00 Praha 10

jiri.sliva@lf3.cuni.cz