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Estrogen | Reproductive system physiology | NCLEX-RN | Khan Academy
Estrogen | Reproductive system physiology | NCLEX-RN | Khan Academy
Published: 2014/11/25
Channel: khanacademymedicine
1.5 YEARS ON ESTROGEN!
1.5 YEARS ON ESTROGEN!
Published: 2016/11/29
Channel: Maya
10 Early Warning Signs Your Estrogen Levels Are Too High & How To Fix It
10 Early Warning Signs Your Estrogen Levels Are Too High & How To Fix It
Published: 2017/08/30
Channel: Natural Cures
The Top 5 High Estrogen Foods to Avoid
The Top 5 High Estrogen Foods to Avoid
Published: 2014/09/11
Channel: Dr. Josh Axe
10 YEARS ON ESTROGEN | HORMONE REPLACEMENT THERAPY RESULTS EXPLAINED
10 YEARS ON ESTROGEN | HORMONE REPLACEMENT THERAPY RESULTS EXPLAINED
Published: 2017/04/28
Channel: Elle Bradford
Pure Estrogen Boost
Pure Estrogen Boost
Published: 2013/04/05
Channel: Sapien Medicine
SIX MONTH ESTROGEN UPDATE!
SIX MONTH ESTROGEN UPDATE!
Published: 2016/04/08
Channel: Chloe Arden
2.5 YEARS ON ESTROGEN!
2.5 YEARS ON ESTROGEN!
Published: 2017/11/23
Channel: Maya
Estrogen, the Good, the Bad & the Ugly
Estrogen, the Good, the Bad & the Ugly
Published: 2016/10/17
Channel: Dr. Eric Berg DC
Estrogen Is Killing Men: How To Lower Estrogen Naturally
Estrogen Is Killing Men: How To Lower Estrogen Naturally
Published: 2017/11/16
Channel: Christopher Walker
ONE YEAR ESTROGEN UPDATE!! | Chloe Arden
ONE YEAR ESTROGEN UPDATE!! | Chloe Arden
Published: 2016/11/06
Channel: Chloe Arden
2 Years On Estrogen!
2 Years On Estrogen!
Published: 2018/01/20
Channel: Jordan Volness
3 months on estrogen!
3 months on estrogen!
Published: 2017/01/30
Channel: Life with Hope
Dwa Sławy - Estrogen (prod. No Echoes)
Dwa Sławy - Estrogen (prod. No Echoes)
Published: 2017/01/19
Channel: EMBRYO NAGRANIA
Estrogen Levels In Women | Her Body
Estrogen Levels In Women | Her Body
Published: 2014/04/25
Channel: HerBody mDhil
Too Much Estrogen?  Every Man Should Watch This!
Too Much Estrogen? Every Man Should Watch This!
Published: 2015/04/22
Channel: iHealthTube.com
HOW TO NATURALLY INCREASE ESTROGEN LEVELS FOR MTF TRANSGENDERS
HOW TO NATURALLY INCREASE ESTROGEN LEVELS FOR MTF TRANSGENDERS
Published: 2017/03/13
Channel: Dawn Marie
90 Minute Estrogen Release Binaural Beats
90 Minute Estrogen Release Binaural Beats
Published: 2013/08/19
Channel: StandardBinauralBeat
3 Foods to Reduce Estrogen to Lose Weight- Thomas DeLauer
3 Foods to Reduce Estrogen to Lose Weight- Thomas DeLauer
Published: 2016/01/13
Channel: Thomas DeLauer
2 YEARS ON ESTROGEN!
2 YEARS ON ESTROGEN!
Published: 2017/06/02
Channel: Maya
Animation: The Estrogen Mechanism
Animation: The Estrogen Mechanism
Published: 2013/10/02
Channel: Breast Cancer Prevention Partners - BCPP
Balancing Hormones Naturally, Estrogen & Progesterone w/ Dr. Shari Caplan
Balancing Hormones Naturally, Estrogen & Progesterone w/ Dr. Shari Caplan
Published: 2016/10/27
Channel: High Intensity Health
omg i overdosed on estrogen + woke up in hospital!!!
omg i overdosed on estrogen + woke up in hospital!!!
Published: 2017/07/13
Channel: Cluam Sutherland
Top 10 Foods High in Estrogen
Top 10 Foods High in Estrogen
Published: 2014/07/07
Channel: KMONIC
two months on estrogen
two months on estrogen
Published: 2017/01/20
Channel: Jamie Dee
The Iodine-Estrogen Connection: MUST WATCH!
The Iodine-Estrogen Connection: MUST WATCH!
Published: 2016/06/28
Channel: Dr. Eric Berg DC
Low Estrogen Symptoms
Low Estrogen Symptoms
Published: 2017/02/17
Channel: Your Education Video
How to Increase Estrogen
How to Increase Estrogen
Published: 2017/04/08
Channel: Health
What is estrogen and functions
What is estrogen and functions
Published: 2015/11/14
Channel: Home Remedies and medical tips
Abundant Estrogen - 1351HZ with Phi - 1.618033HZ
Abundant Estrogen - 1351HZ with Phi - 1.618033HZ
Published: 2016/03/31
Channel: Anthony Sommer
High and Low Estrogen Symptoms in Men:  By Dylan Gemelli
High and Low Estrogen Symptoms in Men: By Dylan Gemelli
Published: 2017/05/03
Channel: Dylan Gemelli
Estrogen and Cortisol: 2 Hormones That Affect Belly Fat: Thomas DeLauer
Estrogen and Cortisol: 2 Hormones That Affect Belly Fat: Thomas DeLauer
Published: 2017/08/05
Channel: Thomas DeLauer
1 YEAR ESTROGEN TRANSGENDER TRANSFORMATION TIME-LAPSE
1 YEAR ESTROGEN TRANSGENDER TRANSFORMATION TIME-LAPSE
Published: 2016/05/29
Channel: Maya
Understanding the Menstrual Cycle and Estrogen Dominance
Understanding the Menstrual Cycle and Estrogen Dominance
Published: 2013/03/20
Channel: Dr. Eric Berg DC
2 YEARS on Estrogen! | How I
2 YEARS on Estrogen! | How I've Changed | Stef Sanjati
Published: 2017/11/20
Channel: Stef Sanjati
Estrogen vs Progesterone Hormonal Dominance: Control Low Hormones Symptoms
Estrogen vs Progesterone Hormonal Dominance: Control Low Hormones Symptoms
Published: 2016/03/12
Channel: Get Lean Today
Estrogen & Your Prostate
Estrogen & Your Prostate
Published: 2017/03/14
Channel: Dr. Eric Berg DC
5 Signs of High Estrogen
5 Signs of High Estrogen
Published: 2016/03/04
Channel: Rambo Cuztha Gunz
Detox Cleanse : Do this to Detox Estrogen Naturally - VitaLife Show Episode 237
Detox Cleanse : Do this to Detox Estrogen Naturally - VitaLife Show Episode 237
Published: 2017/04/25
Channel: VitaTree VitaLife Show
Should I wait for estrogen symptoms before starting an aromatase inhibitor?:  By Dylan Gemelli
Should I wait for estrogen symptoms before starting an aromatase inhibitor?: By Dylan Gemelli
Published: 2017/03/17
Channel: Dylan Gemelli
Low Estrogen
Low Estrogen
Published: 2018/01/17
Channel: SpiritofHealthKC
1 YEAR ON ESTROGEN | My Transition Timeline
1 YEAR ON ESTROGEN | My Transition Timeline
Published: 2017/01/18
Channel: AJ Clementine
Why Estrogen Dominance After Menopause?
Why Estrogen Dominance After Menopause?
Published: 2016/12/23
Channel: Dr. Eric Berg DC
Foods High in Estrogen - Super Foods Good Health - Benefits of Wellness
Foods High in Estrogen - Super Foods Good Health - Benefits of Wellness
Published: 2015/07/17
Channel: WELLNESS
High Estrogen Foods That Men Should avoid At All Times
High Estrogen Foods That Men Should avoid At All Times
Published: 2017/03/08
Channel: 24 Physic
Estrogen: How to Balance Hormones | Health Hacks- Thomas DeLauer
Estrogen: How to Balance Hormones | Health Hacks- Thomas DeLauer
Published: 2017/01/22
Channel: BeFiT
Early Warning Signs Your Body Has TOO MUCH Estrogen
Early Warning Signs Your Body Has TOO MUCH Estrogen
Published: 2017/07/17
Channel: Imaginación
Anti Estrogen Foods - Eat THESE Foods to Lower Estrogen
Anti Estrogen Foods - Eat THESE Foods to Lower Estrogen
Published: 2016/02/01
Channel: Criticalbench
Thận trọng khi bổ sung nội tiết tố nữ ESTROGEN
Thận trọng khi bổ sung nội tiết tố nữ ESTROGEN
Published: 2015/12/22
Channel: Mẹo Làm Đẹp
Learn How Estrogen Effects The Female Body | What is Estrogen?
Learn How Estrogen Effects The Female Body | What is Estrogen?
Published: 2014/11/13
Channel: My Luminology
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WIKIPEDIA ARTICLE

From Wikipedia, the free encyclopedia
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Estrogen
Drug class
Estradiol.svg
Estradiol, the major estrogen sex hormone in humans and a widely used medication.
Class identifiers
Use Contraception, Menopause, hypogonadism, transgender women, prostate cancer, breast cancer, others
ATC code G03C
Biological target Estrogen receptors (ERα, ERβ, mERs (e.g., GPER, others))
External links
MeSH D004967
In Wikidata

Estrogen, or oestrogen, is the primary female sex hormone. It is responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens in women that have estrogenic hormonal activity: estrone, estradiol, and estriol. The estrane steroid estradiol is the most potent and prevalent of these.

Estrogens are synthesized in all vertebrates[1] as well as some insects.[2] Their presence in both vertebrates and insects suggests that estrogenic sex hormones have an ancient evolutionary history. The three major naturally occurring forms of estrogen in women are estrone (E1), estradiol (E2), and estriol (E3). Another type of estrogen called estetrol (E4) is produced only during pregnancy. Quantitatively, estrogens circulate at lower levels than androgens in both men and women.[3] While estrogen levels are significantly lower in males compared to females, estrogens nevertheless also have important physiological roles in males.[4]

Like all steroid hormones, estrogens readily diffuse across the cell membrane. Once inside the cell, they bind to and activate estrogen receptors (ERs) which in turn modulate the expression of many genes.[5] Additionally, estrogens bind to and activate rapid-signaling membrane estrogen receptors (mERs),[6][7] such as GPER (GPR30).[8]

In addition to their role as natural hormones, estrogens are used as medications, for instance in menopausal hormone therapy and hormonal birth control; for information on estrogens as medications, see the estrogen (medication) article.

Types and examples[edit]

The three major naturally occurring estrogens in women are estrone (E1), estradiol (E2), and estriol (E3). Estradiol is the predominant estrogen during reproductive years both in terms of absolute serum levels as well as in terms of estrogenic activity. During menopause, estrone is the predominant circulating estrogen and during pregnancy estriol is the predominant circulating estrogen in terms of serum levels. Though estriol is the most plentiful of the three estrogens it is also the weakest, whereas estradiol is the strongest with a potency of approximately 80 times that of estriol.[9] Thus, estradiol is the most important estrogen in non-pregnant females who are between the menarche and menopause stages of life. However, during pregnancy this role shifts to estriol, and in postmenopausal women estrone becomes the primary form of estrogen in the body. Another type of estrogen called estetrol (E4) is produced only during pregnancy. All of the different forms of estrogen are synthesized from androgens, specifically testosterone and androstenedione, by the enzyme aromatase.

Minor endogenous estrogens, the biosyntheses of which do not involve aromatase, include 27-hydroxycholesterol, dehydroepiandrosterone (DHEA), 7-oxo-DHEA, 7α-hydroxy-DHEA, 16α-hydroxy-DHEA, 7β-hydroxyepiandrosterone, androstenedione (A4), androstenediol (A5), 3α-androstanediol, and 3β-androstanediol.[10][11] Some estrogen metabolites, such as the catechol estrogens 2-hydroxyestradiol, 2-hydroxyestrone, 4-hydroxyestradiol, and 4-hydroxyestrone, as well as 16α-hydroxyestrone, are also estrogens with varying degrees of activity.[12] The biological importance of these minor estrogens is not entirely clear.

Biological function[edit]

Reference ranges for the blood content of estradiol, the primary type of estrogen, during the menstrual cycle.[13]

The actions of estrogen are mediated by the estrogen receptor (ER), a dimeric nuclear protein that binds to DNA and controls gene expression. Like other steroid hormones, estrogen enters passively into the cell where it binds to and activates the estrogen receptor. The estrogen:ER complex binds to specific DNA sequences called a hormone response element to activate the transcription of target genes (in a study using an estrogen-dependent breast cancer cell line as model, 89 such genes were identified).[14] Since estrogen enters all cells, its actions are dependent on the presence of the ER in the cell. The ER is expressed in specific tissues including the ovary, uterus and breast. The metabolic effects of estrogen in postmenopausal women has been linked to the genetic polymorphism of the ER.[15]

While estrogens are present in both men and women, they are usually present at significantly higher levels in women of reproductive age. They promote the development of female secondary sexual characteristics, such as breasts, and are also involved in the thickening of the endometrium and other aspects of regulating the menstrual cycle. In males, estrogen regulates certain functions of the reproductive system important to the maturation of sperm[16][17][18] and may be necessary for a healthy libido.[19] Furthermore, there are several other structural changes induced by estrogen in addition to other functions.

Overview of actions[edit]

Female pubertal development[edit]

Estrogens are responsible for the development of female secondary sexual characteristics during puberty, including breast development, widening of the hips, and female fat distribution. Conversely, androgens are responsible for pubic and body hair growth, as well as acne and axillary odor.

Breast development[edit]

Estrogen, in conjunction with growth hormone (GH) and its secretory product insulin-like growth factor 1 (IGF-1), is critical in mediating breast development during puberty, as well as breast maturation during pregnancy in preparation of lactation and breastfeeding.[26][27] Estrogen is primarily and directly responsible for inducing the ductal component of breast development,[28][29][30] as well as for causing fat deposition and connective tissue growth.[28][29] It is also indirectly involved in the lobuloalveolar component, by increasing progesterone receptor expression in the breasts[28][30][31] and by inducing the secretion of prolactin.[32][33] Allowed for by estrogen, progesterone and prolactin work together to complete lobuloalveolar development during pregnancy.[29][34]

Androgens such as testosterone powerfully oppose estrogen action in the breasts, such as by reducing estrogen receptor expression in them.[35][36]

Female reproductive system[edit]

Estrogens are responsible for maturation and maintenance of the vagina and uterus, and are also involved in ovarian function, such as maturation of ovarian follicles. In addition, estrogens play an important role in regulation of gonadotropin secretion. For these reasons, estrogens are required for female fertility.

Brain and behavior[edit]

Sex drive[edit]

Estrogens are involved in sex drive in both women and men.

Cognition[edit]

Verbal memory scores are frequently used as one measure of higher level cognition. These scores vary in direct proportion to estrogen levels throughout the menstrual cycle, pregnancy, and menopause. Furthermore, estrogens when administered shortly after natural or surgical menopause prevents decreases in verbal memory. In contrast, estrogens have little effect on verbal memory if first administered years after menopause.[37] Estrogens also have positive influences on other measures of cognitive function.[38] However the effect of estrogens on cognition is not uniformly favorable and is dependent on the timing of the dose and the type of cognitive skill being measured.[39]

The protective effects of estrogens on cognition may be mediated by estrogens anti-inflammatory effects in the brain.[40] Studies have also shown that the Met allele gene and level of estrogen mediates the efficiency of prefrontal cortex dependent working memory tasks.[41][42]

Mental health[edit]

Estrogen is considered to play a significant role in women’s mental health. Sudden estrogen withdrawal, fluctuating estrogen, and periods of sustained estrogen low levels correlate with significant mood lowering. Clinical recovery from postpartum, perimenopause, and postmenopause depression has been shown to be effective after levels of estrogen were stabilized and/or restored.[43][44][45]

Compulsions in male lab mice, such as those in obsessive-compulsive disorder (OCD), may be caused by low estrogen levels. When estrogen levels were raised through the increased activity of the enzyme aromatase in male lab mice, OCD rituals were dramatically decreased. Hypothalamic protein levels in the gene COMT are enhanced by increasing estrogen levels which are believed to return mice that displayed OCD rituals to normal activity. Aromatase deficiency is ultimately suspected which is involved in the synthesis of estrogen in humans and has therapeutic implications in humans having obsessive-compulsive disorder.[46]

Local application of estrogen in the rat hippocampus has been shown to inhibit the re-uptake of serotonin. Contrarily, local application of estrogen has been shown to block the ability of fluvoxamine to slow serotonin clearance, suggesting that the same pathways which are involved in SSRI efficacy may also be affected by components of local estrogen signaling pathways.[47]

Parenthood[edit]

Studies have also found that fathers had lower levels of cortisol and testosterone but higher levels of estrogen (estradiol) compared to non-fathers.[48]

Binge eating[edit]

Estrogen may play a role in suppressing binge eating. Hormone replacement therapy using estrogen may be a possible treatment for binge eating behaviors in females. Estrogen replacement has been shown to suppress binge eating behaviors in female mice.[49] The mechanism by which estrogen replacement inhibits binge-like eating involves the replacement of serotonin (5-HT) neurons. Women exhibiting binge eating behaviors are found to have increased brain uptake of neuron 5-HT, and therefore less of the neurotransmitter serotonin in the cerebrospinal fluid.[50] Estrogen works to activate 5-HT neurons, leading to suppression of binge like eating behaviors.[49]

It is also suggested that there is an interaction between hormone levels and eating at different points in the female menstrual cycle. Research has predicted increased emotional eating during hormonal flux, which is characterized by high progesterone and estradiol levels that occur during the mid-luteal phase. It is hypothesized that these changes occur due to brain changes across the menstrual cycle that are likely a genomic effect of hormones. These effects produce menstrual cycle changes, which result in hormone release leading to behavioral changes, notably binge and emotional eating. These occur especially prominently among women who are genetically vulnerable to binge eating phenotypes.[51]

Binge eating is associated with decreased estradiol and increased progesterone.[52] Klump et al.[53] Progesterone may moderate the effects of low estradiol (such as during dysregulated eating behavior), but that this may only be true in women who have had clinically diagnosed binge episodes (BEs). Dysregulated eating is more strongly associated with such ovarian hormones in women with BEs than in women without BEs.[53]

The implantation of 17β-estradiol pellets in ovariectomized mice significantly reduced binge eating behaviors and injections of GLP-1 in ovariectomized mice decreased binge-eating behaviors.[49]

The associations between binge eating, menstrual-cycle phase and ovarian hormones correlated.[52][54][54][55]

Masculinization in rodents[edit]

In rodents, estrogens (which are locally aromatized from androgens in the brain) play an important role in psychosexual differentiation, for example, by masculinizing territorial behavior;[56] the same is not true in humans.[57] In humans, the masculinizing effects of prenatal androgens on behavior (and other tissues, with the possible exception of effects on bone) appear to act exclusively through the androgen receptor.[58] Consequently, the utility of rodent models for studying human psychosexual differentiation has been questioned.[59]

Bone/skeletal system[edit]

Estrogens are responsible for both the pubertal growth spurt, which causes an acceleration in linear growth, and epiphyseal closure, which limits height and limb length, in both females and males. In addition, estrogens are responsible for bone maturation and maintenance of bone mineral density throughout life. Due to hypoestrogenism, the risk of osteoporosis increases during menopause.

Cardiovascular system[edit]

Women suffer less from heart disease due to vasculo-protective action of estrogen which helps in preventing atherosclerosis.[60] It also helps in maintaining the delicate balance between fighting infections and protecting arteries from damage thus lowering the risk of cardiovascular disease.[61]

Immune system[edit]

Estrogen has anti-inflammatory properties and helps in mobilization of polymorphonuclear white blood cells or neutrophils.[61]

Associated conditions[edit]

Estrogens are implicated in various estrogen-dependent conditions, such as ER-positive breast cancer, as well as a number of genetic conditions involving estrogen signaling or metabolism, such as estrogen insensitivity syndrome, aromatase deficiency, and aromatase excess syndrome.

Biochemistry[edit]

Biosynthesis[edit]

Steroidogenesis, showing estrogens at bottom right as in pink triangle.[62]

Estrogens, in females, are produced primarily by the ovaries, and during pregnancy, the placenta.[63] Follicle-stimulating hormone (FSH) stimulates the ovarian production of estrogens by the granulosa cells of the ovarian follicles and corpora lutea. Some estrogens are also produced in smaller amounts by other tissues such as the liver, adrenal glands, and the breasts. These secondary sources of estrogens are especially important in postmenopausal women. Fat cells produce estrogen as well.[64]

In females, synthesis of estrogens starts in theca interna cells in the ovary, by the synthesis of androstenedione from cholesterol. Androstenedione is a substance of weak androgenic activity which serves predominantly as a precursor for more potent androgens such as testosterone as well as estrogen. This compound crosses the basal membrane into the surrounding granulosa cells, where it is converted either immediately into estrone, or into testosterone and then estradiol in an additional step. The conversion of androstenedione to testosterone is catalyzed by 17β-hydroxysteroid dehydrogenase (17β-HSD), whereas the conversion of androstenedione and testosterone into estrone and estradiol, respectively is catalyzed by aromatase, enzymes which are both expressed in granulosa cells. In contrast, granulosa cells lack 17α-hydroxylase and 17,20-lyase, whereas theca cells express these enzymes and 17β-HSD but lack aromatase. Hence, both granulosa and theca cells are essential for the production of estrogen in the ovaries.

Estrogen levels vary through the menstrual cycle, with levels highest near the end of the follicular phase just before ovulation.

Distribution[edit]

Estrogens are plasma protein bound to albumin and/or sex hormone-binding globulin in the circulation.

Metabolism[edit]

Estrogens are metabolized via hydroxylation by cytochrome P450 enzymes such as CYP1A1 and CYP3A4 and via conjugation by estrogen sulfotransferases (sulfation) and UDP-glucuronyltransferases (glucuronidation). In addition, estradiol is dehydrogenated by 17β-Hydroxysteroid dehydrogenase into the much less potent estrogen estrone. These reactions occur primarily in the liver, but also in other tissues.

Excretion[edit]

Estrogens are excreted primarily by the kidneys as conjugates via the urine.

Medical use[edit]

Estrogens are used as medications, mainly in hormonal contraception and hormone replacement therapy.[65]

Chemistry[edit]

The estrogen steroid hormones are estrane steroids.

History[edit]

In 1929, Adolf Butenandt and Edward Adelbert Doisy independently isolated and purified estrone, the first estrogen to be discovered.[66] Then, estriol and estradiol were discovered in 1930 and 1933, respectively. Shortly following their discovery, estrogens, both natural and synthetic, were introduced for medical use. Examples include estriol glucuronide (Emmenin, Progynon), estradiol benzoate, conjugated estrogens (Premarin), diethylstilbestrol, and ethinylestradiol.

Society and culture[edit]

Etymology[edit]

The name estrogen is derived from the Greek οἶστρος (oistros), literally meaning "verve or inspiration" but figuratively sexual passion or desire,[67] and the suffix -gen, meaning "producer of".

Environment[edit]

A range of synthetic and natural substances that possess estrogenic activity have been identified in the environment and are referred to xenoestrogens.[68]

Estrogens are among the wide range of endocrine-disrupting compounds (EDCs) because they have high estrogenic potency. When an EDC makes its way into the environment, it may cause male reproductive dysfunction to wildlife.[69] The estrogen excreted from farm animals makes its way into fresh water systems.[70] During the germination period of reproduction the fish are exposed to low levels of estrogen which may cause reproductive dysfunction to male fish.[71][72]

Cosmetics[edit]

Some hair shampoos on the market include estrogens and placental extracts; others contain phytoestrogens. In 1998, there were case reports of four prepubescent African-American girls developing breasts after exposure to these shampoos.[73] In 1993, the FDA determined that not all over-the-counter topically applied hormone-containing drug products for human use are generally recognized as safe and effective and are misbranded. An accompanying proposed rule deals with cosmetics, concluding that any use of natural estrogens in a cosmetic product makes the product an unapproved new drug and that any cosmetic using the term "hormone" in the text of its labeling or in its ingredient statement makes an implied drug claim, subjecting such a product to regulatory action.[74]

In addition to being considered misbranded drugs, products claiming to contain placental extract may also be deemed to be misbranded cosmetics if the extract has been prepared from placentas from which the hormones and other biologically active substances have been removed and the extracted substance consists principally of protein. The FDA recommends that this substance be identified by a name other than "placental extract" and describing its composition more accurately because consumers associate the name "placental extract" with a therapeutic use of some biological activity.[74]

See also[edit]

References[edit]

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  2. ^ Mechoulam R, Brueggemeier RW, Denlinger DL (September 2005). "Estrogens in insects" (PDF). Cellular and Molecular Life Sciences. 40 (9): 942–944. doi:10.1007/BF01946450. 
  3. ^ Burger HG (2002). "Androgen production in women". Fertility and Sterility. 77 Suppl 4: S3–5. doi:10.1016/S0015-0282(02)02985-0. PMID 12007895. 
  4. ^ Lombardi G, Zarrilli S, Colao A, Paesano L, Di Somma C, Rossi F, De Rosa M (2001). "Estrogens and health in males". Molecular and Cellular Endocrinology. 178 (1–2): 51–5. doi:10.1016/S0303-7207(01)00420-8. PMID 11403894. 
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