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The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
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Updated: Sep 24, 2025

An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
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Unopposed estrogens: current and future perspectives.

M Montanino Oliva1, R Gambioli, G Forte

  • 1The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy. vunfer@gmail.com.

European Review for Medical and Pharmacological Sciences
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Maintaining hormonal balance is crucial for reproductive health. D-chiro-inositol shows promise in treating conditions caused by estrogen dominance, offering a potential new therapeutic avenue.

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Area of Science:

  • Reproductive endocrinology
  • Gynecological pathology

Background:

  • Estrogens and progestogens have opposing effects on female reproductive tissues; hormonal imbalance can lead to disease.
  • Unopposed estrogens, often due to aromatase overproduction, can induce endometrial proliferation and invasion.
  • Pathologies include endometrial hyperplasia, polyps, endometriosis, and adenomyosis.

Purpose of the Study:

  • To explore the potential of d-chiro-inositol as a therapeutic agent for estrogen-dominant conditions.
  • To investigate d-chiro-inositol's mechanisms, including insulin sensitization and aromatase regulation.

Main Methods:

  • Literature review of current understanding of estrogen-progestogen balance and related pathologies.
  • Analysis of recent findings on metformin and d-chiro-inositol in preclinical or clinical studies.
  • Evaluation of d-chiro-inositol's role as an insulin second messenger and aromatase down-regulator.

Main Results:

  • Unopposed estrogens drive proliferative and invasive endometrial diseases.
  • Current treatments have limitations and side effects.
  • Metformin demonstrates positive effects by reducing insulin's proliferative stimulus.
  • D-chiro-inositol exhibits insulin-sensitizing and aromatase-downregulating properties.

Conclusions:

  • D-chiro-inositol's dual action on insulin signaling and estrogen production suggests therapeutic potential.
  • It may offer a novel treatment strategy for conditions associated with unopposed estrogens.
  • Further research is warranted to confirm its efficacy and safety in clinical settings.