Related Experiment Video
Updated: Jun 4, 2026

An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
Published on: August 13, 2019
Beyond GnRH analogues: The renaissance of estrogens in prostate cancer management
Madalina Matthys1, Clément Klein1, Thierry Roumeguère2
1Urology Department, CHU de Bordeaux, 33000 Bordeaux, France.
Context:
Androgen deprivation therapy (ADT) induced by LHRH agonists or antagonists for the treatment of advanced prostate cancer induces a concomitant suppression of estradiol levels. This estrogen deficiency is responsible for significant side effects that impair patients' quality of life (QoL). The role of estrogens in prostate cancer management is currently being investigated in multiple clinical trials, either as a replacement for conventional ADT or as add-back therapy combined with standard ADT.
Methods:
A literature search was conducted on PubMed using the following keywords: androgen deprivation therapy (ADT), bone loss, estrogen deficiency symptoms, hot flushes, and transdermal estradiol (tE2), for articles published between 1970 and 2026.
Results:
Estrogen suppression is responsible for multiple adverse effects, including loss of bone mineral density (BMD), vasomotor symptoms, metabolic disorders, and fatigue. However, the use of tE2 remains associated with a notably higher incidence of gynecomastia compared with conventional ADT.
Conclusions:
The suppression of estrogens by ADT induces multiple deleterious effects justifying the re-evaluation of controlled estrogen replacement. Available data regarding the use of transdermal estradiol or estetrol (E4) as add-on therapy are preliminary but encouraging although larger randomized trials are needed to confirm their integration into routine clinical practice.
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