Endogenous opioids and hot flushes still hypothetical
2006; Elsevier BV; Volume: 367; Issue: 9505 Linguagem: Inglês
10.1016/s0140-6736(06)67940-3
ISSN1474-547X
AutoresLaura J. Hanisch, Jun J. Mao, Michael Kodransky, James C. Coyne,
Tópico(s)Menstrual Health and Disorders
ResumoBoth withdrawal and activation of endogenous opioids have been suggested as mechanisms of menopausal hot flushes. Casper and Yen 1 Casper RF Yen SS Neuroendocrinology of menopausal flushes: an hypothesis of flush mechanism. Clin Endocrinol. 1985; 22: 293-312 Crossref PubMed Scopus (202) Google Scholar proposed that hot flushes are hypothalamic thermoregulatory events originating from increased brain norepinephrine activity due to decreased activity of hypothalamic opioids, which in turn is caused by oestrogen withdrawal. Consistent with this hypothesis, Elizabeth Nedstrand and colleagues 2 Nedstrand E Wijma K Wyon Y Hammar M Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study. Climacteric. 2005; 8: 243-250 Crossref PubMed Scopus (91) Google Scholar recently proposed that acupuncture reduces the frequency of hot flushes by increasing hypothalamic β-endorphin activity. However, opioid activation has also been suspected because people receiving chlorpropamide flush after drinking alcohol. 3 Leslie RDG Pyke DA Stubbs WA Sensitivity to enkephalin as a cause of non-insulin dependent diabetes. Lancet. 1979; 1: 341-343 Summary PubMed Scopus (105) Google Scholar Research has linked raised norepinephrine and opioids as well as oestrogen withdrawal to hot flushes, but current evidence is insufficient to ascertain the role of opioid withdrawal, because of an absence of studies with appropriate design.
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