Estrogen treatment for acromegaly

  title={Estrogen treatment for acromegaly},
  author={Ilan Shimon and Ariel L. Barkan},
Estrogens have been used in patients with acromegaly since the 1930–1940s, suppressing plasma IGF-1 levels and improving clinical signs and symptoms of acromegaly. Estrogens antagonize GH function at the post-receptor level, inhibiting GH signaling, thus decreasing GH-induced hepatic IGF-1 synthesis. We report our experience with four female patients with active acromegaly, naïve to medical treatment or inadequately controlled by somatostatin receptor ligands (SRLs) or the GH-receptor… 

Estrogens and selective estrogen receptor modulators in acromegaly

The effect of estrogens and also of selective estrogen receptor modulators on IGF-1 control was reviewed, and proved to be an ancillary tool in the management of acromegaly.

Clomiphene citrate for treatment of acromegaly not controlled by conventional therapies.

Addition of CC should be considered an option in male acromegaly patients not controlled by current available options, with a considerable cost-saving benefit, and improvement of T levels can be obtained in those patients with concurrent central hypogonadism.

Estrogen and selective estrogen receptor modulators (SERMs) for the treatment of acromegaly: a meta-analysis of published observational studies

It was concluded that estrogen and SERMs are a low cost and effective treatment to achieve control of IGF-1 levels in acromegalic women either as concomitant treatment for refractory disease, or where access to conventional therapy is restricted.

A prospective study on the efficacy of oral estrogen in female patients with acromegaly

Oral estrogen was well tolerated, but the somatotropinoma that presented ER-α expression was the only somatotropic cancer that presented growth during treatment, and a trial with oral estrogen can be an option for young women.

The place of medical treatment of acromegaly: current status and perspectives

Novel therapy targets based on molecular pathogenesis of GH-secreting tumors are currently in development, aiming at fulfilling this important gap in medical treatment.

Current therapies and mortality in acromegaly

Mortality in acromegaly can be reduced to expected levels from general population by using modern therapies either in monotherapy or by using multimodal approaches in experienced centers.

The significance of estrogen receptors in acromegaly: Are they useful as predictors of prognosis and therapy regimen?

  • Selma OzturkH. Donmez-Altuntas F. Bayram
  • Medicine, Biology
    Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society
  • 2020

Pharmacological treatment of acromegaly: its place in the overall therapeutic approach

Goal of treatment of acromegaly include elimination of the mass effect of the tumor, normalization of GH and IGF-1 levels and preservation of pituitary function whenever possible, which is expected to reverse or mitigate the increased mortality and morbidity risks.

The multimodal treatment of acromegaly: current status and future perspectives.

Acromegaly is a chronic systemic disorder caused by a GH-secreting pituitary adenoma. Active acromegaly results in a poor quality of life due to symptoms such as headache, fatigue, arthralgia,

Biochemical following-up of treated acromegaly. Limitations of the current determinations of IGF-I and perspective.

  • M. Granada
  • Medicine, Biology
    Minerva endocrinologica
  • 2019
Clinical guidelines related to the diagnosis and management of patients with acromegaly state that "normal" IGF-I concentrations, (within an established age- and sex- reference range), excludes the diagnosis of active acromEGaly, and mean disease control in patients who have received treatment.



Raloxifene decreases serum IGF-I in male patients with active acromegaly.

Raloxifene might be useful in the treatment of male patients with active acromegaly, but longer term studies are clearly needed.

Raloxifene lowers IGF-I levels in acromegalic women.

RAL decreases IGF-I levels in most acromegalic women with mild or intermediate disease and normalizes it in many and a prospective randomized study in patients resistant or partially sensitive to other medical treatments is warranted.

Mechanism of estrogenic action in acromegaly.

The experimental data suggest that estrogen may be a peripheral antagonist of the effects of excessive growth hormone secretion in acromegalic patients and in more negative nitrogen balances than previously thought.

Effects of tamoxifen on GH and IGF-I levels in acromegaly

Tamoxifen (TAM), a non steroid partially competitive antagonist to the estrogen receptors, has been reported to decrease plasma GH and IGF-I levels both in vitro and in vivo, and it is likely that the observed decrease in plasma IGF- I levels is dependent on TAM activity at the hepatic level.

Estroprogestinic pill normalizes IGF-I levels in acromegalic women

A pilot study shows a marked IGF-I lowering effect of pill in acromegalic women, and warrants a prospective randomized study in patients resistant or partially sensitive to other medical treatments.

Tamoxifen enhances the control of acromegaly treated with somatostatin analog lanreotide

The case of a 51-year old female patient with acromegaly that was resistant to somatostatin analogs and dopamine agonists and diagnosed with breast cancer requiring treatment with the anti-estrogen tamoxifen is presented.

Effect of estrogen therapy on carbohydrate metabolism in acromegaly.

During estrogen therapy, the concentration of fasting plasma growth hormone was consistently and significantly reduced in only one of the patients, indicating that the initial effects of estrogen therapy upon carbohydrate and insulin metabolism were initially beneficial.

Oral estroprogestin: an alternative low cost therapy for women with postoperative persistent acromegaly?

Oral estrogen treatment appears to normalize serum IGF-1 concentrations in over 70% of women with acromegaly uncured by surgery irrespective of their sensitivity to octreotide LAR, and it is suggested that estrogens may be a temporary cost-effective and safe treatment for women with postoperative persistent acromEGaly.

Acromegaly. The effects of various steroid hormones on the insulin-induced growth hormone response.

In the dosage schedules used in this study, it was not possible to suppress either basal growth hormone secretion or blunt its responsiveness to the normal physiologic stimulus of hypoglycemia.

Long-term effects of pegvisomant in patients with acromegaly

  • I. HodishA. Barkan
  • Biology, Medicine
    Nature Clinical Practice Endocrinology &Metabolism
  • 2008
The long-term data that have been gathered on pegvisomant therapy are presented, the related risks and benefits are discussed, and a potential therapeutic approach is frame.