WOMEN 'S HEALTH AND MENOPAUSE : - National Heart, Lung ...

TABLE 1–3
Women’s Health and Menopause: Future Needs
20
Menopause and Aging
• Conduct more research on the biologic and psychosocial processes of menopause.
• Conduct additional longitudinal studies using prospective observational designs and large cohorts on the natural
history of menopause representing women from a broad array of racial/ethnic and socioeconomic backgrounds.
• Undertake additional menstrual diary research with concurrent hormone measures, to establish biomarkers of
women’s proximity to menopause.
• Undertake additional research on fertility and contraception in the perimenopause.
• Further understanding is needed about the reciprocal influences of lifestyle, decision to use HRT, and quality of life.
• Providing women and their families with balanced information about menopause, fostering positive attitudes
towards aging and menopause, and encouraging healthy lifestyles may improve their health and quality of life
related to menopause.
Symptoms and the Menopause
• Better document the natural menopausal transition through prospective investigations to distinguish
menopause-related changes from those of aging or disease.
• Conduct questionnaire studies validating phytoestrogen intake against metabolic measures of metabolites in
different cultural settings.
• Conduct a larger RCT of phytoestrogen supplementation, including metabolic measures of metabolite levels.
Sociocultural Issues
• Undertake better controlled population-based studies using standardized instruments adapted to the culture studied.
• Develop an interactive psycho-bio-cultural model of menopause.
• Disseminate research results within cultures under study, so that women can make their own decisions about the
need for and choice of interventions and treatment strategies.
• Conduct more interdisciplinary research for a better understanding of interactive factors.
Physiological Role of Estrogen and Estrogen Receptors and Pharmacologic Modulation
of Estrogen Receptor Activity
• Further characterize a possible antiproliferative role of ERβ in the uterus and mammary gland.
• Determine the physiologic functions of ERβ in the ovary (role in polycystic ovarian syndrome?), bladder, urethra,
bone, cardiovascular system, immune system, and CNS.
• Develop ERα- and ERβ-specific agonists and antagonists for experimental and therapeutic purposes.
• Attain different profiles of action for exogenous estradiol through use of different formulations.
• Obtain higher specificity of action by identification of new target molecules involved in gene transcription.
• Increase knowledge of the mechanisms involved in ER activation through membrane receptors to develop new
pharmacologic compounds acting along these pathways.