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Estrogen treatment for acromegaly

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Abstract

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 antagonist. Adding estrogen treatment (contraceptive pills or transdermal estrogen patches) to their ongoing medical treatment, suppressed IGF-1 significantly in all patients, achieving hormonal remission in three of them. We review the available data on the use of estrogens and selective estrogen receptor modulators in acromegaly, and their mechanisms of action. Estrogens could be an alternative, inexpensive adjuvant treatment for females with active acromegaly, who are only partially responding to SRLs or to the GH-receptor antagonist.

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Authors and Affiliations

  1. Division of Metabolism, Endocrinology and Diabetes, Department of Neurosurgery, University of Michigan Medical Center, Ann Arbor, MI, USA

    Ariel Barkan

  2. Institute of Endocrinology and Metabolism, Rabin Medical Center, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Ilan Shimon

  3. Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, 49100, Petah Tiqva, Israel

    Ilan Shimon

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  1. Ilan Shimon
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  2. Ariel Barkan
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Correspondence to Ilan Shimon.

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Shimon, I., Barkan, A. Estrogen treatment for acromegaly. Pituitary 15, 601–607 (2012). https://doi.org/10.1007/s11102-012-0426-4

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