[Equine estrogens vs. esterified estrogens in the climacteric and menopause. The controversy arrives in Mexico].

The research discusses the controversies surrounding the use of equine estrogens versus esterified estrogens in managing climacteric and menopause symptoms, with a specific focus on usage trends and regulations in Mexico.

Understanding Equine and Esterified Estrogens

• This study focuses on two types of estrogens – equine and esterified. Both of these compounds are used in managing the symptoms of climacteric and menopause.
• Equine estrogens are extracted from the urine of pregnant mares, while esterified estrogens are synthesized from plant sources.
• There has been controversy comparing these two compounds due to differences in their chemical compositions and bioavailability.
• One significant difference is that esterified estrogens lack delta 8,9 dehydroestrone, a compound present in equine estrogens.

Esterified Estrogens Usage and Regulation

• The usage of esterified estrogens is prevalent in the United States and other countries for treating symptoms of climacteric and for preventing postmenopausal osteoporosis.
• However, the Food and Drug Administration (FDA) in the USA has not authorized a generic version of conjugated estrogens (i.e., a combination of estrogen hormones), which includes equine estrogens.
• In Mexican medical institutions like the Instituto Mexicano del Seguro Social (IMSS), esterified estrogens have largely been used for these treatments since the year 2000.

Pharmacology, Clinical Use, and Cost

• The paper reviews the current knowledge on the pharmacology, chemical composition, and clinical use of both equine and esterified estrogens.
• It seeks to provide a solid knowledge base to inform decisions on the purchase and use of these compounds in Mexican healthcare settings.
• The paper also evaluates the cost-effectiveness of these treatments, which is an important consideration for health institutions managing limited budgets.