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Alfatradiol





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This article is about 17α-estradiol as a medication. For its role as a hormone, see 17α-Estradiol.

Alfatradiol, also known as 17α-estradiol and sold under the brand names Avicis, Avixis, Ell-Cranell Alpha, and Pantostin, is a weak estrogen and 5α-reductase inhibitor medication which is used topically in the treatment of pattern hair loss (androgenic alopecia or pattern baldness) in men and women.[1][2][3][4] It is a stereoisomer of the endogenous steroid hormone and estrogen 17β-estradiol (or simply estradiol).[1]

Alfatradiol
Skeletal formula of alfatradiol
Ball-and-stick model of the alfatradiol molecule
Clinical data
Trade namesAvicis, Avixis, Ell-Cranell Alpha, Pantostin
Other names17α-Estradiol; 17-Epiestradiol; MX-4509; Estra-1,3,5(10)-triene-3,17α-diol; β-Estradiol (obsolete, misleading)[1]
AHFS/Drugs.comInternational Drug Names
Pregnancy
category
  • No studies
Routes of
administration		Topical
Drug classEstrogen; 5α-Reductase inhibitor
ATC code
  • None
Legal status
Legal status
Identifiers

  • (8R,9S,13S,14S,17R)-13-methyl-6,7,8,9,11,12,14,15,16,17-decahydrocyclopenta[a]phenanthrene-3,17-diol

CAS Number
PubChem CID
ChemSpider
UNII
ChEBI
ChEMBL
Chemical and physical data
FormulaC18H24O2
Molar mass272.388 g·mol−1
3D model (JSmol)

  • OC1CCC3C1(C)CCC(c2cc4)C3CCc2cc4O

  • InChI=1S/C18H24O2/c1-18-9-8-14-13-5-3-12(19)10-11(13)2-4-15(14)16(18)6-7-17(18)20/h3,5,10,14-17,19-20H,2,4,6-9H2,1H3/t14-,15-,16+,17-,18+/m1/s1 checkY

  • Key:VOXZDWNPVJITMN-SFFUCWETSA-N checkY

  (verify)

Medical uses

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Alfatradiol is used in form of an ethanolic solution for topical application on the scalp. Similarly to other drugs against alopecia, topical or oral, it has to be applied continuously to prevent further hair loss.[5] Regrowth of hair that was already lost is only possible to a limited extent. In general, advanced alopecia does not respond well to medical treatment, which has historically been thought to be a consequence of the hair roots being lost.[6]

A university-led study (including several authors who are advisors to companies such as Pfizer) in 103 women comparing alfatradiol to minoxidil, another topical hair loss treatment, found the latter to be more effective. In contrast to minoxidil, alfatradiol did not result in an increase of hair density or thickness, but only in slowing down or stabilization of hair loss in this study.[7] In an earlier study, no systemic side effects were noted, and 17α-estradiol was found to reduce androgenic hair loss, though it was not effective at growing new hair.[8]

Other efforts of alfatradiol had been directed at neurodegenerative diseases including Parkinson's.[9]

Other hair loss medications include ketoconazole, finasteride, and dutasteride.

Contraindications

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Nothing is known about the use of alfatradiol during pregnancyorlactation, or in patients under 18 years of age. The package leaflet recommends against using it under these circumstances.[10]

Side effects

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Local burning or itching is not an effect of alfatradiol, but of the ethanol in the solvent. The solution can stimulate sebum production.[10]

Pharmacology

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Pharmacodynamics

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Alfatradiol (top) and 17β-estradiol (bottom).

Alfatradiol (17α-estradiol) is distinguished from estradiol (17β-estradiol), the predominant sex hormone in females, only by the stereochemistry of the carbon atom 17. In contrast to 17β-estradiol, 17α-estradiol, while it still binds to the estrogen receptor, has less or no feminizing estrogenic activity depending on its dosage and the tissue it is affecting.[11] Alfatradiol acts as an inhibitor of the enzyme 5α-reductase, which is responsible for the activation of testosteronetodihydrotestosterone, and which plays a role in regulating hair growth.[5] 17α-Estradiol has been studied as a therapeutic with potential to treat Alzheimer's and Parkinson's disease and other patients with neurodegenerative diseases.[12] 17α-Estradiol (as the sodium salt of its sulfated form) is a minor component (<10%) of hormone replacement products (such as conjugated estrogens, brand name Premarin), which have been studied and/or marketed in women and men since the 1930s. A survey of the effects of various forms of 17α-estradiol in humans on biochemical parameters, efficacy, estrogenicity, metabolism, safety, and tolerability has been published.[13]

Alfatradiol binds to the ERα and ERβ with 58% and 11% of the relative binding affinity of 17β-estradiol.[14] However, it has 100-fold lower estrogenic activity relative to estradiol.[15] On the other hand, alfatradiol has been found to bind to and activate the brain-expressed ER-X with a greater potency than estradiol, indicating that it may be the predominant endogenous ligand for the receptor.[16] In contrast to estradiol, alfatradiol is not a ligand of the G protein-coupled estrogen receptor (affinity >10 μM).[17]

  • t
  • e
    • Affinities of estrogen receptor ligands for the ERα and ERβ
    Ligand Other names Relative binding affinities (RBA, %)a Absolute binding affinities (Ki, nM)a Action
    ERα ERβ ERα ERβ
    Estradiol E2; 17β-Estradiol 100 100 0.115 (0.04–0.24) 0.15 (0.10–2.08) Estrogen
    Estrone E1; 17-Ketoestradiol 16.39 (0.7–60) 6.5 (1.36–52) 0.445 (0.3–1.01) 1.75 (0.35–9.24) Estrogen
    Estriol E3; 16α-OH-17β-E2 12.65 (4.03–56) 26 (14.0–44.6) 0.45 (0.35–1.4) 0.7 (0.63–0.7) Estrogen
    Estetrol E4; 15α,16α-Di-OH-17β-E2 4.0 3.0 4.9 19 Estrogen
    Alfatradiol 17α-Estradiol 20.5 (7–80.1) 8.195 (2–42) 0.2–0.52 0.43–1.2 Metabolite
    16-Epiestriol 16β-Hydroxy-17β-estradiol 7.795 (4.94–63) 50 ? ? Metabolite
    17-Epiestriol 16α-Hydroxy-17α-estradiol 55.45 (29–103) 79–80 ? ? Metabolite
    16,17-Epiestriol 16β-Hydroxy-17α-estradiol 1.0 13 ? ? Metabolite
    2-Hydroxyestradiol 2-OH-E2 22 (7–81) 11–35 2.5 1.3 Metabolite
    2-Methoxyestradiol 2-MeO-E2 0.0027–2.0 1.0 ? ? Metabolite
    4-Hydroxyestradiol 4-OH-E2 13 (8–70) 7–56 1.0 1.9 Metabolite
    4-Methoxyestradiol 4-MeO-E2 2.0 1.0 ? ? Metabolite
    2-Hydroxyestrone 2-OH-E1 2.0–4.0 0.2–0.4 ? ? Metabolite
    2-Methoxyestrone 2-MeO-E1 <0.001–<1 <1 ? ? Metabolite
    4-Hydroxyestrone 4-OH-E1 1.0–2.0 1.0 ? ? Metabolite
    4-Methoxyestrone 4-MeO-E1 <1 <1 ? ? Metabolite
    16α-Hydroxyestrone 16α-OH-E1; 17-Ketoestriol 2.0–6.5 35 ? ? Metabolite
    2-Hydroxyestriol 2-OH-E3 2.0 1.0 ? ? Metabolite
    4-Methoxyestriol 4-MeO-E3 1.0 1.0 ? ? Metabolite
    Estradiol sulfate E2S; Estradiol 3-sulfate <1 <1 ? ? Metabolite
    Estradiol disulfate Estradiol 3,17β-disulfate 0.0004 ? ? ? Metabolite
    Estradiol 3-glucuronide E2-3G 0.0079 ? ? ? Metabolite
    Estradiol 17β-glucuronide E2-17G 0.0015 ? ? ? Metabolite
    Estradiol 3-gluc. 17β-sulfate E2-3G-17S 0.0001 ? ? ? Metabolite
    Estrone sulfate E1S; Estrone 3-sulfate <1 <1 >10 >10 Metabolite
    Estradiol benzoate EB; Estradiol 3-benzoate 10 ? ? ? Estrogen
    Estradiol 17β-benzoate E2-17B 11.3 32.6 ? ? Estrogen
    Estrone methyl ether Estrone 3-methyl ether 0.145 ? ? ? Estrogen
    ent-Estradiol 1-Estradiol 1.31–12.34 9.44–80.07 ? ? Estrogen
    Equilin 7-Dehydroestrone 13 (4.0–28.9) 13.0–49 0.79 0.36 Estrogen
    Equilenin 6,8-Didehydroestrone 2.0–15 7.0–20 0.64 0.62 Estrogen
    17β-Dihydroequilin 7-Dehydro-17β-estradiol 7.9–113 7.9–108 0.09 0.17 Estrogen
    17α-Dihydroequilin 7-Dehydro-17α-estradiol 18.6 (18–41) 14–32 0.24 0.57 Estrogen
    17β-Dihydroequilenin 6,8-Didehydro-17β-estradiol 35–68 90–100 0.15 0.20 Estrogen
    17α-Dihydroequilenin 6,8-Didehydro-17α-estradiol 20 49 0.50 0.37 Estrogen
    Δ8-Estradiol 8,9-Dehydro-17β-estradiol 68 72 0.15 0.25 Estrogen
    Δ8-Estrone 8,9-Dehydroestrone 19 32 0.52 0.57 Estrogen
    Ethinylestradiol EE; 17α-Ethynyl-17β-E2 120.9 (68.8–480) 44.4 (2.0–144) 0.02–0.05 0.29–0.81 Estrogen
    Mestranol EE 3-methyl ether ? 2.5 ? ? Estrogen
    Moxestrol RU-2858; 11β-Methoxy-EE 35–43 5–20 0.5 2.6 Estrogen
    Methylestradiol 17α-Methyl-17β-estradiol 70 44 ? ? Estrogen
    Diethylstilbestrol DES; Stilbestrol 129.5 (89.1–468) 219.63 (61.2–295) 0.04 0.05 Estrogen
    Hexestrol Dihydrodiethylstilbestrol 153.6 (31–302) 60–234 0.06 0.06 Estrogen
    Dienestrol Dehydrostilbestrol 37 (20.4–223) 56–404 0.05 0.03 Estrogen
    Benzestrol (B2) – 114 ? ? ? Estrogen
    Chlorotrianisene TACE 1.74 ? 15.30 ? Estrogen
    Triphenylethylene TPE 0.074 ? ? ? Estrogen
    Triphenylbromoethylene TPBE 2.69 ? ? ? Estrogen
    Tamoxifen ICI-46,474 3 (0.1–47) 3.33 (0.28–6) 3.4–9.69 2.5 SERM
    Afimoxifene 4-Hydroxytamoxifen; 4-OHT 100.1 (1.7–257) 10 (0.98–339) 2.3 (0.1–3.61) 0.04–4.8 SERM
    Toremifene 4-Chlorotamoxifen; 4-CT ? ? 7.14–20.3 15.4 SERM
    Clomifene MRL-41 25 (19.2–37.2) 12 0.9 1.2 SERM
    Cyclofenil F-6066; Sexovid 151–152 243 ? ? SERM
    Nafoxidine U-11,000A 30.9–44 16 0.3 0.8 SERM
    Raloxifene – 41.2 (7.8–69) 5.34 (0.54–16) 0.188–0.52 20.2 SERM
    Arzoxifene LY-353,381 ? ? 0.179 ? SERM
    Lasofoxifene CP-336,156 10.2–166 19.0 0.229 ? SERM
    Ormeloxifene Centchroman ? ? 0.313 ? SERM
    Levormeloxifene 6720-CDRI; NNC-460,020 1.55 1.88 ? ? SERM
    Ospemifene Deaminohydroxytoremifene 0.82–2.63 0.59–1.22 ? ? SERM
    Bazedoxifene – ? ? 0.053 ? SERM
    Etacstil GW-5638 4.30 11.5 ? ? SERM
    ICI-164,384 – 63.5 (3.70–97.7) 166 0.2 0.08 Antiestrogen
    Fulvestrant ICI-182,780 43.5 (9.4–325) 21.65 (2.05–40.5) 0.42 1.3 Antiestrogen
    Propylpyrazoletriol PPT 49 (10.0–89.1) 0.12 0.40 92.8 ERα agonist
    16α-LE2 16α-Lactone-17β-estradiol 14.6–57 0.089 0.27 131 ERα agonist
    16α-Iodo-E2 16α-Iodo-17β-estradiol 30.2 2.30 ? ? ERα agonist
    Methylpiperidinopyrazole MPP 11 0.05 ? ? ERα antagonist
    Diarylpropionitrile DPN 0.12–0.25 6.6–18 32.4 1.7 ERβ agonist
    8β-VE2 8β-Vinyl-17β-estradiol 0.35 22.0–83 12.9 0.50 ERβ agonist
    Prinaberel ERB-041; WAY-202,041 0.27 67–72 ? ? ERβ agonist
    ERB-196 WAY-202,196 ? 180 ? ? ERβ agonist
    Erteberel SERBA-1; LY-500,307 ? ? 2.68 0.19 ERβ agonist
    SERBA-2 – ? ? 14.5 1.54 ERβ agonist
    Coumestrol – 9.225 (0.0117–94) 64.125 (0.41–185) 0.14–80.0 0.07–27.0 Xenoestrogen
    Genistein – 0.445 (0.0012–16) 33.42 (0.86–87) 2.6–126 0.3–12.8 Xenoestrogen
    Equol – 0.2–0.287 0.85 (0.10–2.85) ? ? Xenoestrogen
    Daidzein – 0.07 (0.0018–9.3) 0.7865 (0.04–17.1) 2.0 85.3 Xenoestrogen
    Biochanin A – 0.04 (0.022–0.15) 0.6225 (0.010–1.2) 174 8.9 Xenoestrogen
    Kaempferol – 0.07 (0.029–0.10) 2.2 (0.002–3.00) ? ? Xenoestrogen
    Naringenin – 0.0054 (<0.001–0.01) 0.15 (0.11–0.33) ? ? Xenoestrogen
    8-Prenylnaringenin 8-PN 4.4 ? ? ? Xenoestrogen
    Quercetin – <0.001–0.01 0.002–0.040 ? ? Xenoestrogen
    Ipriflavone – <0.01 <0.01 ? ? Xenoestrogen
    Miroestrol – 0.39 ? ? ? Xenoestrogen
    Deoxymiroestrol – 2.0 ? ? ? Xenoestrogen
    β-Sitosterol – <0.001–0.0875 <0.001–0.016 ? ? Xenoestrogen
    Resveratrol – <0.001–0.0032 ? ? ? Xenoestrogen
    α-Zearalenol – 48 (13–52.5) ? ? ? Xenoestrogen
    β-Zearalenol – 0.6 (0.032–13) ? ? ? Xenoestrogen
    Zeranol α-Zearalanol 48–111 ? ? ? Xenoestrogen
    Taleranol β-Zearalanol 16 (13–17.8) 14 0.8 0.9 Xenoestrogen
    Zearalenone ZEN 7.68 (2.04–28) 9.45 (2.43–31.5) ? ? Xenoestrogen
    Zearalanone ZAN 0.51 ? ? ? Xenoestrogen
    Bisphenol A BPA 0.0315 (0.008–1.0) 0.135 (0.002–4.23) 195 35 Xenoestrogen
    Endosulfan EDS <0.001–<0.01 <0.01 ? ? Xenoestrogen
    Kepone Chlordecone 0.0069–0.2 ? ? ? Xenoestrogen
    o,p'-DDT – 0.0073–0.4 ? ? ? Xenoestrogen
    p,p'-DDT – 0.03 ? ? ? Xenoestrogen
    Methoxychlor p,p'-Dimethoxy-DDT 0.01 (<0.001–0.02) 0.01–0.13 ? ? Xenoestrogen
    HPTE Hydroxychlor; p,p'-OH-DDT 1.2–1.7 ? ? ? Xenoestrogen
    Testosterone T; 4-Androstenolone <0.0001–<0.01 <0.002–0.040 >5000 >5000 Androgen
    Dihydrotestosterone DHT; 5α-Androstanolone 0.01 (<0.001–0.05) 0.0059–0.17 221–>5000 73–1688 Androgen
    Nandrolone 19-Nortestosterone; 19-NT 0.01 0.23 765 53 Androgen
    Dehydroepiandrosterone DHEA; Prasterone 0.038 (<0.001–0.04) 0.019–0.07 245–1053 163–515 Androgen
    5-Androstenediol A5; Androstenediol 6 17 3.6 0.9 Androgen
    4-Androstenediol – 0.5 0.6 23 19 Androgen
    4-Androstenedione A4; Androstenedione <0.01 <0.01 >10000 >10000 Androgen
    3α-Androstanediol 3α-Adiol 0.07 0.3 260 48 Androgen
    3β-Androstanediol 3β-Adiol 3 7 6 2 Androgen
    Androstanedione 5α-Androstanedione <0.01 <0.01 >10000 >10000 Androgen
    Etiocholanedione 5β-Androstanedione <0.01 <0.01 >10000 >10000 Androgen
    Methyltestosterone 17α-Methyltestosterone <0.0001 ? ? ? Androgen
    Ethinyl-3α-androstanediol 17α-Ethynyl-3α-adiol 4.0 <0.07 ? ? Estrogen
    Ethinyl-3β-androstanediol 17α-Ethynyl-3β-adiol 50 5.6 ? ? Estrogen
    Progesterone P4; 4-Pregnenedione <0.001–0.6 <0.001–0.010 ? ? Progestogen
    Norethisterone NET; 17α-Ethynyl-19-NT 0.085 (0.0015–<0.1) 0.1 (0.01–0.3) 152 1084 Progestogen
    Norethynodrel 5(10)-Norethisterone 0.5 (0.3–0.7) <0.1–0.22 14 53 Progestogen
    Tibolone 7α-Methylnorethynodrel 0.5 (0.45–2.0) 0.2–0.076 ? ? Progestogen
    Δ4-Tibolone 7α-Methylnorethisterone 0.069–<0.1 0.027–<0.1 ? ? Progestogen
    3α-Hydroxytibolone – 2.5 (1.06–5.0) 0.6–0.8 ? ? Progestogen
    3β-Hydroxytibolone – 1.6 (0.75–1.9) 0.070–0.1 ? ? Progestogen
    Footnotes: a = (1) Binding affinity values are of the format "median (range)" (# (#–#)), "range" (#–#), or "value" (#) depending on the values available. The full sets of values within the ranges can be found in the Wiki code. (2) Binding affinities were determined via displacement studies in a variety of in-vitro systems with labeled estradiol and human ERα and ERβ proteins (except the ERβ values from Kuiper et al. (1997), which are rat ERβ). Sources: See template page.
  • t
  • e
    • Selected biological properties of endogenous estrogens in rats
    Estrogen ERTooltip Estrogen receptor RBATooltip relative binding affinity (%) Uterine weight (%) Uterotrophy LHTooltip Luteinizing hormone levels (%) SHBGTooltip Sex hormone-binding globulin RBATooltip relative binding affinity (%)
    Control – 100 – 100 –
    Estradiol (E2) 100 506 ± 20 +++ 12–19 100
    Estrone (E1) 11 ± 8 490 ± 22 +++ ? 20
    Estriol (E3) 10 ± 4 468 ± 30 +++ 8–18 3
    Estetrol (E4) 0.5 ± 0.2 ? Inactive ? 1
    17α-Estradiol 4.2 ± 0.8 ? ? ? ?
    2-Hydroxyestradiol 24 ± 7 285 ± 8 +b 31–61 28
    2-Methoxyestradiol 0.05 ± 0.04 101 Inactive ? 130
    4-Hydroxyestradiol 45 ± 12 ? ? ? ?
    4-Methoxyestradiol 1.3 ± 0.2 260 ++ ? 9
    4-Fluoroestradiola 180 ± 43 ? +++ ? ?
    2-Hydroxyestrone 1.9 ± 0.8 130 ± 9 Inactive 110–142 8
    2-Methoxyestrone 0.01 ± 0.00 103 ± 7 Inactive 95–100 120
    4-Hydroxyestrone 11 ± 4 351 ++ 21–50 35
    4-Methoxyestrone 0.13 ± 0.04 338 ++ 65–92 12
    16α-Hydroxyestrone 2.8 ± 1.0 552 ± 42 +++ 7–24 <0.5
    2-Hydroxyestriol 0.9 ± 0.3 302 +b ? ?
    2-Methoxyestriol 0.01 ± 0.00 ? Inactive ? 4
    Notes: Values are mean ± SD or range. ER RBA = Relative binding affinitytoestrogen receptors of rat uterine cytosol. Uterine weight = Percentage change in uterine wet weight of ovariectomized rats after 72 hours with continuous administration of 1 μg/hour via subcutaneously implanted osmotic pumps. LH levels = Luteinizing hormone levels relative to baseline of ovariectomized rats after 24 to 72 hours of continuous administration via subcutaneous implant. Footnotes: a = Synthetic (i.e., not endogenous). b = Atypical uterotrophic effect which plateaus within 48 hours (estradiol's uterotrophy continues linearly up to 72 hours). Sources: See template.

    Society and culture

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    Generic names

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    Alfatradiol is the generic name of the drug and its INNTooltip International Nonproprietary Name.[2] It is also known as 17α-estradiol.[1]

    Brand names

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    Alfatradiol is marketed under the brand names Avicis, Avixis, Ell-Cranell Alpha, and Pantostin.[2]

    Availability

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    Alfatradiol is available in Germany and several Latin American countries, including Argentina, Brazil, and Mexico.

    Research

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    Alfatradiol administered systemically improved metabolic function, reduced insulin resistance, decreased intra-abdominal fat, and decreased inflammation in old male mice without inducing feminization, suggesting potential usefulness in the treatment of type 2 diabetes.[18]

    See also

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    References

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    1. ^ a b c d J. Elks (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. p. 897. ISBN 978-1-4757-2085-3.
  • ^ a b c "Alfatradiol". Drugs.com International.
  • ^ Berger A, Wachter H, eds. (1998). Hunnius Pharmazeutisches Wörterbuch (in German) (8 ed.). Walter de Gruyter Verlag. p. 486. ISBN 978-3-11-015793-2.
  • ^ "Recommended International Nonproprietary Names (rec. Inn): List 46". WHO Drug Information. 15 (3&4). 2001. Archived from the original on 27 November 2009.
  • ^ a b Mutschler E, Geisslinger G, Kroemer HK, Schäfer-Korting M (2001). Arzneimittelwirkungen (in German) (8 ed.). Stuttgart: Wissenschaftliche Verlagsgesellschaft. p. 453. ISBN 978-3-8047-1763-3.
  • ^ Jasek W, ed. (2007). Austria-Codex (in German). Vol. 4 (2007/2008 ed.). Vienna: Österreichischer Apothekerverlag. p. 9673. ISBN 978-3-85200-181-4.
  • ^ Blume-Peytavi U, Kunte C, Krisp A, Garcia Bartels N, Ellwanger U, Hoffmann R (May 2007). "Comparison of the efficacy and safety of topical minoxidil and topical alfatradiol in the treatment of androgenetic alopecia in women". Journal der Deutschen Dermatologischen Gesellschaft. 5 (5): 391–5. doi:10.1111/j.1610-0387.2007.06295.x. PMID 17451383. S2CID 10260867.
  • ^ Orfanos CE, Vogels L (1980). "[Local therapy of androgenetic alopecia with 17 alpha-estradiol. A controlled, randomized double-blind study (author's transl)]". Dermatologica (in German). 161 (2): 124–32. doi:10.1159/000250344. PMID 7398983.
  • ^ "Alfatradiol". Adis Insight.
  • ^ a b Hildegard D, ed. (2005). Rote Liste (in German) (2005 ed.). Aulendorf: Editio Cantor Verlag. 32 369. ISBN 978-3-87193-306-6.
  • ^ Moos WH, Dykens JA, Howell N (2008). "17α-Estradiol: A Less-Feminizing Estrogen". Drug Development Research. 69 (4): 177–184. doi:10.1002/ddr.20244. S2CID 72463459.
  • ^ Dykens JA, Moos WH, Howell N (June 2005). "Development of 17alpha-estradiol as a neuroprotective therapeutic agent: rationale and results from a phase I clinical study". Annals of the New York Academy of Sciences. 1052 (1): 116–35. Bibcode:2005NYASA1052..116D. doi:10.1196/annals.1347.008. PMID 16024755. S2CID 46583658.
  • ^ Moos WH, Dykens JA, Nohynek D, Rubinchik E, Howell N (2009). "Review of the Effects of 17α-Estradiol in Humans: A Less Feminizing Estrogen with Neuroprotective Potential". Drug Development Research. 70: 1–21. doi:10.1002/ddr.20284. S2CID 73114400.
  • ^ Kuiper GG, Carlsson B, Grandien K, Enmark E, Häggblad J, Nilsson S, Gustafsson JA (March 1997). "Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta". Endocrinology. 138 (3): 863–70. doi:10.1210/endo.138.3.4979. PMID 9048584.
  • ^ Trüeb RM, Lee W (13 February 2014). Male Alopecia: Guide to Successful Management. Springer Science & Business Media. p. 93. ISBN 978-3-319-03233-7.
  • ^ Toran-Allerand CD, Tinnikov AA, Singh RJ, Nethrapalli IS (September 2005). "17alpha-estradiol: a brain-active estrogen?". Endocrinology. 146 (9): 3843–50. doi:10.1210/en.2004-1616. PMID 15947006.
  • ^ Prossnitz ER, Arterburn JB (July 2015). "International Union of Basic and Clinical Pharmacology. XCVII. G Protein-Coupled Estrogen Receptor and Its Pharmacologic Modulators". Pharmacol. Rev. 67 (3): 505–40. doi:10.1124/pr.114.009712. PMC 4485017. PMID 26023144.
  • ^ Stout MB, Steyn FJ, Jurczak MJ, Camporez JG, Zhu Y, Hawse JR, et al. (January 2017). "17α-Estradiol Alleviates Age-related Metabolic and Inflammatory Dysfunction in Male Mice Without Inducing Feminization". The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 72 (1): 3–15. doi:10.1093/gerona/glv309. PMC 5155656. PMID 26809497.
    • edit

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