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Apport De La Phytothérapie Dans Le Traitement Des Symptômes De La Ménopause

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Apport De La Phytothérapie Dans Le Traitement Des Symptômes De La Ménopause UNIVERSITE DE LIMOGES Faculté de Pharmacie ANNÉE 2014 THÈSE N° APPORT DE LA PHYTOTHERAPIE DANS LE TRAITEMENT DES SYMPTÔMES DE LA MENOPAUSE THÈSE POUR LE DIPLÔME D'ÉTAT DE DOCTEUR EN PHARMACIE présentée et soutenue publiquement le 12 décembre 2014 par Chloé GONZALES née le 16 juillet 1989, à Limoges EXAMINATEURS DE LA THÈSE Professeur Michel Botineau ............................................................... Président de thèse Docteur Françoise Marre-Fournier, MCU .......................................... Directrice de thèse Docteur Laurent Durengue ...................................................................................... Juge GONZALES Chloé | Faculté de Pharmacie à Limoges | Décembre 2014 2 01.09.2014 DOYEN DE LA FACULTE : Monsieur le Professeur Jean-Luc DUROUX 1er VICE-DOYEN : Madame Catherine FAGNERE, Maître de Conférences PROFESSEURS : BATTU Serge CHIMIE ANALYTIQUE BOTINEAU Michel BOTANIQUE ET CRYPTOGAMIE BUXERAUD Jacques CHIMIE ORGANIQUE ET THERAPEUTIQUE CARDOT Philippe CHIMIE ANALYTIQUE ET BROMATOLOGIE DELAGE Christiane CHIMIE GENERALE ET MINERALE DESMOULIERE Alexis PHYSIOLOGIE DUROUX Jean-Luc BIOPHYSIQUE, BIOMATHEMATIQUES ET INFORMATIQUE LIAGRE Bertrand BIOCHIMIE ET BIOLOGIE MOLECULAIRE MAMBU Lengo PHARMACOGNOSIE ROUSSEAU Annick BIOSTATISTIQUE VIANA Marylène PHARMACOTECHNIE GONZALES Chloé | Faculté de Pharmacie à Limoges | Décembre 2014 3 PROFESSEURS DES UNIVERSITES – PRATICIENS HOSPITALIERS DES DISCIPLINES PHARMACEUTIQUES : MOESCH Christian HYGIENE HYDROLOGIE ENVIRONNEMENT ROGEZ Sylvie BACTERIOLOGIE ET VIROLOGIE SAINT-MARCOUX Franck TOXICOLOGIE MAITRE DE CONFERENCES DES UNIVERSITES – PRATICIEN HOSPITALIER DES DISCIPLINES PHARMACEUTIQUES : (en détachement) PICARD Nicolas PHARMACOLOGIE MAITRES DE CONFERENCES : BASLY Jean-Philippe CHIMIE ANALYTIQUE ET BROMATOLOGIE BEAUBRUN-GIRY Karine PHARMACOTECHNIE BILLET Fabrice PHYSIOLOGIE CALLISTE Claude BIOPHYSIQUE, BIOMATHEMATIQUES ET INFORMATIQUE CLEDAT Dominique CHIMIE ANALYTIQUE ET BROMATOLOGIE COMBY Francis CHIMIE ORGANIQUE ET THERAPEUTIQUE COURTIOUX Bertrand PHARMACOLOGIE, PARASITOLOGIE DELEBASSEE Sylvie MICROBIOLOGIE-PARASITOLOGIE- IMMUNOLOGIE GONZALES Chloé | Faculté de Pharmacie à Limoges | Décembre 2014 4 DEMIOT Claire-Elise PHARMACOLOGIE FAGNERE Catherine CHIMIE ORGANIQUE ET THERAPEUTIQUE FROISSARD Didier BOTANIQUE ET CRYPTOGAMIE JAMBUT Anne-Catherine CHIMIE ORGANIQUE ET THERAPEUTIQUE LABROUSSE Pascal BOTANIQUE ET CRYPTOGAMIE LEGER David BIOCHIMIE ET BIOLOGIE MOLECULAIRE MARRE-FOURNIER Françoise BIOCHIMIE ET BIOLOGIE MOLECULAIRE MERCIER Aurélien PARASITOLOGIE MILLOT Marion PHARMACOGNOSIE MOREAU Jeanne MICROBIOLOGIE-PARASITOLOGIE IMMUNOLOGIE PASCAUD Patric PHARMACIE GALENIQUE - BIOMATERIAUX CERAMIQUES POUGET Christelle CHIMIE ORGANIQUE ET THERAPEUTIQUE SIMON Alain CHIMIE GENERALE ET MINERALE TROUILLAS Patrick BIOPHYSIQUE, BIOMATHEMATIQUES ET INFORMATIQUE VIGNOLES Philippe BIOPHYSIQUE, BIOMATHEMATIQUES ET INFORMATIQUE GONZALES Chloé | Faculté de Pharmacie à Limoges | Décembre 2014 5 PROFESSEUR : ROUMIEUX Gwenhaël ANGLAIS ATTACHE TEMPORAIRE D’ENSEIGNEMENT ET DE RECHERCHE : PARENT Marianne PHARMACOTECHNIE, PHARMACIE GALENIQUE VEDRENNE Nicolas CHIMIE ANALYTIQUE DETACHEMENT à compter du 1/09/2014 pour 2 ans MARION-THORE Sandrine CHIMIE ORGANIQUE ET THERAPEUTIQUE GONZALES Chloé | Faculté de Pharmacie à Limoges | Décembre 2014 6 REMERCIEMENTS Au Docteur Françoise Marre-Fournier ; un grand merci d’avoir encadré cette thèse. Vous m’avez guidé dans mon travail et aidé à trouver des solutions pour avancer. Au Professeur Michel Botineau ; merci d’avoir accepté de présider cette thèse. Vous vous êtes montré à l’écoute et disponible tout au long de sa réalisation. Je vous remercie donc sincèrement pour l’aide et le temps que vous m’avez accordés. Au Docteur Laurent Durengue ; merci d’avoir accepté de faire partie de mon jury de thèse. Ma vie professionnelle a débuté dans votre officine. J’ai eu la chance d’avoir franchi cette étape en étant encadrée par votre équipe compétente et dynamique qui m’a permis de progresser et de m’épanouir. Je remercie donc Romain, Cécile, Noémie et Jessica. Vous m’avez fait progresser tout au long de ces derniers mois. Romain, merci pour ta gentillesse et ta bonne humeur ; Cécile, merci pour ton dynamisme et tes recommandations constructives ; Noémie, merci pour ta joie de vivre et ton écoute ; Jessica, merci pour ta douceur et ta patience. À mes parents ; un immense merci pour l’éducation et l’ouverture d’esprit que vous m’avez transmis. Vous avez grandement contribué à ma réussite. Merci de m’avoir toujours soutenue dans mes choix et de m’avoir permis de réaliser de longues études. Je vous aime fort. À mon petit frère ; Théo, merci d’être présent dans les moments importants de ma vie. Tu es merveilleux et je souhaite que ta vie soit remplie de bonheur et de réussite. Je suis fière de toi et je t’aime énormément ! À mes grands-parents ; malgré la distance plus ou moins longue qui nous sépare, nous nous retrouvons toujours pour les moments primordiaux. Je vous aime tous très fort et j’ai une grande pensée pour mon grand-papa. À Tonton Alain, Tatie Michelle et Joël ; je suis contente de vous avoir auprès de moi. Je suis fière de vous et aimerais vous voir encore plus souvent. Merci Joël pour toujours avoir su te rendre disponible. À ma cousine ; Sylvie, après toute notre jeunesse passée ensemble puis 4 années en colocation, nos vies enfin trouvent des chemins différents. Malgré cela , je souhaite que l’on ne perde jamais notre complicité, ce lien si fort qui nous rassemble et cette joie à chaque fois que l’on se retrouve. GONZALES Chloé | Faculté de Pharmacie à Limoges | Décembre 2014 7 Je pense également à toute ma famille de Montréal. J’ai cependant la chance d’avoir près de moi ma Marraine. Tatie, que tu aies fait tout ce chemin pour être présente en ce jour si particulier est le plus beau cadeau que tu aies pu me faire. Tu es merveilleuse et je suis fière d’être ta filleule. À mes ami(e)s ; vous m’avez apporté tellement. Nous avons tous évolué durant ces années ; et oui, on est grands maintenant !! Je garde pour toujours des merveilleux souvenirs de tous les moments passés ensemble ainsi que de toutes nos folles vacances et sorties. Marine, Charline, Charlène, Mathilde, Marion et Laura : je vous aime fort les filles !!! C’est aussi le cas pour vous, les garçons : Ricou, Paul, Jean, Hugo, Titi, Thomas… Merci également à toutes les personnes ayant contribué de près ou de loin à mon épanouissement durant cette période. GONZALES Chloé | Faculté de Pharmacie à Limoges | Décembre 2014 8 SOMMAIRE REMERCIEMENTS .................................................................................................... 7 SOMMAIRE ................................................................................................................ 9 LISTE DES ABRÉVIATIONS .................................................................................... 11 INTRODUCTION ...................................................................................................... 13 1. La ménopause ...................................................................................................... 14 1.1. Généralités ..................................................................................................... 14 1.2. Les hormones stéroïdes ................................................................................. 23 1.3. Quel bilan et quel suivi doit être réalisé à la ménopause ? ............................ 29 1.4. Les répercussions de la ménopause .............................................................. 31 2. Traitement hormonal de la ménopause ................................................................ 36 2.1. Les thérapeutiques hormonales ..................................................................... 36 2.2. Contre-indications aux THM ........................................................................... 46 2.3. Les bénéfices et risques du THM ................................................................... 47 2.4. Traitement de l’ostéoporose post-ménopausique .......................................... 53 3. Les phyto-œstrogènes .......................................................................................... 60 3.1. Définition des phyto-œstrogènes ................................................................... 60 3.2. Structure chimique ......................................................................................... 62 3.3. Biodisponibilité et mécanisme d’action ........................................................... 63 3.4. Effets des phyto-œstrogènes sur l’organisme ................................................ 66 3.5. Intérêt des phyto-œstrogènes ........................................................................ 68 4. Les plantes à activité œstrogénique ..................................................................... 71 4.1. Le Soja ........................................................................................................... 71 4.2. Trèfle des prés ............................................................................................... 82 4.3. Le Lin ............................................................................................................. 85 4.4. Le kudzu ........................................................................................................ 89 4.5. Le Houblon ..................................................................................................... 93 4.6. L’Alfalfa .........................................................................................................
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