RESUMO
In this study, we evaluated genetic factors related to the mineral density during post-menopause. We evaluated 110 women in the first 5 years post-menopause, without previous hormone replacement therapy. Cytochrome P450 17 (CYP17) (rs743572), catechol-O-methyl transferase (COMT) (rs4680), and estrogen receptor 1 (ESR1) (rs9322331) were examined for the presence of polymorphisms. Clinical data were collected by anamnesis; all patients had the osseous densitometry examined using a lunar instrument to determine mineral osseous densitometry in the lumbar column (L2-L4). CYP17, COMT, and ESR1 genotyping was carried out by polymerase chain reaction with DNA collected from buccal swabs. The average age was 51.96 years. The average weights of the patients in control and osteopenia groups were 70.25 ± 12.00 and 62.45 ± 11.64, respectively (P = 0.001) and body mass index (P = 0.006; control: 29.43 ± 5.25; osteopenia: 26.72 ± 4.57). Related to CYP17 polymorphisms, 28.18% of women were TT (wild-type homozygous), 60% were TC (heterozygous), and 11.82% were CC (mutated homozygous). Related to COMT polymorphisms, 53.64% of women were GG (wild-type homozygous), 37.27% were GA (heterozygous), and 9.09% were AA (mutated homozygous). Related to ESR1, 53.64% of women were CC (wild-type homozygous), 40.91% were CT (heterozygous), and 5.45% were TT (mutated homozygous). The ESR1 variant allele was significantly higher in the osteopenia group when compared with women in the normal group (P = 0.02). ESR1 may be associated with low mineral osseous densitometry, while CYP17 and COMT gene polymorphisms were not associated with mineral osseous densitometry.
Assuntos
Densidade Óssea/genética , Catecol O-Metiltransferase/genética , Receptor alfa de Estrogênio/genética , Estudos de Associação Genética , Polimorfismo de Nucleotídeo Único , Pós-Menopausa , Esteroide 17-alfa-Hidroxilase/genética , Adulto , Alelos , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/patologia , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Razão de Chances , Fatores de RiscoRESUMO
OBJECTIVE: To evaluate whether soybean extracts and estrogens present additive effects on adult rat uterus. METHODS: Fifty ovariectomized rats were randomly divided into five equal groups of ten animals: Control, treated with vehicle; SE46 and SE120, treated with 46 and 120 mg/kg soybean concentrated extract (SE), respectively; EE, treated with conjugated equine estrogens (CE) 50 µg/kg; SE120 + EE, treated with 50 µg/kg (CE) plus 120 mg/kg SE. The substances were administered daily by gavage for 21 consecutive days. Thereafter the animals were weighed and killed by decapitation; trunk blood was collected for hormone determinations. Uteri were removed immediately and fixed in 10% formaldehyde, followed by dehydration, embedding in paraffin and 6-m sections staining with hematoxylin and eosin for histomorphometric analyses of myometrium and endometrium. After ANOVA analysis of the data, the study was complemented with the Tukey-Kramer test for multiple comparisons. RESULTS: The concentrated extract of soybean at high concentration (SE 120 kg/mg) and estrogens proved to have a trophic effect on the uterus (endometrium and myometrium) of castrated rats. In groups SE120, EE and SE120 + EE, all morphometric parameters examined (number of glands, eosinophils, blood vessels and the glandular area) were increased. No significant addictive effects of soybean extract plus estrogens were detected in the SE120 + EE group. CONCLUSIONS: Our results indicate that soy extract has a trophic effect on rat uterine structures. Treatment of ovariectomized rats with a concentrated soy extract in combination with conjugated estrogens had no addictive effect on the uterine response.
Assuntos
Estrogênios Conjugados (USP)/farmacologia , Estrogênios/farmacologia , Fitoestrógenos/farmacologia , Extratos Vegetais/farmacologia , Útero/anatomia & histologia , Útero/efeitos dos fármacos , Análise de Variância , Animais , Endométrio/anatomia & histologia , Endométrio/efeitos dos fármacos , Estradiol/sangue , Feminino , Genisteína/farmacologia , Isoflavonas/farmacologia , Miométrio/anatomia & histologia , Miométrio/efeitos dos fármacos , Tamanho do Órgão , Ovariectomia , Progesterona/sangue , Ratos , Glycine maxRESUMO
AIM: To identify aspects of health in postmenopausal Brazilian women using a health-related educational program provided by a multidisciplinary team as part of the primary care approach for early and late postmenopausal symptoms. DESIGN: A prospective cohort was formed with 69 postmenopausal women; they were divided into groups corresponding to early (n = 32) and late postmenopause (n = 37) through gynecological and clinical evaluations. We administered the Kuppermann-Blatt Menopausal Index and the Women's Health Questionnaire before and after health education instructions. RESULTS: The average age for the onset of menopause was 47.9 years (n = 69). Fifty women (72.5%) in this study had completed their primary education, 78.3% (n = 54) performed manual labor, and 60.9% (n = 42) showed concomitant chronic illnesses. After attending a series of health-related presentations, the mean weight of the women was reduced by 3.54% in early postmenopausal women (p < 0.001) and by 2.06% in the late postmenopausal group (p < 0.001). The mean abdominal circumference was reduced by 1.75% (p < 0.001) in the early postmenopausal group. In addition, the total score in the Kuppermann-Blatt Menopausal Index decreased by 34.38% in the early and by 33.33% in the late postmenopausal groups. According to the Women's Health Questionnaire, there was a decrease in the domain Depressive mood by 0.839 to 0.700 (p < 0.001) in the early and by 0.814 to 0.648 (p < 0.001) in the late postmenopausal groups. CONCLUSION: Regardless of improving menopausal symptoms and anthropometric parameters, the effects of the multidisciplinary team activities in early postmenopausal women may be similar to those in late postmenopausal women.
Assuntos
Educação em Saúde/métodos , Pós-Menopausa , Fatores Etários , Pressão Sanguínea , Índice de Massa Corporal , Brasil , Estudos de Coortes , Feminino , Promoção da Saúde , Humanos , Lipídeos/sangue , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Fatores de Tempo , Circunferência da Cintura , Redução de Peso , Saúde da MulherRESUMO
OBJECTIVE: To identify clinical, physical, life quality and nutritional aspects of Brazilian women during menopausal transition and postmenopausal periods. METHODS: 115 women agreed to participate in the study. They were divided into two groups: GI--menopausal transition (n = 48) and GII--postmenopause (n = 67). The Kupperman-Blatt Menopausal Index (IMK) and Women's Health Questionnaire (WHQ), Food Frequency Questionnaire and functional capacity were used. All patients were examined and underwent clinical and gynecological examination. RESULTS: There was no significant difference in IMK, WHQ and functional capacity in either group. There was a higher caloric intake, especially in sugars, in postmenopause women than in menopausal transition women. Both groups presented reduced parameters in life quality and functional capacity. CONCLUSION: Our data suggests that there is no significant difference between women in menopausal transition and postmenopause, except in relation to the nutritional parameter. In both groups, the women presented low quality of life and reduced functional capacity.
Assuntos
Dieta , Menopausa/fisiologia , Pós-Menopausa/fisiologia , Qualidade de Vida , Índice de Massa Corporal , Brasil , Sacarose Alimentar/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Estado Civil , Pessoa de Meia-Idade , Fenômenos Fisiológicos da NutriçãoRESUMO
Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results, the ESR1 PvuII TT genotype was associated with increased levels of HDL after 1 year of HRT.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , HDL-Colesterol/sangue , Terapia de Reposição de Estrogênios , Receptor alfa de Estrogênio/genética , Estrogênios Conjugados (USP)/uso terapêutico , Acetato de Medroxiprogesterona/uso terapêutico , Polimorfismo Genético/genética , Estudos de Coortes , HDL-Colesterol/genética , Genótipo , Polimorfismo de Fragmento de Restrição , Estudos ProspectivosRESUMO
Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results, the ESR1 PvuII TT genotype was associated with increased levels of HDL after 1 year of HRT.
Assuntos
HDL-Colesterol/sangue , Receptor alfa de Estrogênio/genética , Terapia de Reposição de Estrogênios , Estrogênios Conjugados (USP)/uso terapêutico , Acetato de Medroxiprogesterona/uso terapêutico , Polimorfismo Genético/genética , HDL-Colesterol/genética , Estudos de Coortes , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Polimorfismo de Fragmento de Restrição , Estudos ProspectivosRESUMO
In this report we evaluated the action of conjugated equine estrogens (CEE) on vaginal symptoms, cytology, pH, and flora in late postmenopausal women without any previous hormone therapy. The study was a randomized, double-blind, placebo-controlled trial with 48 late postmenopausal women who received placebo or unopposed CEE (0.625mg/day of CEE orally) during three months of treatment. Vaginal and sexual complaints were evaluated through daily diary cards. We analyzed vaginal changes through cytology and pH measurements. After three months of treatment, 20% of placebo-treated patients and 80% of the CEE-treated patients reported improvement in vaginal dryness and irritation. In the latter group, the vaginal cells and Lactobacillus increased and the vaginal pH decreased, without other changes in sexual complaints. We concluded that estrogen ameliorated the genital tract of late postmenopausal women without any previous hormone therapy.
Assuntos
Estrogênios Conjugados (USP)/uso terapêutico , Estrogênios/uso terapêutico , Pós-Menopausa , Vagina/efeitos dos fármacos , Atrofia/tratamento farmacológico , Método Duplo-Cego , Endométrio/diagnóstico por imagem , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Concentração de Íons de Hidrogênio , Lactobacillus/crescimento & desenvolvimento , Lactobacillus/isolamento & purificação , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Ultrassonografia , Vagina/química , Vagina/microbiologia , Vagina/patologia , Esfregaço VaginalRESUMO
Finasteride has been used frequently in the treatment of prostate hyperplasia, but this drug inhibits 5alpha-reductase and for this reason could be useful for the treatment of hirsutism. The aim of this study was to evaluate the clinical and hormonal effects of finasteride on hirsute women with idiopathic hirsutism or polycystic ovary syndrome. Twenty-four women were randomly divided into two groups: those given placebo and those given finasteride 5 mg/day. The treatment period was 6 months. All patients were evaluated before the beginning of treatment (baseline) and after 3 and 6 months of treatment using clinical examination through Ferriman-Gallwey score, blood pressure, cardiac frequency and body mass index. Also, we collected blood for hormonal determination of levels of prolactin, 17alpha-hydroxyprogesterone, follicle stimulating hormone, luteinizing hormone, total and free testosterone, dehydroepiandrosterone sulfate, androstenedione and dihydrotestosterone. Furthermore, all patients were asked about their concerns and satisfaction with the treatment. The results showed that the Ferriman-Gallwey score in the 6th month of finasteride treatment was significantly lower than at baseline and the 3rd month of this drug treatment. The dihydrotestosterone level in the finasteride group was also significantly reduced compared to that in the placebo group. The other hormones did not show any statistical difference during the study. All the patients treated with finasteride perceived a reduction in hirsutism after 6 months. In conclusion, our data suggest that finasteride may be effective for the treatment of the hirsute woman with idiopathic hirsutism or polycystic ovary syndrome.
Assuntos
Inibidores Enzimáticos/uso terapêutico , Finasterida/uso terapêutico , Hirsutismo/tratamento farmacológico , Síndrome do Ovário Policístico/complicações , 17-alfa-Hidroxiprogesterona/sangue , Inibidores de 5-alfa Redutase , Adulto , Androstenodiona/sangue , Índice de Massa Corporal , Sulfato de Desidroepiandrosterona/sangue , Di-Hidrotestosterona/sangue , Método Duplo-Cego , Feminino , Finasterida/efeitos adversos , Hormônio Foliculoestimulante/sangue , Hirsutismo/etiologia , Humanos , Hormônio Luteinizante , Ovário/diagnóstico por imagem , Placebos , Prolactina/sangue , Testosterona/sangue , UltrassonografiaRESUMO
In this report we examined the ultrastructural features of the postmenopausal endometrial cells of women treated with different doses of conjugated equine estrogen (CEE), or transdermal 17beta-estradiol. Eight women with uterine prolapse and at least 5 years of menopause were randomly divided into four groups and treated as follows: (I) no hormonal treatment; (II) 0.625mg/day of CEE orally; (III) 1.25mg/day of CEE orally; (IV) 50microg/day of 17beta-estradiol transdermally. Hormones were administered for 28 days followed by vaginal hysterectomy. Fragments of the endometrium were prepared for transmission electron microscopic analysis. We observed that the postmenopausal endometrium of the untreated group was atrophic with lined superficial epithelial cuboidal cells. The presence of gland and stroma cells with clear cytoplasm containing few organelles and heterochromatin nuclei were also observed. On the contrary, the endometrium of the group that received 0.625mg/day of CEE showed signs of proliferative cells such as the presence of numerous organelles in the cytoplasm and euchromatic nuclei. All of the proliferative effects on the endometrium were more pronounced in the groups that received 1.25mg/day of CEE and 50microg/day of transdermal 17beta-estradiol. We concluded that the ultrastructural proliferative changes of the postmenopausal endometrium induced by 1.25mg/day of CEE were similar to 50microg/day of transdermal 17beta-estradiol.
Assuntos
Endométrio/efeitos dos fármacos , Endométrio/ultraestrutura , Estradiol/farmacologia , Estrogênios Conjugados (USP)/farmacologia , Administração Cutânea , Administração Oral , Estradiol/administração & dosagem , Estrogênios Conjugados (USP)/administração & dosagem , Feminino , Humanos , Pessoa de Meia-Idade , Pós-MenopausaRESUMO
The effects of gonadal steroids or tamoxifen over the synaptic density of the CA1 region of the hippocampus was investigated in ovariectomized (OVX) rats. Chronic oral administration of conjugated equine estrogen, conjugated equine medroxyprogesterone, a combination of both or tamoxifen was performed in ovariectomized (OVX) rats over a period of 60 days. Synaptic density of the stratum radiatum of the CA1 region was evaluated by means of electron microscopy. Significant increases in the range of 34-49% were found for treated animals as compared to OVX controls not subject to hormonal replacement. Our results confirm previously reported effects of estradiol over synaptic density in this region and reports for the first time an effect of medroxyprogesterone (alone or in combination with estrogen) and tamoxifen. Our findings support the notion that hormonal replacement therapy and tamoxifen might have beneficial effects for cognitive function.
Assuntos
Estrogênios/administração & dosagem , Hipocampo/efeitos dos fármacos , Medroxiprogesterona/administração & dosagem , Sinapses/efeitos dos fármacos , Tamoxifeno/administração & dosagem , Administração Oral , Animais , Contagem de Células , Esquema de Medicação , Antagonistas de Estrogênios/farmacologia , Feminino , Hipocampo/ultraestrutura , Ovariectomia , Congêneres da Progesterona/farmacologia , Ratos , Ratos Wistar , Sinapses/ultraestruturaRESUMO
Recent basic and clinical advances have consolidated the concept of tissue-selective estrogens, i.e. molecules that express different degrees of partial agonist, full agonist or antagonist activity in different tissues or cells. Delta8,9-Dehydroestrone sulfate (delta8,9-DHES) is a conjugated estrogen and a component of conjugated equine estrogens (CEE). It is metabolized in the human in at least a 1:1 ratio to its 17beta form, 17beta-delta8,9-DHES. To evaluate its activity in different clinical and biochemical parameters, a clinical research study was conducted with delta8,9-DHES and estrone sulfate as a comparator in postmenopausal women. Delta8,9-DHES was given orally at a daily dose of 0.125 mg for 12 weeks in a group of 10 women. Two additional groups of women received either estrone sulfate alone (1.25 mg/day) or the combination of delta8,9-DHES and estrone sulfate at the previously specified doses. A significant and consistent suppression of hot flushes (number, severity, and total score) was observed with delta8,9-DHES, reaching more than 95% suppression in all parameters of vasomotor symptoms. This level of activity was equal to that obtained with the much higher dose of estrone sulfate, and it was sustained for the duration of the treatment period (12 weeks). Measurements of a bone resorption marker, i.e. urinary excretion of N-telopeptide, demonstrated that delta8,9-DHES at 8 weeks produced a degree of suppression (40%) similar to that observed with the higher dose of estrone sulfate. Gonadotropin secretion (FSH and LH) was significantly suppressed in women receiving delta8,9-DHES, similar to that observed with estrone sulfate alone or with the combination of the two. Other parameters, such as total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol were not modified significantly, whereas serum globulins (sex hormone-binding globulin and corticosteroid-binding globulin) showed only marginal increases after delta8,9-DHES administration. Taken together with preclinical data, it is found that delta8,9-DHES is an active estrogen with a distinct pharmacological profile that results in significant clinical activity in vasomotor, neuroendocrine (gonadotropin and PRL) and bone preservation parameters, whereas displaying little or no efficacy, at the dose tested, on other peripheral parameters normally affected by estrogens. Collectively, this information supports the concept that delta8,9-DHES is an integral component of CEE, with distinct tissue selectivity contributing to the CEE's overall clinical activity, and places this estrogen as a distinct member of a novel class of centrally active molecules with unique peripheral tissue selectivity.
Assuntos
Estrogênios/sangue , Estrona/análogos & derivados , Pós-Menopausa/sangue , Adulto , Reabsorção Óssea/sangue , Estrona/farmacologia , Feminino , Fogachos/sangue , Humanos , Pessoa de Meia-Idade , Projetos PilotoRESUMO
OBJECTIVE: To investigate the ovarian activity before and after gonadal suppression with GnRH-analog in patients with PCO, hyperandrogenism, hyperinsulinism and acanthosis nigricans. DESIGN: Controlled clinical study. SETTING: Tertiary academic medical center. PATIENTS: Six patients with clinical findings of PCO, hirsutism and acanthosis nigricans. INTERVENTIONS: Morning blood samples in the follicular phase to determine the steroid levels, glucose and insulin curve, comparing to a control group. Administration for 2 consecutive months of a GnRH-analog, comparing, in the study group, the free testosterone levels before and after ovarian suppression. MAIN OUTCOME MEASURE: Determination of insulin levels in PCO, hirsutism and acanthotic patients and the free-testosterone levels before and after gonadal suppression. RESULTS: Insulin levels were significantly higher in the study group when compared to normal women during the glycemic test. We also found a significant decrease in the free-testosterone levels after 2 months of gonadal suppression with GnRH-analog when compared to the initial time. CONCLUSIONS: Patients with PCO, hirsutism and acanthosis nigricans present high levels of insulin, suggesting an ovarian hyperesponsiveness, which is not sustained when gonadotrophic blockage was achieved.
Assuntos
Acantose Nigricans/metabolismo , Doenças do Sistema Endócrino/metabolismo , Hormônio Liberador de Gonadotropina/análise , Síndrome do Ovário Policístico/metabolismo , Adolescente , Adulto , Feminino , Teste de Tolerância a Glucose , Hormônio Liberador de Gonadotropina/análogos & derivados , Humanos , Hiperandrogenismo/metabolismo , Hiperinsulinismo/metabolismo , Insulina/análise , Ovário/fisiopatologiaRESUMO
Objective. To investigate the ovarian activity before and after gonadal suppression with GnRH-analog in patients with PCO, hyperandrogenism, hyperinsulinism and ancathosis nigricans. Design: Controlled clinical study. Setting: Tertiary academic medical center. Patients: Six patients with clinical findings of PCO, hirsutism and acanthosis nigricans. Interventions. Morning blood samples in the follicular phase to determine the seteroid levels, glucose and insulin curve, comparing to a control group. Administration for 2 consecutive months of a GnRH-analog, comparing, in the study group, the free testosterone levels before and after ovarian suppression. Main Outcome Measure. Determination of insulin levels in PCO, hirsutism and acanthotic patients and the free-testosterone levels before and after gonadal suppression. Results. Insulin levels were significantly higher in the study group when compared to normal women during the glycemic test. We also found a significant decrease in the free-testosterone levels after 2 months of gonadal suppression with GnRH-analog when compared to the initial time. Conclusions. Patients with PCO, hirsutism and acanthosis nicrigans present high levels of in sulin, suggesting an ovarian hyperesponsiveness, which is not sustained when gonadotrophic blockage was achieved.
Assuntos
Feminino , Humanos , Adolescente , Adulto , Hormônio Liberador de Gonadotropina/análise , Doenças do Sistema Endócrino/metabolismo , Acantose Nigricans/metabolismo , Síndrome do Ovário Policístico/metabolismo , Ovário/fisiopatologia , Hormônio Liberador de Gonadotropina/análogos & derivados , Hiperandrogenismo/metabolismo , Teste de Tolerância a Glucose , Hiperinsulinismo/metabolismo , Insulina/análiseRESUMO
BACKGROUND: This study was performed to evaluate antithrombin III levels in postmenopausal women receiving hormonal replacement treatment. METHODS: It is a prospective randomized study concerning 19 postmenopausal patients, aged 40 to 65 years, who received either continuous daily oral equine conjugated estrogen 0.625 mg (group A, N=10) or daily transdermal 17beta-estradiol 50 microg (group B, N=9). Medroxyprogesterone acetate (5 mg/day, 14 days monthly) was given to all patients. Blood samples were obtained before and after 3, 6, 9 and 12 months of treatment. Coagulation tests included Antithrombin III (functional method), prothrombin time, partial activated prothrombin time, thrombin time, factor V, fibrinogen, platelet count and euglobulin lysis time. Friedman analysis of variance and Mann-Whitney test were used for statistical analysis. RESULTS: Antithrombin III level was reduced (p<0.05) in group A but not in group B, although it remained within normal range. No changes were detected in the other coagulation tests. CONCLUSIONS: These data suggest that oral conjugated estrogen replacement reduces functional ATIII, whereas transdermal estradiol replacement therapy does not modify it.
Assuntos
Antitrombina III/análise , Estradiol/farmacologia , Terapia de Reposição de Estrogênios/métodos , Estrogênios Conjugados (USP)/farmacologia , Pós-Menopausa/sangue , Administração Cutânea , Administração Oral , Adulto , Antitrombina III/efeitos dos fármacos , Estudos de Coortes , Estradiol/administração & dosagem , Estrogênios Conjugados (USP)/administração & dosagem , Feminino , Humanos , Medroxiprogesterona/administração & dosagem , Medroxiprogesterona/farmacologia , Pessoa de Meia-Idade , Pós-Menopausa/efeitos dos fármacos , Congêneres da Progesterona/administração & dosagem , Congêneres da Progesterona/farmacologia , Estudos ProspectivosRESUMO
OBJECTIVE: The aim of the study is to observe the morphology and morphometry of the endometrium of postmenopausal women treated with cyclic conjugated oestrogens. STUDY DESIGN: Three groups of nine postmenopausal women received cyclic conjugated oestrogens for 21 days (with a seven-day pause) during six months. The endometrial specimens were obtained using a modified Novak suction curet, in the second or third day of the period of drug washout. The slides were stained with haematoxylin and eosin (H.E.) in order to measure epithelial height and determine the gland/stroma ratio. RESULTS: Morphologic examination showed that single daily doses of 0.3 mg of conjugated oestrogens caused discrete endometrial proliferation after three and six months of treatment. However, a more intense effect was observed in women receiving doses of 0.625 and 1.25 mg/day of the hormone, in the same period. Morphometric study revealed significant increases both in epithelial thickness and in the gland-stroma ratio, specially in women receiving higher doses of the conjugated oestrogen (0.625 and 1.25 mg/day). CONCLUSIONS: We concluded that there were marked proliferative alterations without atypias in the endometrium of women that received 0.625 and 1.25 mg of conjugated oestrogens during six months.
Assuntos
Endométrio/citologia , Terapia de Reposição de Estrogênios , Pós-Menopausa , Divisão Celular , Endométrio/patologia , Células Epiteliais , Estrogênios Conjugados (USP)/administração & dosagem , Feminino , Humanos , Hiperplasia , Pessoa de Meia-Idade , Mucosa/citologia , Células Estromais/citologiaRESUMO
The ACTH test has been used to confirm the diagnosis of adrenal insufficiency and the classic and the non-classic adrenal hyperplasia due to the 3-HSD, 21 OH e 110H deficiencies. This article reviews the historical aspects of the use of ACTH in the diagnosis of hirsutism and points out its mains indications. In spite of new biological molecular advances in the diagnosis of adrenal enzymatic deficiencies, the use of the ACTH test can help the physician to predict both genothipus and fenothipus in populations with hyperandrogenic manifestations due to non-classical or late-onset congenital adrenal hyperplasia.
Assuntos
Hormônio Adrenocorticotrópico , Hirsutismo/diagnóstico , Humanos , Sistema Hipófise-Suprarrenal/enzimologiaRESUMO
Estudo comparativo, aberto, randomizado, foi conduzido em 10 centros da América Latina (oito no Brasil, um na Argentina e um no Chile), para avaliar a eficácia e segurança de dois sistemas transdérmicos para liberação de estradiol. Um total de 182 pacientes foi aleatoriamente distribuído para receber o sistema matricial (Climaderm-Wyeth-Ayerst) ou sistema clássico do tipo reservatório (Estraderm TTS 50 - Ciba-Geigy). Os sistemas foram aplicados na região inferior do abdome em áreas alternadas, durante seis ciclos consecutivos de 28 dias. Os sistemas liberavam aproximadamente, 50gr de estradiol por dia. Em ambos os grupos houve, em relação ao pré-tratamento, decréscimo significativo do número diário de fogachos nos ciclos de um a seis, porém houve, em relação ao sistema matricial, melhora significativa nos ciclos 4 (p = 0,033) e 6 (p = 0,046). Houve também diferença significativa entre os grupos com relação à fraqueza nos ciclos 2 (p = 0,019) e 3 (p + 0,015), fadiga no ciclo 2 (p = 0,033), interrupções do sono no ciclo 6 (p + 0,048), nervosismo no ciclo 3 (p = 0,045) e escore total nos ciclos 2 (p = 0,030) e 3 (p = 0,041), a favor do sistema matricial e 18 ( 21,2 por cento) do grupo medicado com o sistema reservatório abandonaram o tratamento
Assuntos
Humanos , Feminino , Administração Cutânea , Climatério/efeitos dos fármacos , Estradiol/administração & dosagem , Estradiol/uso terapêutico , Menopausa/efeitos dos fármacosRESUMO
OBJECTIVE: To evaluate clinically, and with laboratory, tests, women with polycystic ovary syndrome (PCO). PATIENTS: One hundred and twelve women with PCO were studied. METHODS: The following data was recorded: Current age; age at menarche; menstrual irregularity, occurrence of similar cases in the family; fertility, obstetric history; body mass index (BMI); and presence of hirsutism. Serum measurements of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, free testosterone, and dehydroepiandrosterone sulfate were taken. RESULTS: All patients presented either oligomenorrhea (31 percent), periods of secondary amenorrhea (9 percent), or both alterations (60 percent). The majority of the patients were infertile (75.6 percent). The LH/FSH ratio was higher than 2:1 in 55 percent of the patients and higher than 3:1 in 26.2 percent. The ultrasonographic aspect of the ovaries was considered to be normal in 31 percent. CONCLUSION: The main clinical feature of the PCO is the irregularity of menses since menarche, and that the laboratory tests would be important to exclude other disorders such as hyperprolactinemia or hyperandrogenemia caused by late-onset congenital adrenal hyperplasia.
Assuntos
Síndrome do Ovário Policístico/diagnóstico , Adolescente , Adulto , Feminino , Humanos , Estudos RetrospectivosRESUMO
An open-label, randomised, crossover study was conducted with in healthy postmenopausal women to compare the relative bioavailability of a matrix transdermal estradiol delivery system worn for 7 consecutive days, versus a reservoir transdermal patch worn for 4 days followed by its immediate replacement by another patch worn for further 3 consecutive days. There was a minimum 7-day washout period between the two study periods. Both systems were labelled to release approximately 50 micrograms/day of estradiol. Twenty-six subjects were evaluated with regard to estradiol serum levels. Blood samples were taken immediately before and at regular intervals until 192 h after the initiation of each study treatment (patch application) and assayed for estradiol. There was no difference between the patches with regard to Cmax. Based on the relative bioavailability, one matrix patch proved to be bioequivalent to two reservoir patches worn consecutively for 7 days. These results demonstrate the ability of one matrix patch to deliver consistent therapeutic levels of estradiol over a 7-day period.
Assuntos
Estradiol/administração & dosagem , Terapia de Reposição de Estrogênios/métodos , Administração Cutânea , Disponibilidade Biológica , Estudos Cross-Over , Esquema de Medicação , Estradiol/farmacocinética , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Estudos ProspectivosRESUMO
The authors documented by means of light and transmission electron microscopy that the ovaries of women with premature ovarian failure (POF) displayed dense connective tissue and rare corpora albicantia. Eight of the ten studied cases did not present ovarian follicles; in two cases, it was verified the presence of ovarian follicles, atypical primordial follicles and in one case, a corpus luteum was identified (after stimulation with exogenous gonadotrophin). Regarding the ultrastructural analysis, it was noted that the fibroblasts were united one to each other by cellular prolongations that formed a woof, constituting a cellular syncicius.