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1.
J Bone Miner Metab ; 33(6): 658-65, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25300746

RESUMEN

This study sought to investigate the prevalence of osteoporosis and the role of sex hormone levels in the determination of bone mineral density (BMD) and osteoporosis in a Vietnamese population of women and men. The cross-sectional study involved 269 women and 222 men aged 13-83 years, who were randomly selected from urban and rural areas in northern Vietnam. Serum concentrations of estradiol and testosterone were analyzed, and BMD was measured by dual X-ray absorptiometry. We found that the prevalence of osteoporosis in postmenopausal women was 18, 17, and 37 % for the femoral neck, total hip, and lumbar spine, respectively. For men aged 50 years or older, the corresponding values were 8, 7, and 12 %. In men, the most important predictors of BMD for the femoral neck and total hip were age, body mass index, and serum levels of estradiol. For the BMD of the lumbar spine, testosterone also had a significant influence. Determinants of osteoporosis in men for the total hip and lumbar spine were age, weight, and serum concentrations of estradiol and testosterone. In postmenopausal women, age, weight, and residence (urban vs rural) were the most important predictors of BMD and osteoporosis. For all women (including those of reproductive age), serum levels of estradiol were also significant. These data suggest that the prevalence of osteoporosis in the Vietnamese population is high also in men, and that estradiol levels are essential for bone mass in both men and women. The results should have clinical implications and increase awareness of an important health issue within Vietnamese society.


Asunto(s)
Densidad Ósea , Hormonas Esteroides Gonadales/sangre , Osteoporosis/sangre , Osteoporosis/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Intervalos de Confianza , Demografía , Estradiol/sangre , Femenino , Cuello Femoral/patología , Humanos , Masculino , Persona de Mediana Edad , Posmenopausia/sangre , Reproducción , Testosterona/sangre , Vietnam , Adulto Joven
2.
Gynecol Endocrinol ; 30(10): 681-2, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25242337

RESUMEN

Unintended pregnancy is an important public health problem worldwide. Unwanted pregnancies may end in induced abortion (legal or illegal, safe or unsafe) or in childbirth. In many parts of the world both can be life threatening. Even where both are safe, abortion is distressing for all concerned while unwanted births often lead to poor health and social outcomes for both the mother and her child.


Asunto(s)
Anticoncepción Postcoital/métodos , Anticonceptivos , Levonorgestrel , Norpregnadienos , Sociedades Médicas/normas , Anticoncepción Postcoital/normas , Anticonceptivos/administración & dosificación , Anticonceptivos/efectos adversos , Anticonceptivos/farmacología , Femenino , Humanos , Levonorgestrel/administración & dosificación , Levonorgestrel/efectos adversos , Levonorgestrel/farmacología , Norpregnadienos/administración & dosificación , Norpregnadienos/efectos adversos , Norpregnadienos/farmacología
3.
Gynecol Endocrinol ; 29(2): 173-6, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23095007

RESUMEN

Both estrogen and testosterone insufficiency has been associated with reduced psychological well-being including fatigue. However, hormonal replacement studies on fatigue are rare. Therefore, we wanted to study the effect of testosterone and estrogen replacement therapy on cognitive fatigue and the relation between sex hormone levels and cognitive fatigue in oophorectomized women. Fifty women with surgically induced menopause (mean age: 54.0 ± 2.9 years) were randomly assigned to treatment with estradiol valerate in combination with testosterone undecanoate or placebo for 24 weeks in a double-blind cross-over study. Neuropsychological tests and questionnaires were used to assess cognitive fatigue and psychological well-being. Cognitive fatigue was significantly associated to poor self-rated health and higher body mass index but not to general psychological well-being or sex hormone levels. Treatment with testosterone + estrogen had no significant effect on cognitive fatigue but the results indicated a curvilinear relation for hormonal levels. The estrogen/testosterone ratio was more related to functions rather than high or low hormone levels per se. We found that cognitive fatigue is frequent in oophorectomized women and negatively associated to self-perceived health and positively associated to BMI. A well-balanced ratio between estrogen and testosterone levels may be important for cognitive fatigue.


Asunto(s)
Andrógenos/uso terapéutico , Trastornos del Conocimiento/tratamiento farmacológico , Estradiol/análogos & derivados , Estrógenos/uso terapéutico , Terapia de Reemplazo de Hormonas , Fatiga Mental/tratamiento farmacológico , Testosterona/análogos & derivados , Algoritmos , Andrógenos/sangre , Andrógenos/farmacocinética , Índice de Masa Corporal , Trastornos del Conocimiento/sangre , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/etiología , Estudios Cruzados , Método Doble Ciego , Quimioterapia Combinada , Estradiol/sangre , Estradiol/farmacocinética , Estradiol/uso terapéutico , Estrógenos/sangre , Estrógenos/farmacocinética , Femenino , Humanos , Fatiga Mental/sangre , Fatiga Mental/complicaciones , Fatiga Mental/etiología , Persona de Mediana Edad , Pruebas Neuropsicológicas , Ovariectomía/efectos adversos , Sobrepeso/complicaciones , Salpingectomía/efectos adversos , Suecia/epidemiología , Testosterona/sangre , Testosterona/farmacocinética , Testosterona/uso terapéutico
4.
Gynecol Endocrinol ; 29(1): 59-62, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22967437

RESUMEN

Several studies have suggested gender differences in cognitive function, but data on the association between sex hormones and cognitive function are contradictory. The aim of our randomized double-blind study was to explore the possible relations between cognitive function and serum levels of sex hormones, oxytocin and insulin-like growth factor-I (IGF-I) in postmenopausal women. Two-hundred healthy postmenopausal women were randomly assigned to receive estrogen, testosterone or placebo treatment for 1 month. The associations of spatial ability, verbal fluency and verbal memory with serum levels of estradiol, testosterone, estradiol/testosterone ratio, androstanediol, oxytocin and IGF-I were analyzed. Spatial ability showed a negative correlation with serum estradiol, estradiol/testosterone ratio, oxytocin levels and a positive association with androstanediol levels. Verbal fluency displayed a negative relationship with serum levels of testosterone, IGF-I and a positive with estradiol/testosterone ratio. Verbal memory displayed a positive correlation to androstanediol. Data suggest that not only absolute levels of sex hormones but also the balance between estrogen and testosterone and their metabolites may be important for cognitive function in women.


Asunto(s)
Cognición/efectos de los fármacos , Estradiol/análogos & derivados , Terapia de Reemplazo de Estrógeno/métodos , Hormonas Esteroides Gonadales/sangre , Posmenopausia/efectos de los fármacos , Testosterona/análogos & derivados , Andrógenos/administración & dosificación , Andrógenos/sangre , Androstano-3,17-diol/sangre , Método Doble Ciego , Estradiol/administración & dosificación , Estradiol/sangre , Femenino , Humanos , Factor I del Crecimiento Similar a la Insulina/metabolismo , Memoria/efectos de los fármacos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Oxitocina/sangre , Placebos , Posmenopausia/sangre , Testosterona/administración & dosificación , Testosterona/sangre , Aprendizaje Verbal/efectos de los fármacos
5.
Proc Natl Acad Sci U S A ; 106(16): 6535-8, 2009 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-19366676

RESUMEN

Existing correlative evidence suggests that sex hormones may affect economic behavior such as risk taking and reciprocal fairness. To test this hypothesis we conducted a double-blind randomized study. Two-hundred healthy postmenopausal women aged 50-65 years were randomly allocated to 4 weeks of treatment with estrogen, testosterone, or placebo. At the end of the treatment period, the subjects participated in a series of economic experiments that measure altruism, reciprocal fairness, trust, trustworthiness, and risk attitudes. There was no significant effect of estrogen or testosterone on any of the studied behaviors.


Asunto(s)
Conducta/efectos de los fármacos , Economía , Estrógenos/farmacología , Testosterona/farmacología , Anciano , Altruismo , Método Doble Ciego , Estrógenos/administración & dosificación , Estrógenos/sangre , Femenino , Humanos , Persona de Mediana Edad , Placebos , Asunción de Riesgos , Testosterona/administración & dosificación , Testosterona/sangre
6.
Lancet Oncol ; 10(2): 135-46, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19167925

RESUMEN

BACKGROUND: Vasomotor symptoms and bone loss are complications frequently induced by adjuvant treatment for breast cancer. Tibolone prevents both side-effects, but its effect on cancer recurrence is unknown. The aim of this study was to show non-inferiority of tibolone to placebo regarding risk of recurrence in breast-cancer patients with climacteric complaints. METHODS: Between July 11, 2002, and Dec 20, 2004, women surgically treated for a histologically confirmed breast cancer (T(1-3)N(0-2)M(0)) with vasomotor symptoms were randomly assigned to either tibolone 2.5 mg daily or placebo at 245 centres in 31 countries. Randomisation was done by use of a centralised interactive voice response system, stratified by centre, with a block size of four. The primary endpoint was breast-cancer recurrence, including contralateral breast cancer, and was analysed in the intention-to-treat (ITT) and per-protocol populations; the margin for non-inferiority was set as a hazard ratio of 1.278. This study is registered with ClinicalTrials.gov, number NCT00408863. FINDINGS: Of the 3148 women randomised, 3098 were included in the ITT analysis (1556 in the tibolone group and 1542 in the placebo group). Mean age at randomisation was 52.7 years (SD 7.3) and mean time since surgery was 2.1 years (SD 1.3). 1792 of 3098 (58%) women were node positive and 2185 of 3098 (71%) were oestrogen-receptor positive. At study entry, 2068 of 3098 (67%) women used tamoxifen and 202 of 3098 (6.5%) women used aromatase inhibitors. The mean daily number of hot flushes was 6.4 (SD 5.1). After a median follow-up of 3.1 years (range 0.01-4.99), 237 of 1556 (15.2%) women on tibolone had a cancer recurrence, compared with 165 of 1542 (10.7%) on placebo (HR 1.40 [95% CI 1.14-1.70]; p=0.001). Results in the per-protocol population were similar (209 of 1254 [16.7%] women in the tibolone group had a recurrence vs 138 of 1213 [11.4%] women in the placebo group; HR 1.44 [95% CI 1.16-1.79]; p=0.0009). Tibolone was not different from placebo with regard to other safety outcomes, such as mortality (72 patients vs 63 patients, respectively), cardiovascular events (14 vs 10, respectively), or gynaecological cancers (10 vs 10, respectively). Vasomotor symptoms and bone-mineral density improved significantly with tibolone, compared with placebo. INTERPRETATION: Tibolone increases the risk of recurrence in breast cancer patients, while relieving vasomotor symptoms and preventing bone loss. FUNDING: Schering-Plough (formerly NV Organon, Oss, Netherlands).


Asunto(s)
Antineoplásicos Hormonales/efectos adversos , Neoplasias de la Mama/inducido químicamente , Terapia de Reemplazo de Estrógeno/efectos adversos , Sofocos/tratamiento farmacológico , Recurrencia Local de Neoplasia/inducido químicamente , Norpregnenos/efectos adversos , Adulto , Anciano , Neoplasias de la Mama/patología , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Osteoporosis Posmenopáusica/prevención & control , Sistema Vasomotor/efectos de los fármacos
7.
J Econ Sci Assoc ; 5(2): 149-169, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31894199

RESUMEN

Many studies report on the association between 2D:4D, a putative marker for prenatal testosterone exposure, and economic preferences. However, most of these studies have limited sample sizes and test multiple hypotheses (without preregistration). In this study we mainly replicate the common specifications found in the literature for the association between the 2D:4D ratio and risk taking, the willingness to compete, and dictator game giving separately. In a sample of 330 women we find no robust associations between any of these economic preferences and 2D:4D. We find no evidence of a statistically significant relation for 16 of the 18 total regressions we run. The two regression specifications which are statistically significant have not previously been reported and the associations are not in the expected direction, and therefore they are unlikely to represent a real effect.

8.
Clin Obstet Gynecol ; 51(3): 592-606, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18677153

RESUMEN

Valid evidence from randomized-controlled trials indicates that breast cancer risk is increased with combined estrogen/progestogen use and that such treatment implies a risk greater than that of estrogen alone. Overall, risk estimates from observational studies are somewhat higher than in randomized-controlled trials but remain modest as compared with other risk factors even after long-term treatment. For combined estrogen/progestogen therapy, risk increases gradually to reach statistical significance after 4 to 5 years. Apart from its many beneficial health effects, the safety data for use of estrogen alone are quite reassuring. The only justifications for progestogen addition are for bleeding control and endometrial protection. At present, there are several new therapeutic compounds and concepts in development, which hold promise to provide both endometrial protection and breast safety.


Asunto(s)
Neoplasias de la Mama/epidemiología , Terapia de Reemplazo de Estrógeno/métodos , Medición de Riesgo , Neoplasias de la Mama/inducido químicamente , Terapia de Reemplazo de Estrógeno/efectos adversos , Femenino , Humanos , Posmenopausia , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo
9.
Menopause ; 14(1): 89-96, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17019374

RESUMEN

OBJECTIVE: The aim of this study was to determine the effects of the isopropanolic extract of black cohosh (Remifemin) on mammographic breast density and breast epithelial proliferation in healthy, naturally postmenopausal women with climacteric symptoms. DESIGN: This was a prospective, open, uncontrolled drug safety study in which baseline status was compared with status after 6 months of treatment by blinded observers. A total of 74 women were treated with 40 mg black cohosh daily, and 65 women completed the study. Mammograms were performed, and breast cells were collected by percutaneous fine needle aspiration biopsies at baseline and after 6 months. Mammographic density was quantified according to the Wolfe classification or a percentage scale. Breast cell proliferation was assessed using the Ki-67/MIB-1 monoclonal antibody. Safety was monitored by adverse event reporting, laboratory assessments, and measurement of the endometrium by vaginal ultrasound. RESULTS: None of the women showed any increase in mammographic breast density. Furthermore, there was no increase in breast cell proliferation. The mean change +/- SD in proportion of Ki-67-positive cells was -0.5% +/- 2.4% (median, 0.0; 95% CI = -1.32 to 0.34) for paired samples. The mean change in endometrial thickness +/- SD was 0.0 +/- 0.9 mm (median, 0.0). A modest number of adverse events were possibly related to treatment, but none of these were serious. Laboratory findings and vital signs were normal. CONCLUSIONS: The findings suggest that the isopropanolic extract of black cohosh does not cause adverse effects on breast tissue. Furthermore, our data do not indicate to any endometrial or general safety concerns during 6 months of treatment.


Asunto(s)
Mama/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Cimicifuga/efectos adversos , Extractos Vegetales/efectos adversos , Posmenopausia/efectos de los fármacos , 2-Propanol/química , Anciano , Biopsia con Aguja Fina , Mama/patología , Cimicifuga/química , Endometrio/efectos de los fármacos , Endometrio/patología , Femenino , Humanos , Mamografía , Persona de Mediana Edad , Extractos Vegetales/farmacología , Estudios Prospectivos , Método Simple Ciego
10.
Menopause ; 14(2): 183-90, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17108847

RESUMEN

OBJECTIVE: During the past few years serious concern has been raised about the safety of combined estrogen/progestogen hormone therapy, in particular about its effects on the breast. Several observations suggest that androgens may counteract the proliferative effects of estrogen and progestogen in the mammary gland. Thus, we aimed to study the effects of testosterone addition on breast cell proliferation during postmenopausal estrogen/progestogen therapy. DESIGN: We conducted a 6-month prospective, randomized, double-blind, placebo-controlled study. A total of 99 postmenopausal women were given continuous combined estradiol 2 mg/norethisterone acetate 1 mg and were equally randomly assigned to receive additional treatment with either a testosterone patch releasing 300 microg/24 hours or a placebo patch. Breast cells were collected by fine needle aspiration biopsy at baseline and after 6 months, and the main outcome measure was the percentage of proliferating breast cells positively stained by the Ki-67/MIB-1 antibody. RESULTS: A total of 88 women, 47 receiving active treatment and 41 in the placebo group, completed the study. In the placebo group there was a more than fivefold increase (P<0.001) in total breast cell proliferation from baseline (median 1.1%) to 6 months (median 6.2%). During testosterone addition, no significant increase was recorded (1.6% vs 2.0%). The different effects of the two treatments were apparent in both epithelial and stromal cells. CONCLUSIONS: Addition of testosterone may counteract breast cell proliferation as induced by estrogen/progestogen therapy in postmenopausal women.


Asunto(s)
Mama/efectos de los fármacos , Terapia de Reemplazo de Estrógeno , Posmenopausia , Testosterona/administración & dosificación , Administración Cutánea , Anciano , Biopsia con Aguja , Mama/patología , Neoplasias de la Mama/patología , Neoplasias de la Mama/prevención & control , Proliferación Celular/efectos de los fármacos , Estradiol/administración & dosificación , Estradiol/sangre , Femenino , Humanos , Inmunohistoquímica , Factor I del Crecimiento Similar a la Insulina , Persona de Mediana Edad , Noretindrona/administración & dosificación , Noretindrona/sangre , Globulina de Unión a Hormona Sexual , Testosterona/sangre , Resultado del Tratamiento
11.
Maturitas ; 57(1): 47-9, 2007 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-17386984

RESUMEN

There is increasing interest in the role of androgens in the treatment of women but little is known about their long-term safety. There are also very few studies on testosterone therapy and breast cancer risk. However, some observations support the concept that androgens may counteract the stimulatory effects of estrogen and progestogen in the mammary gland. Mammographic breast density and breast cell proliferation could be regarded as surrogate markers for the risk of breast cancer. Recently the addition of testosterone to a common estrogen/progestogen regimen was found to inhibit the stimulatory effects of hormones on breast cell proliferation. The effects of testosterone alone on the postmenopausal breast remain to be investigated.


Asunto(s)
Andrógenos/uso terapéutico , Neoplasias de la Mama/etiología , Mama/efectos de los fármacos , Administración Cutánea , Andrógenos/efectos adversos , Mama/fisiología , Proliferación Celular/efectos de los fármacos , Femenino , Genes BRCA1/efectos de los fármacos , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Receptores Androgénicos/fisiología , Testosterona/farmacología , Testosterona/uso terapéutico
12.
Fertil Steril ; 107(5): 1238-1245, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28433366

RESUMEN

OBJECTIVE: To determine whether there is a causal effect of oral contraceptive (OC) treatment on general well-being and depressed mood in healthy women. DESIGN: Double-blind, randomized, and placebo-controlled trial. SETTING: University hospital. PATIENT(S): Three hundred and forty healthy women aged 18-35 years randomized to treatment, of whom 332 completed the data collection at follow-up evaluation. INTERVENTION(S): A combined OC (150 µg levonorgestrel and 30 µg ethinylestradiol) or placebo for 3 months of treatment. MAIN OUTCOME MEASURE(S): Primary outcome measures: global score of Psychological General Well-Being Index (PGWBI) and the Beck Depression Inventory (BDI); secondary outcome measures: six separate dimensions of the PGWBI. RESULT(S): The OC treatment statistically significantly decreased general well-being compared with placebo -4.12 (95% CI, -7.18 to -1.06). Furthermore, OC decreased the following PGWBI dimensions compared with placebo: positive well-being -3.90 (95% CI, -7.78 to -0.01), self-control -6.63 (95% CI, -11.20 to -2.06), and vitality -6.84 (95% CI, -10.80 to -2.88). The effect of OC on depressive symptoms and on the PGWBI dimension depressed mood were not statistically significant. CONCLUSION(S): This study demonstrates a statistically significant reduction in general well-being by a first-choice OC in comparison with placebo in healthy women. We found no statistically significant effects on depressive symptoms. A reduction in general well-being should be of clinical importance.


Asunto(s)
Anticonceptivos Orales Combinados/uso terapéutico , Depresión/epidemiología , Depresión/prevención & control , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Estado de Salud , Embarazo/psicología , Embarazo/estadística & datos numéricos , Adolescente , Adulto , Método Doble Ciego , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/psicología , Femenino , Humanos , Incidencia , Prioridad del Paciente , Efecto Placebo , Valores de Referencia , Suecia/epidemiología , Resultado del Tratamiento , Salud de la Mujer/estadística & datos numéricos , Adulto Joven
13.
Climacteric ; 14(5): 598-9, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21910672
14.
J Clin Endocrinol Metab ; 101(11): 4046-4053, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27525531

RESUMEN

CONTEXT: There is a lack of knowledge about how oral contraceptives may affect sexual function. OBJECTIVE: To determine whether there is a causal effect of oral contraceptives on sexuality. We hypothesized that a widely used pill impairs sexuality. DESIGN: A double-blind, randomized, placebo-controlled trial. Enrollment began in February 2012 and was completed in August 2015. SETTING: Karolinska University Hospital, Stockholm, Sweden. PARTICIPANTS: A total of 340 healthy women, aged 18-35 years, were randomized to treatment, and 332 completed the study. INTERVENTIONS: A combined oral contraceptive (150 µg levonorgestrel and 30 µg ethinylestradiol) or placebo for 3 months of treatment. MAIN OUTCOME MEASURES: The primary outcome was the aggregate score on the Profile of Female Sexual Function (PFSF). Secondary outcomes were the seven domains of the PFSF, the Sexual Activity Log, and the Personal Distress Scale. RESULTS: Overall sexual function was similar in women in the oral contraceptive and placebo groups. The PFSF domains desire (-4.4; 95% confidence interval [CI], -8.49 to -0.38; P = .032), arousal (-5.1; 95% CI, -9.63 to -0.48; P = .030), and pleasure (-5.1; 95% CI, -9.97 to -0.32; P = .036) were significantly reduced in comparison to placebo, whereas orgasm, concern, responsiveness, and self-image were similar between groups. The mean frequency of satisfying sexual episodes and personal distress were also similar between groups. CONCLUSIONS: This study shows no negative impact of a levonorgestrel-containing oral contraceptive on overall sexual function, although three of seven sexual function domains were adversely affected.


Asunto(s)
Anticonceptivos Orales Combinados/efectos adversos , Etinilestradiol/efectos adversos , Levonorgestrel/efectos adversos , Disfunciones Sexuales Fisiológicas/inducido químicamente , Disfunciones Sexuales Psicológicas/inducido químicamente , Adolescente , Adulto , Nivel de Alerta/efectos de los fármacos , Método Doble Ciego , Combinación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Perdida de Seguimiento , Pacientes Desistentes del Tratamiento , Satisfacción del Paciente , Placer/efectos de los fármacos , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad , Disfunciones Sexuales Fisiológicas/fisiopatología , Disfunciones Sexuales Psicológicas/psicología , Estrés Psicológico/inducido químicamente , Estrés Psicológico/psicología , Suecia , Adulto Joven
15.
J Clin Endocrinol Metab ; 89(2): 702-7, 2004 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-14764784

RESUMEN

The aim of this study was to evaluate the diurnal pattern of testosterone and pituitary hormones in endurance female athletes with different types of menstrual disorder. Age- and body mass index-matched groups of endurance athletes with amenorrhea (n = 10) and oligomenorrhea (n = 6), regularly cycling athletes (n = 8), and sedentary controls (n = 8) were compared with respect to 24-h hormonal profiles of testosterone, LH, prolactin (PRL), GH, insulin, IGF binding protein 1 (IGFBP-1), and cortisol. The 24-h hormone profiles in amenorrheic athletes were characterized by decreased LH pulsatility and peak amplitude of PRL and increased baseline levels of GH and cortisol. However, oligomenorrheic athletes displayed a significantly different pattern with higher diurnal testosterone secretion than all other groups. Furthermore, LH, PRL, GH, and cortisol secretions were comparable with regularly menstruating subjects. In the combined group of athletes with menstrual disturbances, diurnal secretions of testosterone, LH, and PRL were positively, whereas cortisol was negatively correlated with the number of menstruations the last year. Although this could be explained by a gradual inhibition of the hypothalamic-pituitary-gonadal axis, our results indicate that the symptoms of amenorrhea and oligomenorrhea may reflect two hormonally distinct conditions. Thus, amenorrheic athletes displayed a hormonal pattern in agreement with hypothalamic inhibition due to energy deficiency, whereas oligomenorrheic athletes demonstrated increased diurnal secretion of testosterone, suggesting a different mechanism, e.g. essential hyperandrogenism.


Asunto(s)
Ritmo Circadiano , Trastornos de la Menstruación/fisiopatología , Resistencia Física , Hormonas Hipofisarias/sangre , Deportes , Testosterona/sangre , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Hidrocortisona/sangre , Hormona Luteinizante/sangre , Trastornos de la Menstruación/sangre , Prolactina/sangre
16.
J Clin Endocrinol Metab ; 89(9): 4364-70, 2004 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15328063

RESUMEN

Menstrual disturbances are common among female athletes, and oral contraceptives (OCs) are often recommended as estrogen substitution. However, there is little information about the effects of OC use in athletes, and there is great concern that OCs might impair physical performance. The aim of this study was to investigate the effects of OC use on body composition and physical performance in female athletes. Twenty-six endurance athletes (13 with oligo-/amenorrhea and 13 regularly menstruating athletes) and 12 sedentary controls were examined before and after 10 months of treatment with a low dose, monophasic, combined OC. Significant changes in body composition were recorded in the athletes, but not in the controls. There was an increase in weight and fat mass only in athletes with oligo-/amenorrhea. These changes were associated with a decrease in ovarian androgens. OC treatment also increased bone mineral density, with the largest increase in athletes with a low bone mineral density at baseline. Despite significant changes in body composition, little impact on physical performance was recorded. We have demonstrated that OC treatment in female athletes has predominantly beneficial effects on body composition without adverse effects on physical performance and could be used for the prevention of osteoporosis in athletic amenorrhea. However, it cannot be excluded that a marked increase in fat mass might have unfavorable effects for athletic performance in individual women.


Asunto(s)
Composición Corporal/efectos de los fármacos , Anticonceptivos Orales/farmacología , Resistencia Física/efectos de los fármacos , Medicina Deportiva , Adolescente , Adulto , Densidad Ósea/efectos de los fármacos , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Consumo de Oxígeno/efectos de los fármacos
17.
Reprod Biol Endocrinol ; 1: 7, 2003 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-12646074

RESUMEN

The progesterone receptor (PR) and androgen receptor (AR) belong to the nuclear receptor superfamily. Two isoforms of PR (A and B) have been identified with different functions. The expression of AR, each isoform of PR and their involvement in long-term effects on the endometrium after hormonal replacement therapy (HRT) or tamoxifen (TAM) treatment is not known. The aims of this study were to determine PR(A+B), PRB and AR distribution by immunohistochemistry in the macaque (Macaca fascicularis) endometrium. Ovariectomized (OVX) animals were orally treated continuously for 35 months with either conjugated equine estrogens (CEE); medroxyprogesterone acetate (MPA); the combination of CEE/MPA; or TAM. Treatment with CEE/MPA tended to down-regulate PR in the superficial glands, but increased it in the stroma. TAM treatment increased both the PR and PRB levels in the stroma. Overall, less than 20% of the cells were positive for the PRB isoform and less variation was observed after steroid treatment. AR was found in the stroma, mainly distributed in the basal layer of the endometrium in the OVX and steroid treated groups, but was absent in the TAM treated group. No AR was found in the glandular epithelium. The present data show that long-term hormone treatment affects the PR level, and also the ratio between PRA and PRB in the endometrium.


Asunto(s)
Endometrio/efectos de los fármacos , Estrógenos Conjugados (USP)/farmacología , Regulación de la Expresión Génica/efectos de los fármacos , Acetato de Medroxiprogesterona/farmacología , Receptores Androgénicos/biosíntesis , Receptores de Progesterona/biosíntesis , Tamoxifeno/farmacología , Animales , Neoplasias Endometriales/inducido químicamente , Neoplasias Endometriales/prevención & control , Endometrio/metabolismo , Estrógenos Conjugados (USP)/administración & dosificación , Femenino , Terapia de Reemplazo de Hormonas/efectos adversos , Macaca fascicularis , Acetato de Medroxiprogesterona/administración & dosificación , Ovariectomía , Receptores Androgénicos/genética , Receptores de Progesterona/genética , Tamoxifeno/administración & dosificación
18.
Fertil Steril ; 79(4): 947-55, 2003 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-12749436

RESUMEN

OBJECTIVE: To evaluate endocrine mechanisms underlying oligomenorrhea or amenorrhea in female athletes. DESIGN: Cross-sectional study. SETTING: Women's health clinical research unit at a university hospital. PATIENT(S): Age- and BMI-matched groups of athletes active in endurance sports with and without menstrual disturbances and regularly cycling sedentary controls. INTERVENTION(S): Groups were compared with respect to endocrine status, body composition, and physical performance. MAIN OUTCOME MEASURE(S): Identification of a subgroup of oligomenorrheic or amenorrheic athletes with increased androgen levels and anabolic body composition. RESULT(S): A subgroup of 8 of 25 athletes with menstrual disturbances had significantly higher serum levels of free and total testosterone, androstenedione, LH-FSH ratio, and lower SHBG levels than did all other groups. Other oligomenorrheic or amenorrheic athletes had normal values comparable to those in regularly menstruating athletes and controls. The hyperandrogenic subgroup showed a more anabolic body composition, with higher total bone mineral density and upper-lower fat mass ratio than did oligomenorrheic or amenorrheic athletes with normal androgen levels. The hyperandrogenic subgroup had the highest VO2 max and the highest performance values in general. CONCLUSION(S): Menstrual disturbances in female athletes are often explained as a consequence of hypothalamic inhibition and caloric deficiency. We suggest that essential hyperandrogenism is an alternative mechanism underlying oligomenorrhea or amenorrhea in some female athletes and may imply an advantage for physical performance.


Asunto(s)
Amenorrea/sangre , Hiperandrogenismo/sangre , Oligomenorrea/sangre , Deportes/fisiología , Adulto , Amenorrea/etiología , Androstenodiona/sangre , Composición Corporal/fisiología , Densidad Ósea/fisiología , Estudios Transversales , Sulfato de Deshidroepiandrosterona/sangre , Femenino , Humanos , Hiperandrogenismo/complicaciones , Insulina/sangre , Factor I del Crecimiento Similar a la Insulina/metabolismo , Oligomenorrea/etiología , Resistencia Física/fisiología , Globulina de Unión a Hormona Sexual/metabolismo , Testosterona/sangre , Transcortina/metabolismo
19.
Fertil Steril ; 81(6): 1617-23, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15193485

RESUMEN

OBJECTIVE: To study the effect on mammographic breast density of two different continuous combined regimens for hormone therapy. DESIGN: Randomized clinical study. SETTING: University hospital. PATIENT(S): Postmenopausal women without any previous history of breast disorder. INTERVENTION(S): The women received either estradiol valerate/dienogest or estradiol/norethisterone acetate. Mammograms and venous blood samples were obtained at baseline and after 6 months. MAIN OUTCOME MEASURE(S): Change in mammographic breast density. Correlations with levels of hormones, growth factors, and binding proteins. RESULT(S): An increase in mammographic density was recorded in approximately 50% of the women, and there were no differences between treatments. Increased density showed a positive correlation with estradiol, estrone, and sex hormone-binding globulin and showed a negative association to free T. Among hormonal factors, levels of free T were the most important for predicting increased density. CONCLUSION(S): Continuous combined hormone therapy with different progestogens has a marked impact on the breast.


Asunto(s)
Terapia de Reemplazo de Estrógeno , Sustancias de Crecimiento/sangre , Hormonas/sangre , Mamografía , Nandrolona/análogos & derivados , Noretindrona/análogos & derivados , Mama/efectos de los fármacos , Estradiol/administración & dosificación , Estradiol/sangre , Estrona/sangre , Femenino , Humanos , Nandrolona/administración & dosificación , Noretindrona/administración & dosificación , Acetato de Noretindrona , Globulina de Unión a Hormona Sexual/metabolismo , Testosterona/sangre
20.
Maturitas ; 49(1): 90-6, 2004 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-15351100

RESUMEN

Estrogen is a well-known mitogen in human breast epithelium but the action of progestogen is complex and incompletely understood. During the last years, accumulating data from animal, clinical and observational studies suggest a proliferative effect in breast tissue when progestogen is added to estrogen. Findings in surrogate markers like breast density add to clinical and epidemiological reports indicating that continuous combined HRT may carry a higher risk of breast cancer than treatment with estrogen alone. Whether the results are valid for all progestogens remains to elucidated. It is also clear that not all women respond in the same way to the same treatment and the biological basis for the marked individual variation in breast response has to be clarified. Further knowledge about the role of androgens and of the impact of different treatment regimens is important and prospective randomized clinical studies are needed.


Asunto(s)
Mama/efectos de los fármacos , Terapia de Reemplazo de Estrógeno , Hormonas Esteroides Gonadales/farmacología , Mama/citología , Proliferación Celular/efectos de los fármacos , Femenino , Humanos
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