[Use of a new steroid (Org OD 14) in the climacteric syndrome]. / Uso de un nuevo esteroide (Org OD 14) en el síndrome climatérico.

A double-blind study was carried out in 60 women with climacteric symptoms: 30 women were given Org OD 14 (2.5 mg) and 30 were given a placebo to be taken daily for six weeks. The effects of the medication on the climacteric symptoms, the subjective sensations, the plasma FSH levels and endometrial histology were studied. In the treated group compared with the control group the relief or improvement of the following climacteric symptoms were recorded: perspiration, palpitations, irritability and backache. A favourable effect on the subjective sensations was noted in both groups, although no significant difference for the group which received Org OD 14 was found. At the end of the treatment with Org OD 14, the FSH levels were found to be greatly reduced in comparison with the basal values; this, however, was not the case with the placebo group. With regard to endometrial histology, no sign of hyperplasia was found in any of the patients. No relevant side effects or symptoms of estrogenic or androgenic stimulation were recorded. For the climacteric patient needing estrogen therapy, it can be concluded that Org OD 14 is an effective and innocuous medication in the doses used.

Bromocriptine in the treatment of hyperolactinemic amenorrhea.

Thirty women with secondary amenorrhea and hyperprolactinemia were studied; galactorrhea was present in 25 of them, and 18 were infertile. Serum prolactin (PRL) levels were high in all cases, between 26 and 120 ng/ml. All women were treated with bromocriptine in increasing doses from 2.5 to 5.0 or 7.5 mg daily, according to the response obtained, for 4 months. In 27 patients a PRL determination was performed during treatment; values returned to normal (up to 20 ng/ml) in 23 women and remained high in 4. Galactorrhea disappeared in 21 of 25 women. Ovulatory menses were re-established in 17 patients (56.6%). Seven women became pregnant (38.8%), one of them after bromocriptine and clomiphene were given simultaneously in the same cycle. According to our results and a literature review the following conclusions may be drawn: (1) bromocriptine is a useful therapeutic tool for re-establishing menstruation and inducing ovulation in patients with the hyperprolactinemic-amenorrhea syndrome; (2) the association of bromocriptine and clomiphene could be the next step in the treatment of patients who fail to ovulate with bromocriptine alone.

Plasma levels of norepinephrine during the periovulatory period in normal women. Further studies.

Eleven normally cycling women in whom laparotomy was indicated for benign gynecologic pathology were studied. Surgery was performed on day 0 (expected day of ovulation). Blood samples were drawn daily from day -8 to day -4, and every 8 hours from day -3 to day +2; estradiol (E2), progesterone (P), norepinephrine (NE), and LH were determined by RIA. Ovulation was certified by ovarian visualization and biopsy during laparotomy. In nine ovulatory patients mean E2 peak was found 48 hours before LH peak. Mean NE levels showed minimal variations until 48 hours before LH peak; 8 hours after E2 peak mean NE values increased significantly, fell 8 hours later, and rose immediately again, reaching maximal levels 24 hours after E2 peak. These values remained high until 16 hours before the LH peak and decreased gradually, thereafter reaching basal levels 32 hours after LH peak. Two anovulatory patients showed an atypical pattern of ovarian steroids and LH secretion and NE showed large variations without any correlation with estradiol or LH levels. This study confirms previous findings in women and experimental work in animals regarding the existence of a noradrenergic trigger mechanism to the LH ovulatory discharge.

Luteinizing hormone-releasing hormone in the treatment of anovultory infertility.

Fifteen infertile, anovulatory women, ages 20 to 37, were treated with synthetic luteinizing hormone-releasing hormone (LH-RH) to stimulate follicular maturation and/or ovulation. Thirteen of the patients had been treated unsuccessfully with other therapeutic regimens. To obtain follicular maturation, LH-RH was given intramuscularly in daily doses of 25 mu-g for 7 days and 50 mu-g for the next 7 days, or 100 mu-g for 3 days and 150 mu-g for the next 3 days. Both regimens were begun on the 4th day of a spontaneous or induced cycle. Follicular maturation (evaluated by the cervical mucus scale) occurred in three of seven cycles treated withe the first regimen and three of five treated with the second regimen. To induce ovulation, LH-RH was given in intravenous infusion (50 to 500 mu-g), intramuscularly (100 mu-g), or in a combination of both methods. The drug was administered after follicular maturation with LH-RH, clomiphene citrate, or human menopausal gonadotropin had been achieved; it was also given during four cycles in which spontaneous follicular maturation had occurred. Ovulation occurred in 10 of 25 treated cycles. Five pregnancies resulted, three in the first post-treatment cycle.

[Treatment of the anovulatory sterility with LH-RH (author's transl)]. / Tratmiento de la esterilidad anovulatoria con LH-RH

Thirthy one infertile women with different forms of anovulation were treated with LH-RH on various schemes of application: continuous intravenous (i.v.) infusion, intramuscular (i.m.) unique injection, continuous i.v. infusión plus i.m. unique injection, repeated i.v. injection, repeated i.m. injection and estrogens plus unique i.m. injection. On 46 cycles treated, ovulation was obtained in 18 (39.1%), 13 patients ovulated at least one cycle (41.8%) and six became pregnant (19.3%) three during the treatment and three during the first cycle post-treatment. The best results were obtained (63.2%) of ovulation) with the repeated i.v. injection scheme. Though the results obtained with LH-RH in relation to pregnancies, are lower than those obtained with other therapies of anovulation, the fact that we have been sucessful in cases on which other therapies of anovulation had been unsuccessful, the report up to now of only one case of mild ovary hyperestimulation, and the recent development of LH-RH analogs of more powerful and longer action, justifies the continuing of therpeutic assays with this hormone as to find the most effective scheme to induce ovulation.