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The relation between plasma oestrogen, progesterone and prolactin concentrations and the efficacy of vaginal prostaglandin E2 gel in initiating labour.

In an attempt to relate the efficacy of treatment to endogenous hormone levels, plasma oestrogen, progesterone and prolactin levels were analysed in women at term following the vaginal administration of prostaglandin E2 gel to induce labour. Patients who went into labour after treatment had significantly higher oestradiol-17 beta levels before treatment compared with those requiring formal surgical induction the following day. No difference could be demonstrated in levels of progesterone or prolactin in the two groups of patients. The significance of these results is discussed.

Estradiol

Comparison of serum oestrogen concentrations in post-menopausal women taking oestrone sulphate and oestradiol.

Mean serum concentrations of oestradiol-17beta, oestrone, and oestrone sulphate in postmenopausal women were the same when measured up to six hours after treatment with either piperazine oestrone sulphate 1.5 mg or oestradiol valerate 2 mg. Maximum concentrations of oestradiol were less than those of oestrone, but oestrone sulphate reached concentrations about 30 times higher than those of oestrone. The rapid conversion of oestradiol valerate to oestrone and oestrone sulphate does not support the suggestion that in menopausal women oestradiol is less likely to be associated with a risk of endometrial carcinoma than oestrone sulphate, since the two preparations appear to become identical after ingestion.

Climacteric

Failure of estrogen-induced discharge of luteinizing hormone in lactating women.

Pituitary-ovarian relationships were studied in seven lactating women by measuring the basal plasma concentrations of pituitary and ovarian hormones and their responses to an estrogen provocation test at 7, 30, and 100 days after delivery. The results were compared to a similar group of seven women who did not breast feed. The first ovulation occurred in five of the nonlactating women beteen 43-87 days after delivery, as judged by the urinary excretion of total estrogen and pregnanediol. In all lactating women, ovarian cyclicity was suppressed for at least 150 days after delivery or until weaning. The basal concentration of PRL in lactating women was significantly higher than in the nonlactating women at all three times measured. At 30 and 100 days, the concentration of estradiol was significantly lower in the lactating women, although the basal concentrations of FSH were similar in the two groups. After an injection of 1 mg estradiol benzoate, the concentrations of FSH and LH in plasma were suppressed to a greater extent in lactating than in nonlactating women. In addition, fewer of the lactating group (one of seven and none of seven at 30 and 100 days, respectively) than the nonlactating group (two of seven and five of seven) subsequently showed a rise in the concentration of LH 58--96 h after the estrogen injection (positive feedback). These results suggest that during lactation the hypothalamic-pituitary system is more sensitive to the negative feedback and relatively insensitive to the positive feedback of estrogen.

Adult

Interaction of rifampicin treatment with pharmacokinetics and metabolism of ethinyloestradiol in man.

[6,7-3H]Ethinyloestradiol (50 microng) was administered intravenously to volunteers and the free extractable ethinyloestradiol in the plasma was measured. The compound showed a biphasic plasma decline. The half-life of the second phase was 7.5+/-1.7 (SD) hours. Administration of rifampicin (600 mg for 6 days) shifted the half-life of ethinyloestradiol to 3.3+/-0.9 h while the apparent volume of distribution for the second phase of elimination was not changed. When [2,4,6,7-3H]ethinyloestradiol (100 microng) was administered orally, some of the tritium was released by oxidative metabolism from the steroid and transformed to tritiated water (HTO) which equilibrated with whole body water. This portion, normally 7.17+/-1.66% of the tritium dose, was increased by previous administration of rifampicin to 10.62+/-2.27%. The initial rate of oxication of [2,4,6,7-3H]ethinyloestradiol was increased more than twofold by rifampicin treatment. The results are consistent with previous findings that rifampicin induces the oestrogen-2-hydroxylase in the endoplasmic reticulum of human liver, and explain the reduced effectiveness of ethinyloestradiol in oral contraceptives, if the patients are treated with rifampicin.

Administration, Oral

Oestrogenic activity of oestradiol-decanoate after oral administration to rodents.

Oestradiol-decanoate, dissolved in arachis oil and orally administered to rodents, produces oestrogenic effects. Compared on a molecular basis the ester has 0.1-1.0 times the activity of ethinyl oestradiol, dependent on the species and the parameter studied. The effects of oestradiol-decanoate are less or absent when the oil is omitted. It is likely that absorption of the steroid ester takes place via the intestinal lymphatics in conjunction with the oil.

Administration, Oral

A study of peroxidase levels in human cervical mucus as an index of ovulation.

Fourteen healthy women were screened for the following parameters throughout one complete menstrual cycle: levels of urinary oestrogens and pregnanediol; levels of plasma and urinary gonadotrophins; and pH, protein content and levels of peroxidase in the cervical mucus. It was found that concentrations of peroxidase in the cervical mucus were not a reliable index of ovulation.

Cervix Mucus

Steroid sex hormones and prolactin in postmenopausal women with generalized mammary carcinoma during prolonged dexamethasone treatment.

The endocrine response to prolonged dexamethasone treatment was investigated in six postmenopausal women with generalized mammary carcinoma. Plasma cortisol levels decreased rapidly and became undetectable whereas significant concentrations of plasma dehydroepiandrosterone and androstenedione persisted throughout the study, even in two ovariectomized patients, indicating a certain degree of autonomy or a greater resistance of adrenal 'androgens' to the inhibition of ACTH secretion. Except in the ovariectomized patients, plasma testosterone did not fall significantly whereas the plasma oestrogens tended progressively towards undetectable concentrations. A similar response was found in six normal postmenopausal women although the disappearance of their oestrogens was relatively rapid. This indicates that much of the testosterone present after the menopause could still be produced by the ovaries whereas the ovarian production of oestrogens becomes negligible. The delayed disappearance of oestrogens in the patients with mammary carcinoma indicates that the persisting adrenal 'androgens' remained efficient precursors of oestrogen synthesis within the peripheral tissues and presumably within the mammary tumour itself. Plasma dihydrotestosterone behaved like the plasma oestrogens. Despite the fall in plasma oestrogens, plasma gonadotrophins did not increase further but plasma prolactin rose progressively. The persistance of steroid sex hormones and the rise of plasma prolactin might explain the poor response to dexamethasone treatment in mammary carcinoma.

Aged

Cyclic fluctuation in noradrenaline transmitter of the monkey oviduct.

Cyclic variations in noradrenaline of the sympathetic nerves ("short adrenergic neurons") innervating the smooth musculature of the oviduct have been determined by fluorescence histochemistry and fluorometric measurements in monkeys (Macaca mulatta). During the secretory phase there is more than twice as much neuronal noradrenaline in the oviduct compared with the proliferative phase. This suggests, that the system of adrenergic nerves in the primate oviduct is involved in the motility changes associated with alterations in the level of endogenous estrogen and progesterone during the menstrual cycle.

Animals

Mestranol.

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Animals

Premature ovarian failure.

Twelve cases of premature ovarian failure (POF) are described. The clinical, hormonal, histopathologic and cytogenetic studies of each patient have been presented. The scope and the limitations of laparoscopic ovarian biopsy are discussed, as is the importance of radioimmunoassay of follicle-stimulating and luteinizing hormones (FSH/LH) in comparison to ovarian biopsy for the diagnosis of premature ovarian failure. A plea is made for the early diagnosis of POF so that these young women can be spared the expensive and time-consuming treatment for the associated problem of infertility.

Adult