Cambios histológicos del tracto genital y riesgo de malignidad, en hombres transgénero sometidos a tratamiento androgénico / Histological changes of the genital tract and risk of malignancy in transgender men undergoing androgenic treatment

RESUMEN Introducción y objetivos: La identidad de género es la vivencia interna e individual del género tal como cada persona la siente. En algunos casos, la adquisición de los caracteres sexuales secundarios del otro género es importante en el proceso de reasignación de género, siendo importante el tratamiento endocrinológico. La cuestión es si la administración prolongada de andrógenos es segura en los casos de pacientes transexuales mujer a hombre, ya que es poca la evidencia científica a largo plazo. El objetivo de este estudio es analizar las características clínicas de los pacientes trans de nuestra unidad, y los hallazgos anatomopatológicos de las piezas quirúrgicas de histerectomía y doble anexectomía, para ver la influencia de la androgenoterapia en los genitales internos femeninos. Métodos: Se trata de un estudio descriptivo donde se analizaron datos demográficos y clínicos de los pacientes remitidos para cirugía genital, así como se analizaron los resultados del estudio anatomopatológico de las piezas de histerectomía y anexectomía. Resultados: Se incluyeron 66 pacientes, de los que 59 se intervinieron. No se halló malignidad en ninguna de las piezas quirúrgicas, sí diversos hallazgos benignos como miomas, atrofia/proliferación endometrial, actividad folicular en ovarios u ovarios tipo síndrome de ovario poliquístico. Conclusiones: La exposición a andrógenos a largo plazo no parece producir cambios malignos en la histología uterina ni ovárica, sin embargo, a menudo lleva a cambios en la actividad y la arquitectura ovárica, apreciándose en la mayoría de los casos ovarios funcionales e incluso semejantes a los observados en mujeres con ovario poliquístico.

ABSTRACT Introduction and objectives: Gender identity is the internal and individual experience of the gender as each person feels it. In some cases, the acquisition of secondary sexual characteristics of the other gender is important in the process of gender reassignment, with endocrinological treatment being important. The question is whether prolonged administration of androgens is safe in cases of transsexual women to men, since there is little scientific evidence in the long term. The aim of this study is to analyze the clinical characteristics of trans patients in our unit, and the anatomopathological findings of the surgical pieces of hysterectomy and double adnexectomy, to see the influence of androgen therapy on the female internal genitalia. Methods: This is a descriptive study where demographic and clinical data of the patients referred for genital surgery were analyzed, as well as the results of the anatomopathological study of the hysterectomy and adnexectomy pieces were analyzed. Results: 66 patients were included, of which 59 were intervened. No malignancy was found in any of the surgical pieces, but several benign findings such as myomas, endometrial atrophy / proliferation, follicular activity in ovaries or ovaries like polycystic ovary syndrome. Conclusions: Long-term exposure to androgens does not seem to produce malignant changes in uterine or ovarian histology, however, it often leads to changes in ovarian activity and architecture, with functional ovaries being seen in most cases and even similar ones. those observed in women with polycystic ovary.

Isoflavones in gynecology

SUMMARY

Effects on the female reproductive system of air pollution produced by the use of wood combustion for residential heating: challenges and perspectives of morphological studies / Efectos sobre el sistema reproductivo femenino de la contaminación del aire producido por el uso de la combustión de madera para calefacción residencial: retos y perspectivas de los estudios morfológicos

Previous studies have shown that air pollution affects cardio-respiratory function, but its role regarding reproductive processes is unknown. There are few experimental background studies on its effects on the morpho-function in the reproductive system. The use of wood combustion for residential heating (WCRH) in the cities of south-central Chile has increased significantly. As a result, it has become a source of significant emissions of particulate matter suspended (PM) in the air. The possible association between exposure to PM and reproductive problems has been suggested only on the basis of epidemiological studies, most of them carried out in environments where the main source of PM emission is the combustion of oil by motorized vehicles and industries, ignoring the effects produced by the smoke of WCRH. For example, in the city of Temuco-Padre Las Casas, Chile, 93 % of PM emissions correspond to WCRH smoke, thus being considered an urban area with a single PM emission source and the factors that contribute to this type of contamination are reasonably representative of most of the cities in south-central Chile. We therefore suggest this as an adequate setting to evaluate the real effect of the environmental contamination produced by the smoke of WCRH in the reproductive system. The limited number of studies reported on the effects of this type of emission on the female reproductive system, present a challenge for the morphological sciences and also for those who make decisions that affect public health.

Estudios previos han demostrado que la polución del aire afecta la función cardio-respiratoria, pero el rol que tiene ésta respecto a los procesos reproductivos es desconocida. Existen escasos antecedentes experimentales sobre sus efectos sobre la morfo-función en el sistema reproductivo. El uso de la combustión de madera para calefacción residencial (WCRH) en las ciudades del centro-sur de Chile ha aumentado significativamente. Como resultado, se ha convertido en una fuente de emisión importante de material particulado en suspensión (PM) en el aire ambiental. La posible asociación entre exposición a PM y problemas reproductivos ha sido sugerida solo en base a estudios epidemiológicos, la mayoría de ellos realizados en ambientes donde la principal fuente de emisión de PM es la combustión del petróleo por vehículos motorizados e industrias, ignorando los efectos producidos por el humo de WCRH. Por ejemplo, en la ciudad de Temuco-Padre Las Casas, Chile, el 93 % de las emisiones de PM corresponden al humo de WCRH, por lo tanto, es considerada como un área urbana con una fuente de emisión de PM única y los factores que contribuyen a este tipo de contaminación son razonablemente representativos a la mayoría de las ciudades en el centro-sur de Chile, lo que permite sugerirla como un ambiente adecuado para evaluar el efecto de la contaminación ambiental producida por el humo de la WCRH en el sistema reproductivo. Los escasos estudios reportados sobre los efectos de este tipo de emisión sobre el sistema reproductivo femenino constituyen un desafío no tan solo para las ciencias morfológicas, sino que además, para quienes toman decisiones que afectan la salud pública.

Histopathological and immunohistochemical changes induced by Bisphenol A in reproductive tissues of female rat

Background: Bisphenol A [BPA] is an environmental chemical that has been widely used in the manufacture of polycarbonate plastics and epoxy resins for many years. Due to its major applications in the production of plastic food or beverage containers and the coating of food cans, people of different ages are inevitably exposed to BPA in daily life. It is a contaminant with increasing exposure to it and exerts both toxic and estrogenic effects on mammalian cells

Aim of the work: the present study was designated to evaluate the histopathological and immunohistochemical effect of BPA on the histoarchitecture of pituitary ,adrenal, ovarian and uterine axis of female albino rats and the ameliorative effect of antiestrogen drug and stem enhance

Experimental model and methods: 20 female albino rats weighing 100 - 120 g. were kept under observation for about 15 days before the onset of the experiment for adaptation, then the rats were classified into 4 groups 5 rats for each , the first group was left without any treatment for 30 days as negative control group , the second group was administered with 20 mg/kg.bw of BPA for 15 consecutive days as positive control, the third group administered with 20 mg/kg.bw of BPA for 15 consecutive days and then treated with antiestrogen drug as 0.1 mg/100gm.bw for 15 day, the fourth group administered with the same dose for the same period and the treated with stem enhance [4.5 mg/100.bw] for 15 days. All rats are scarified and organs were histologically examined after processing

Results: The results showed that PA has a histopathological effects on vital organs [pituitary, adrenal, ovary, oviduct and uterus] even for a short period with minimal ameliorative effect of antiestrogen drug and stem enhance

Comparing the effects of continuous hormone replacement therapy and tibolone on the genital tract of menopausal women; a randomized controlled trial

Many postmenopausal women who are on hormone replacement therapy discontinue medications due to vaginal bleeding. Tibolone, a synthetic steroid, has minimal stimulatory effect on the endometrium. The aim of this study was to assess the effects of continuous HRT regimen and tibolone on the onset of vaginal bleeding and vaginal maturation value. A total of 150 healthy women in postmenopausal period were randomly enrolled in this controlled clinical trial. Patients were randomly allocated into three groups, and were followed for six months. The first 50 women received 2.5 mg tibolone plus a Cal+D tablet [500 mg Calcium and 200 IU vitamin D] daily, the second 50 women received 0.625 mg conjugated equine estrogen and 2.5 mg medroxyprogesterone acetate [CEE/MPA] plus one Cal+D tablet daily, and the remaining 50 received only one Cal+D tablet per day and served as the control group. Symptoms were recorded using a questionnaire that assessed vaginal bleeding or spotting, vaginal dryness and intention to continue the medications. Vaginal maturation value was assessed by examining vaginal smears before and after the treatment. The results for the three groups were analyzed using statistical methods. In comparison with the control group, CEE/MPA and tibolone increased vaginal maturation value and decreased the frequency of vaginal dryness [p, 0.01]. Women in tibolone group were more likely to continue the treatment regimen than those in the CEE/MPA or the control groups [p<0.01]. Tibolone can serve as an appropriate choice for HRT as it has low rates of vaginal bleeding/ spotting episodes and high acceptance rate in postmenopausal women

Effect of cigarette smoke on body weight, food intake and reproductive organs in adult albino rats.

One hour daily exposure to cigarette smoke for two months significantly decreased the body weight and food intake in male and female albino rats. The latency for conception increased significantly and the litter size decreased. Mortality rate per litter increased and grayish discoloration of the skin in the experimental group was the only congenital anomaly seen. Testes and ovaries showed a significant decrease in weight. The stroma of the ovaries were occupied by very few Graafian follicles. Testes showed disruption of the normal orderly progression of the spermatogonia. The tubules showed only one layer of spermatogonia and very few germinal cells. The number of sperms was less in the testes. The results show that exposure to cigarette smoke is detrimental to the reproductivity in both, male and female albino rats.

Estrogenic effect of orthopedic DDT on the female genital organs of mice

Insecticide DDT [an organochlorine compound] has been used excessively and widely all over the world. It was shown that orthopedic DDT [o-p'-DDT] a major constituent of technical grade preparation of the pesticide- DDT exhibited estrogenic activity in several animals species [Welch et al., 1969 and Bitman et al., 1968]. The aim of this work is to study the estrogenic effects of o-p'-DDT on the female reproductive organs [ovary, uterus and vagina] of mice in its neonatal period. In this study fifty of newly-born female mice were used and divided into five groups; three groups of them were received ten intraperitoneal injections of o-p'- DDT in doses of 0.25, 0.5 and 1mg/injection. The study included two control groups, the first one was injected with 10 ugm estrogen for 10 injections and considered as positive control, while the second group injected with sesame oil only. The animals were scarified 2 days after the last injection. Paraffin and frozen sections were prepared for both histological and histochemical studies. Different staining techniques were used including Hx., E., modified gomori stain for alkaline phosphatase enzyme, methyl green pyronin for RNA and PAS stain for glycogen content. The results showed a distinct increase in number and size of ovarian growing follicles in those animals treated with o-p'-DDT, also, increased activity of the alkaline phosphatase enzyme, as well as increased content of RNA and glycogen was noticed. The effect of o-p'-DDT on the uterine structure were in the form of hypertrophy of the endometrial epithelium, also increase in number of uterine glands. Marked increase in the activity of alkaline phosphatase enzyme and also in RNA content as well as glycogen deposition. It was noticed also that high dose of o-p'-DDT leads to accelerated development of the vaginal epithelium with evidence of keratinization. The histochemical changes in the vagina were similar to those obtained in the uterus. It can be finally concluded that the obtained results after use of o-p'-DDT were similar to those obtained by estrogen, and this may interfere with implantation of ova and pregnancy

Efeitos da metoclopramida sobre o aparelho genital de ratas virgens / Metoclopramide effects on female rats genital system

A metoclopramida é considerada um antagonista da dopamina. Uma vez que a dopamina inibe a liberaçäo de prolactina pela hipófise anterior é de se esperar que o uso da metoclopramida leve a um aumento dos níveis séricos de prolactina. O seu uso por longos períodos levaria ao aumento do volume das mamas, galactorréia e distúrbios menstruais. Procurando investigar os efeitos desta substânvia sobre os órgäos genitais femininos, utilizaram-se 30 ratos, fêmeas virgens, Wistar-Tecpar, com idade entre 83 e 90 dias e peso variando de 160 a 249 gramas, divididos em dois grupos de 15 animais cada. O grupo experimento recebeu metoclopramida na dose de 10mg/dia por via intraperitoneal e o grupo controle, soluçäo fisiológica de mesmo volume. As aferiçöes foram realizadas no oitavo, décimo sexto e vigésimo quarto dias, quando eram analisados: mamas, ovários e útero. Pode-se constatar que as glândulas mamárias apresentavam-se bem desenvolvidas nos animais com 16 e 24 dias de medicaçäo (p16 = 0,001 e p24 = 0,0003), mostrando maior concentraçäo de alvéolos e ductos. Estes continham secreçäo no seu interior, porém näo houve diferença significante entre os dois grupos. No ovário observou-se a predominância de folículos secundários e o útero mostrou endométrio com características proliferativa em todos os períodos estudados em ambos os grupos. Estes dados sugerem que a metoclopramida atua sobre a glândula mamária estimulando seu desenvolvimento, porém näo se pode constatar influência significante sobre o ovário e útero com esta dose, via de administraçäo e tempo de administraçäo, em ratas virgens

Efeitos do gossypol sobre o aparelho reprodutor feminino / Effects of gossypol on the female reproductive system

Sobre o sistema reprodutor feminino observaram-se os seguintes efeitos do Gossypol: 1) alteraçöes discretas sobre a secreçäo hormonal ovariana; 2) alteraçöes do muco cervical e espermicida efetivo, quando usado por via intravaginal; 3) inibiçäo da implantaçäo, e da reaçäo decidual, em ratas

Mechanism of acti on of chronically administered cannabis extract on the female genital tract of gerbils Meriones hurrianae.

Daily administration of cannabis extract (2.5 mg/day for a period of 60 days) caused degenerative changes in the ovarian tissue. Luteinization was inhibited. Corpus-luteum degeneration was conspicuous. Distinct effects were produced upon the uterine biochemistry, consisting of decreased RNA, protein, sialic acid and glycogen concentration of the uterus. Vaginal RNA and protein contents were low. An anti-estrogenic action of cannabis extract in female gerbils is suggested.