Actions of progesterone on depression-like behavior in a model of surgical menopause are mediated by GABAA receptors / Las acciones de progesterona sobre la conducta tipo depresión en un modelo de menopausia quirúrgica son mediadas por receptores GABAA

Abstract Introduction In rats, long-term ovariectomy results in low concentrations of steroid hormones and reproduces anxiety- and depression-like behavior after surgical menopause in women. Progesterone produces antidepressant-like effects two weeks post-ovariectomy (i.e., early post-ovariectomy) through actions on γ-aminobutyric acid-A (GABAA) receptors, but its antidepressant-like effects and mechanism of action in rats eight weeks post-ovariectomy (i.e., late post-ovariectomy, considered a model of surgical menopause) remain unknown. Objective To explore the antidepressant-like effects of progesterone and the participation of GABAA receptors in rats eight weeks post-ovariectomy. Method Long-term ovariectomized female Wistar rats were treated sub-acutely with vehicle or progesterone (.5, 1, and 2 mg/kg) and subjected to the open field and forced swim tests, and behavior was compared with cycling or fluoxetine-treated rats. The rats were then pretreated with picrotoxin (1 mg/kg) followed by progesterone (1 mg/kg) to explore the role of GABAA receptors in long-term-induced depression-like behavior. Results Long-term ovariectomized rats exhibited depression-like behavior in the forced swim test compared with intact rats, an effect that was not observed in progesterone- and fluoxetine-treated long-term ovariectomized rats. These effects were not attributable to psychomotor alterations. In the open field test, the time spent rearing and grooming was lower in ovariectomized rats compared with intact rats, which was not observed in progesterone- and fluoxetine-treated rats. Picrotoxin blocked the effects of progesterone in both behavioral tests. Discussion and conclusion These results indicated that sub-acute progesterone treatment reduced depression-like behavior through actions on GABAA receptors in a rat model of surgical menopause.

Resumen Introducción En la rata, la ovariectomía a largo plazo reproduce algunos síntomas de la menopausia quirúrgica, incluyendo la conducta de tipo depresiva. La progesterona produce efectos tipo antidepresivo en ratas con dos semanas de post-ovariectomía (post-ovariectomía temprana) con participación del receptor GABAA, pero se desconoce si este efecto y mecanismo de acción se mantiene en ratas con ocho semanas de post-ovariectomía (post-ovariectomía tardía considerada como un modelo de menopausia quirúrgica). Objetivo Evaluar el efecto tipo antidepresivo de la progesterona y la participación del receptor GABAA en ratas con ocho semanas de post-ovariectomía. Método Ratas con ocho semanas de post-ovariectomía fueron tratadas sub-agudamente con vehículo o progesterona (.5, 1, y 2 mg/kg) y comparadas con ratas intactas u ovariectomizadas tratadas con fluoxetina, evaluadas en campo abierto y nado forzado. Posteriormente, se identificó la participación del receptor GABAA en los efectos de progesterona (1 mg/kg) mediante el pretratamiento con picrotoxina (1 mg/kg). Resultados En nado forzado, la ovariectomía produjo conductas tipo depresión en comparación con las ratas intactas de la gónada, un efecto prevenido por la administración de progesterona y fluoxetina. En campo abierto, no hubo cambios significativos en la locomoción, pero la conducta vertical y el acicalamiento fueron bajos en las ratas ovariectomizadas respecto a las ratas intactas; lo cual fue prevenido por progesterona y fluoxetina. La picrotoxina bloqueó los efectos de la progesterona en ambas pruebas conductuales. Discusión y conclusión El tratamiento subagudo con progesterona reduce la conducta tipo depresión inducida en un modelo de menopausia quirúrgica con participación del receptor GABAA.

Effect of surgical menopause on serum lipid profile-a prospective study

Background:Menopause marks the onset of cessation of ovarian function which is associated with changes in cardiovascular risk factors especially an unfavourable change in lipid profile. This is more pronounced is perimenopausal females who have undergone total hysterectomy with bilateral sapingo oopherectomy. This study aimed at looking into the changes occurring in the lipid profile and other cardiovascular risk in patients who have underwent oopherectomy over a 3 months period.Methods: The study was conducted as a case control one. We studied 70 consecutive perimenopausal patients admitted in a tertiary care teaching medical college hospital in Kerala, South India who were admitted for hysterectomy and bilateral oopherectomy over a 1year period. The lipid profile and anthropometric measurement with blood pressure recording was done prior to surgery and the same patients were followed up after 3 months when the cardiovascular risk assessment and lipid profile estimation were repeated. Here, the cases acted as controls after the end of third month.Results: It was found that after the end of 3 months of surgical menopause there was no significant change in body mass index, waist hip ratio or systolic BP. However, the DBP was higher in patients after surgery (78.68�94 vs 83.31�.03, P <0.001). There was also statistically significant increase in total cholesterol (166.07�.22 vs 242.94�.65 [P<0.001]), TG (129.33�.16 vs 177.06�.57 P<0.001) and LDLc (107.83�.06 vs 166.73�.51 P>0.001). The HDLc was found to be 27% after 3 months of surgical menopause (59.31�22 vs 43.73� P>0.001.Conclusions: Thus, it was concluded that there was a significant unfavourable effects on lipid profile and diastolic blood pressure 3 months after surgical menopause

Study of Estradiol, Testosterone and DHEA-S Status in Women After Surgical Menopause.

Aims and Objectives : The study was done to assess the hormones namely Estradiol, Testosterone, and Dehydroepiandrosterone-sulphate (DHEAs) one day before operation and on ninth post-operative day following surgical menopause. Materials and Methods : This is a cross sectional observational study. The study was done amongst the thirty four women aged between 40-48 years with functioning uterus and at least one ovary, not using any exogenous hormone preparations affecting ovarian function for last three months and having at least one menstrual period in three previous months were included in this study. They had under gone hysterectomy with bilateral salpingooophorectomy due to non-ovarian pathology. Fasting venous blood samples were taken one day before operation and on ninth post-operative day of surgical menopause Serum concentration of estradiol, testosterone, and DHEAS were determined. Results : The circulating estradiol level decreased significantly (p = 0.043) from 161 pg/ml preoperatively to 108 pg/ml. on ninth post-operative day after surgical menopause. In spite of reduction in mean testosterone level from 0.11 ng/ml. to 0.09 ng/ml. following surgical menopause, which is statistically insignificant (p = 0.247).There was no significant difference between the serum DHEA-S level before and after surgical menopause. A significant positive correlation was observed between pre-operative circulatory levels of DHEA-S with that of estradiol while there was absence of any significant co-relations corelations between any of the other pairs of values. Conclusion : The circulating estradiol level decreased significantly on ninth day after surgical menopause and significant positive correlation between pre-operative circulatory levels of DHEA-S with that of estradiol, but there was no significant co-relation between post-operative circulating estradiol with that of DHEA-S. Testosterone did not show any significant relation with estradiol neither in pre-operative period nor in post-operative condition.

Respuesta sexual en mujeres posmenopáusicas / Sexual response in postmenopausal women

Comparar la respuesta sexual en mujeres posmenopáusicas según el tipo de menopausia presentada. Se estudiaron 120 pacientes divididas en dos grupos pareados, las cuales fueron valoradas mediante un cuestionario de 46 ítems a través de una escala de Lickert, validado mediante el juicio de expertos y el coeficiente Alfa-Cronbach (0.94). Maternidad Dr. Armando Castillo Plaza, Maracaibo. Durante la excitación, sus indicadores en las menopáusicas naturales se ubicaron en las categorías alta o moderada; mientras que en las histerectomizadas en moderada o baja. En el orgasmo, los indicadores analizados se encontraron en iguales categorías, salvo el indicador tipos de estimulación que resultó alto en las que presentaron menopausia natural y bajo en las quirúrgicas. Por su parte, en las fases de meseta y resolución los indicadores se mostraron en categorías similares. Existen diferencias significativas en las fases de excitación y orgasmo entre ambos grupos, reflejando en las mujeres que tuvieron una menopausia natural bienestar sexual, vida placentera y salud

To compare the sexual response in postmenopausal women according with the menopause type showed. One thousand twenty patients were studied, divided into two matched groups, which were assessed through a questionnaire comprising 46 items through a Lickert´s scale, validated by expert opinion and the Cronbach alpha coefficient (0.94). “Dr. Armando Castillo Plaza” Maternity Center, Maracaibo. During the arousal phase, all indicators were located in the high or moderate category in natural menopausal, while in the hysterectomized women were moderate or low. In the orgasm phase, analyzed indicators were in same categories, although stimulation type in natural menopausal women was high and low in the hysterectomized. Meanwhile, in plateau and resolution phases, the indicators were showed in similar categories. There are significant differences in arousal and orgasm phases between the two groups reflecting in the natural menopausal sexual wellness, pleasant life and health

¿Debemos seguir haciendo salpingoooforectomía como profilaxis de cáncer de ovario? / Should we continue prophylactic salpingo-oophorectomy for ovarian cancer?

Hasta hace algunos años en las mujeres sometidas a histerectomía por patología benigna, que tuvieran 45 o más años, se efectuaba de regla una salpingoooforectomía (SOB) bilateral, como prevención de cáncer de ovario. Esto está actualmente en discusión. Hay dos grandes estudios de cohortes poblacionales y un estudio prospectivo observacional que analizan los efectos adversos cardiovasculares y el cáncer de ovario en mujeres sometidas a SOB. Basados en estos análisis y otros datos de la literatura, se pueden plantear algunas conclusiones. En mujeres premenopáusicas y hasta los 50 años la conducta óptima es preservar los ovarios, entre 51 y 65 años no está claro que lo mejor sea extirparlos y en mayores de 65 aún no se ha probado efectos deletéreos a raíz de la intervención.

The age to perform prophylactic oophorectomy at the time of hysterectomy for benign conditions is being actually discussed. Two population based cohorts studies and one prospective observational study evaluate cardiovascular disease and ovarian cancer with a history of oophorectomy. Some conclusions can be drawn. Until 50 years or premenopausal women, ovarian conservation should be the norm, between 51 and 65 there are no clear indications for removal and in older than 65 no negative effects have been described.

A Study of Estrogen only Therapy and Estrogen Plus Androgen Combination Therapy in Surgical Menopause Patients / 대한불임학회지

OBJECTIVE: To evaluate the difference between estrogen only therapy and estrogen-androgen combination therapy in surgical menopause patients. MATERIALS AND METHOD: Surgical menopause patients received 0.625 mg conjugated equine estrogens or 0.625 mg conjugated equine estrogens plus 1.25 mg methyltestosterone for 2 years. Bone mineral density, menopausal symptoms, lipoprotein profiles were measured. RESULTS: Both groups showed increased bone mineral density. In the combination group, total cholesterol, high density lipoprotein cholesterol and triglycerides decreased. In the estrogen only group, low density lipoprotein cholesterol decreased but high density lipoprotein cholesterol increased significantly. In both groups, menopausal symptoms were much improved. Side effects were easily tolerated in both groups. CONSLUSIONS: Estrogen-androgen combination therapy had comparable benefits compared with estrogen only therapy.

A Study of Estrogen only Therapy and Estrogen Plus Androgen Combination Therapy in Surgical Menopause Patients / 대한불임학회지

OBJECTIVE: To evaluate the difference between estrogen only therapy and estrogen-androgen combination therapy in surgical menopause patients. MATERIALS AND METHOD: Surgical menopause patients received 0.625 mg conjugated equine estrogens or 0.625 mg conjugated equine estrogens plus 1.25 mg methyltestosterone for 2 years. Bone mineral density, menopausal symptoms, lipoprotein profiles were measured. RESULTS: Both groups showed increased bone mineral density. In the combination group, total cholesterol, high density lipoprotein cholesterol and triglycerides decreased. In the estrogen only group, low density lipoprotein cholesterol decreased but high density lipoprotein cholesterol increased significantly. In both groups, menopausal symptoms were much improved. Side effects were easily tolerated in both groups. CONSLUSIONS: Estrogen-androgen combination therapy had comparable benefits compared with estrogen only therapy.

Comparison of bone mineral density between surgical menopausal women and natural menopausal women / 대한산부인과학회잡지

OBJECTIVE: It is widely known that the menopausal complication in the surgical menopause is to proceed rather than that of natural menopause. But, it has not obviously been proven so far. In this study, we surveyed whether BMD between surgical and natural menopausal group, in terms of decrease of the BMD of the menopausal complication would have a difference. METHOD: By using dual energy X-ray absorptiometry, we compared 2nd-4th Lumbar spine BMD in 28 of surgical menopause with that of 187 of natural menopause. RESULT: There is no obvious distinction in FSH and estradiol concentration between two groups. Surgical and natural menopausal groups showed the BMD -1.046+/-0.175 g/cm2, -0.942+/-0.124 g/cm2, respectively. Also, there is no statistical significance. CONCLUSION: Although there is no statistical significance in the BMD of the surgical menopausal group was lower than that of the natural menopausal group. Prevention of the menopausal complication as well as decrease of the BMD in the surgical menopausal group needs to be required more active attitude.

The Clinical Change of Bone Mineral Density after Surgery and Hormone Replacement Therapy on Menopausal Woman / 대한산부인과학회잡지

The objective of this study is to compare bone mineral densities(BMD) between the symptomatic menopausal women and the asymptomatic menopausal women, between the spontaneous menopausal group and the surgical menopausal group, and especially between the HRT group and no-HRT group. From January, 1995 to December 1995, this study was prospectively analysed in 96 menopausal women(47 spontaneous menopausal women, 23 surgical nopausal women) who were admitted to Department of Obstetrics and Gynecology, Chosun University Hospital for HRT. The all women was measured T-score of bone mineral densities at L1, L2, L3 and L4 of lumbar spine and neck, trochanter, ward`s area of femur from dual-energy X-ray absorptiometry(DEXA). Student t-test and chi-squre test were used for statistical comparison. The results obtained were as follows: 1. The mean age of the osteoporotic group(54.96 +/- 6.6) is higher than the non-osteoporotic group(50.55 +/- 81). 2. No difference is detected in the BMD between the surgical menopausal group and the spontaneous menopausal group, because duration of the follow-up is too short and the study group is too small perhaps. 3. Descent of T-score in the symtomatic menopausal women is not severe than the asymptomatic group, but especially in L4 area, T-score of the symptomatic group(-1.76 +/- 1.3 < -1.04 +/- 1.4) is more decreased(p<0.04). 4. T-score between the long term HRT group and the no-HRT group is different markedly. HRT during only 1 year is not attributed to BMD loss. So the continuous HRT over 1 year and Follow-up is need to improvement of BMD in the menopausal women with risk factors.