What is the influence of hormone therapy on homocysteine and crp levels in postmenopausal women?

OBJECTIVE: To evaluate the influence of estrogen therapy and estrogen-progestin therapy on homocysteine and C-reactive protein levels in postmenopausal women. METHODS: In total, 99 postmenopausal women were included in this double-blind, randomized clinical trial and divided into three groups: Group A used estrogen therapy alone (2.0 mg of 17β-estradiol), Group B received estrogen-progestin therapy (2.0 mg of 17 β-estradiol +1.0 mg of norethisterone acetate) and Group C received a placebo (control). The length of treatment was six months. Serum measurements of homocysteine and C-reactive protein were carried out prior to the onset of treatment and following six months of therapy. RESULTS: After six months of treatment, there was a 20.7% reduction in homocysteine levels and a 100.5% increase in C-reactive protein levels in the group of women who used estrogen therapy. With respect to the estrogen-progestin group, there was a 12.2% decrease in homocysteine levels and a 93.5% increase in C-reactive protein levels. CONCLUSION: Our data suggested that hormone therapy (unopposed estrogen or estrogen associated with progestin) may have a positive influence on decreasing cardiovascular risk due to a significant reduction in homocysteine levels. .

Efeitos do estradiol isolado e associado ao acetato de noritisterona sobre a rigidez arterial em mulheres hipertensas após a menopausa / Effects of estradiol isolated and combined with norethisterone acetate on the arterial stiffness in hypertensive postmenopausal women

Muitas investigações relatam maior prevalência na Doença Cardiovacular (DCV), no período após a menopausa, e dentre as DCV está a hipertensão arterial (HA). O aumento crônico da pressão arterial e as flutuações nas concentrações séricas dos estrogênios exercem importante impacto sobre a parede arterial resultando em perturbação, na elasticidade e rigidez arterial (RA). Por isso, avaliou-se a rigidez arterial, em 45 mulheres hipertensas após menopausa / High prevalence of Cardiovascular Disease (CVD) has been frequently reported in postmenopausal women, among the CVDs is the arterial hypertension. It is well know that chronic high arterial pressure (AP) and the fluctuation in estrogen serum levels exert a critical impact on the arterial wall, resulting in disturbances in elasticity and stiffness. Therefore, the goal of this study was to evaluate the arterial stiffness (AS) ,in 45 hypertensive postmenopausal women...

Clinical effects of 17 beta-estradiol and norethisterone acetate in postmenopausal Thai women.

OBJECTIVE: To compare the climacteric symptoms, the bleeding patterns, side effects, endometrial thickness, serum follicular stimulating hormone (FSH) and estradiol level in postmenopause Thai women who received this drug and placebo. STUDY DESIGN: Double blind, randomized placebo controlled trial. MATERIAL AND METHOD: Sixty postmenopausal women attending the menopause clinic at Chulalongkorn Hospital from July, 1996 to December, 1996, were enrolled in the study. The patients were randomized to receive the placebo or drug (17 beta-estradiol 2 mg and norethisterone acetate 1 mg) continuously. After 12 months, 13 patients in the drug group were switched to have placebo and 13 patients in the placebo were switched to the drug group. Recording of patient characteristics, physical and gynecologic examination, pap smear, breast examination and mammogram, climacteric symptom scores, transvaginal ultrasonography, serum FSH and Estradiol level were performed prior to the study. Physical examinations, breast palpitations, measurement of body weight and blood pressure, climacteric symptom scores and side effects were repeated at 3, 6, 12, 18 months. Gynecologic examination, pap smear, serum FSH and estradiol, transvaginal ultrasonography, were repeated at 12 months. RESULTS: The women in the drug group had fewer climacteric symptoms than baseline after 6 months. The incidence of amenorrhea was 74.0 per cent at 12 months. The incidence of abnormal uterine bleeding (spotting and breakthrough bleeding) was 37.0 per cent at 3 months, 29.6 per cent at 6 months, 25.9 per cent at 12 months and 7.1 per cent at 18 months. The women in the drug group had fewer climacteric symptoms than baseline after 6 months. Breast tenderness was the most common side effect. The endometrial thickness decreased significantly in the drug group. Serum FSH decreased and serum estradiol increased significantly in the drug group. CONCLUSION: This combined regimen was more effective in relieving the climacteric symptoms in women who used the drug than those who used the placebo. There was a high incidence of amennorhoea after 12 months. But there was also a high frequency of abnormal bleeding in the first 3 months of treatment. Counseling on the bleeding pattern and common side effects should be conducted before starting the treatment to increase the compliance. This combined regimen proved to be a useful alternative for postmenopausal Thai women who prefer to avoid cyclic bleeding from sequential therapy.

Inhibición del desarrollo embrionario por la 5Ó-Noretisterona / Embryo development inhibition by 5Ó-Norethisterone

Introducción. La 5Ó-Noretisterona (5Ó-NET) es un metabolito sintético que tiene alta afinidad por el receptor de progesterona e inhibe la acción de este esteroide natural. En conejas gestantes se demostró que la administración de este compuesto durante los primeros días post-coito inhibe tanto la implantación del ovocito como la actividad del Factor de Embarazo Temprano (FET), dicho factor es producido por el ovocito una vez que se ha llevado a cabo la fertilización. Sin embargo, en éstos trabajos no desmuestran si este compuesto ejerce acciones deletéreas sobre el ovocito en desarrollo, previas a la implantación. Objetivo. Analizar el efecto in vitro e in vivo de 5Ó-NET sobre el desarrollo del ovocito desde la etapa post-fertilización hasta la formación de la mórula. Material y métodos. Los gametos fueron obtenidos de ratones hembras de la cepa Balb/C y de machos C57BL/6J. La fertilización se llevó a cabo tanto in vitro como in vivo utilizando técnicas previamente descritas, con algunas modificaicones. Una vez que se observó la formación de los cuerpos polares, se inició la administración de 5Ó-NET a diferentes dosis al medio de cultivo y se incubaron a 37ºC, 5 por ciento CO2 y 95 por ciento aire. Los cambios en la estructura y morfología fueron analizados a diferentes tiempos de incubación por microscopio de luz (400x). Un total de 153 ovocitos fueron analizados en el modelo in vivo y de 142 en los experimentos in vitro. En ambos casos el análisis estadístico se hizo mediante la prueba de x2 con Ó=0.05. Resultados. El análisis estadístico en ambos modelos muestra que la presencia de 5Ó-NET en el medio de cultivo ejerce efectos deletéreos sobre el desarrollo y morfología de los ovocitos fertilizados, reflejándose en la destrucción de los blastómeros y la aparición de granulaciones en su interior

Effect of intramuscular norethisterone enanthate on compensatory ovarian hypertrophy in the rat.

Norethisterone enanthate (N.E.) administered in repeated intramuscular doses was found to bring about by and large a dose-related inhibition of compensatory ovarian hypertrophy (COH) which follows after the surgical removal of one ovary in adult rats. The relative inhibition in the responsiveness of the remaining ovary to compensatory gonadotrophic stimulation leading to the COH was of the order of 14.2, 19.0, 26.3, 25.0 and 42.0% with 0.25, 0.50, 1.0, 2.0 and 4.0 mg doses of N.E., respectively. The ED50 was calculated to be of the order of 7.0 mg. There was no effect of the treatment on the weight of the pituitary at any dose, whatsoever. However, the treatment was found to induce a significant increase in the weight of the uterus and the adrenals at higher doses (2.0 and 4.0 mg). The possibility of delineating the antigonadotrophic activity of activity of 'N.E.' from its contraceptive potential, vis-a-vis the dose employed, is discussed.

Long-term regulation of male fertility by norethisterone enanthate 'epididymal' implants: effect on libido and fertility of rabbits.

Bilateral insertion of silastic capsules releasing 38-44 micrograms norethisterone enanthate/24 h into the epididymal fat-pads was found to induce complete azoospermia leading to infertility in adult male rabbits 8 weeks after insertion of the progestin implants. The treatment did not exert any inhibitory effects on the libido and sexual behaviour of the animals as judged by objective parameters of mating. Further, the failure of the hormone-releasing implants was not found to exert any adverse effects on the embryos and pregnancy as indicated by the delivery of normal pups to females mated with implant-bearing males 3 weeks after the insertion of 'epididymal' implants.

Effect of chronic local administration of norethisterone enanthate on the testes of adult rat.

Silastic implants containing crystalline Norethisterone Enanthate (NE) inserted into the epididymal fat-pads unilaterally were found to bring about a drastic reduction (P smaller than 0.01) in the size and weight of the testis six weeks after implant insertion on the side bearing the progestin implant. The ipsilateral (treated side) testis, caput and cauda epididymis and the vas deferens showed either a complete absence of spermatozoa or occasional few immotile and decapitated sperms. In contrast, the smears obtained from the contralateral testis and the corresponding epididymal segments and the vas showed a population of entirely normal and motile spermatozoa. There was apparently no effect on the epididymis as the ipsilateral epididymis was almost similar (weight-wise) to that of the contralateral side. The results suggested an apparently local effect of NE implants inserted into the epididymal fat pads. The feasibility of the approach for long-term fertility regulation in males is discussed.

Further study on the effect of norethisterone enanthate, an injectable contraceptive on body functions.

One hundred and fortythree healthy Bengali women have received norethisterone enanthate, as injectable contraceptive in doses of 200 mg. intramuscularly at intervals of 10 to 12 weeks. The drug have been found to be almost 100 percent effective in the control of fertility. Menstrual disturbance, e.g. amenorrhoea, irregular bleeding and spotting, appeared to be the main complaints of the clients during the initial period of the therapy; but these did not persist long. There was no ill effect of the drug on lactation. No significant change in body weight, blood pressure, platelet count, fasting blood sugar, serum cholesterol and total plasma protein level was observed following administration of norethisterone enanthate over one year.

Experience with norethisterone enanthate as injectable contraceptive.

Norethisterone Enanthate (NE) was used in 151 women as injectable contraceptive. Pregnancy due to method failure was 2% whereas the overall pregnancy was 4%. The results have been discussed.