[Short-term effect of an estroprogestin containing ethinylestradiol 20 mcg + drospirenone 3 mg in 24+4 regimen at hormonal and cutaneous level in ovarian hyperandrogenism]. / Effecto a breve termine di un estroprogestinico contenente etinilestradiolo 20 mcg+drospirenone 3mg in schema 24 + 4 a livello ormonale e cutaneo nell'iperandrogenismo ovarico.

AIM: evaluate the efficacy of an estroprogestin EP containing 20 mcg ethinilestradiol (EE) and 3 mg drospirenone (DRSP) in the treatment of hyperandrogenism. METHODS: In this study, twenty hyperandrogenic patients were treated with an EP containing EE 20 mcg and DRSP 3 mg in 24+4 regimen for three months. Skin evaluation was performed both quantitatively and qualitatively. RESULTS AND CONCLUSION: This EP combination showed, after a short-term treatment (three months) to decrease significantly seborrhea, acne, and circulating androgens (testosterone, deidroepiandrosterone sulphate, and androstenedione), while increased sex hormone binding globulin levels. Moreover, this EE 20 mcg/DRSP 3mg EP combination changed some parameters of skin quality, increasing corneometry (a parameter related to skin hydration), and reduced trans epidermal water loss (TEWL, a parameter related to skin evaporation), and erythema (a parameter related to skin inflammation). These results could be taken into account in individualizing the treatment of hyperandrogenic patients.

[Effect on skin and hormonal hyperandrogenic manifestations of an oral estroprogestin association containing ethynilestradiol 30 mg and drospirenone 3 mg]. / Effetto sulle manifestazioni iperandrogeniche a livello cutaneo ed ormonale dell'associazione orale estroprogestinica contenente Etinilestradiolo 30 mg e Drospirenone 3 mg.

AIM: This study evaluated hormonal and skin effects in hyperandrogenic women of an oral estroprogestin (EP) association containing ethynilestradiol 30 mcg plus drospirenone 3 mg. METHODS: Thirty two women with signs and symptoms of hyperandrogenism (seborrhea, acne, increased hair); hormonal assessment (follicle-stimulating hormone, [FSH]; luteinizing hormone, LH; 17-hydroxi-progesterone, 17OHP; androstenedione, A, testosterone, T; dehydroepiandrosterone sulfate, DHEAS; sex hormone binding globulin, [SHBG]; Free Androgen Index [FAI, Tx100/SHBG] was performed before the start of treatment, and after 3 and 6 months of administration of EP. The impact on seborrhea, acne, and hair pattern (Ferriman-Gallwey score) was assessed, and, by non-invasive technique, hydration, water transpiration, and homogeneity of the skin were evaluated. RESULTS: Treatment with this EP for 6 months decreased significantly circulating androgen levels (A, T, DHEAS) and FAI, and increased SHBG levels, also reducing seborrhea, acne and hirsutism. Moreover, EE/DRSP increased hydration and improved overall appearance of skin surface (homogeneity). CONCLUSION: Treatment with EE 30 mcg+DRSP 3 mg improves hormonal pattern and skin appearance in hyperandrogenic patients, potentially with subsequent, beneficial effects on quality of life of these women.

[Duloxetine in the treatment of urinary incontinence in women]. / L'uso della Duloxetina nel trattamento dell'incontinenza urinaria da sforzo femminile.

Urinary incontinence is a disease able to decrease the quality of life of affected women. It shows a prevalence of about 35% among adult women. Pharmacological treatment can be used when pelvic floor muscle training has failed or when it could be better to postpone or avoid surgery. Duloxetine, a selective serotonin and noradrenaline reuptake inhibitor (SNRI), can act effectively in treating stress urinary incontinence.

Clinical trial of a monophasic estroprogestin oral formulation containing 20 micrograms ethinyl estradiol and 75 micrograms gestodene.

The attempt to decrease the hormonal components of combined estrogen/progestin-containing oral formulations has led to use of low-dose formulations. The monophasic formulation containing ethinyl estradiol 20 micrograms (EE20) plus gestodene 75 micrograms (GSD75) was studied in an open, non-comparative, multicenter, clinical trial investigating its efficacy, safety, effects on body weight, blood pressure and sexual function. To evaluate the impact on sexual function, the Golombok Rust Questionnaire on Sexual Satisfaction (GRISS) was used. The study population comprised 216 women treated for 1 year. The EE20/GSD75 formulation did not show any significant effect on blood pressure, hematological parameters, body weight or sexual function. The treatment was well tolerated with a high compliance rate by the patients, with a low rate of estrogen-dependent symptoms. Moreover, there was no overall effect on sexual function, with no disturbance of sexual behavior or activity. In conclusion, our data show that the EE20/GSD75 has a very good tolerability profile, without any significant side-effects.

Body composition and androgen pattern in the early period of postmenopause.

Body composition is related to age, genetic factors, and hormonal patterns throughout life, Peak bone mass seems to be an important protective factor against osteoporosis, although diet and life-style (smoking, physical activity) are able to influence bone mass. While it is well known that estrogens exert a protective action against bone loss in postmenopausal women, the role of androgens is still not clear. Twenty-five women in the early postmenopausal period (age: 52.8 +/- 5.1 years) were measured by dual-energy x-ray absorptiometry (DXA) to assess the relationship between body composition (fat mass and lean mass), bone mineral content (BMC), bone mineral density (BMD) and androgen pattern. Waist/hip ratio was used to divide the study population in three groups: gynecoid (gluteo-femural fat distribution), android abdominal fat distribution), and intermediate. In all subjects an inverse significant correlations between estradiol and fat mass was found. In the abdominal fat distribution group significant correlations between estradiol and weight (inversely correlated), androstenedione and BMD, learn mass an BMC were found. The data show the important role of androgens (androstenedione, particularly) and lean body mass on the BMD and BMC, respectively, in the early period of postmenopause.