Exposing bovine cumulus-oocyte complexes to aromatizable androgen restore serum-induced low estradiol production in vitro.

We aimed in this study to assess whether serum-decreased bovine cumulus-oocyte complex (COC) steroidogenesis during in vitro maturation (IVM) is caused by deficient androgen milieu. For this approach, bovine COCs were cultured in serum-supplemented IVM medium in the presence or absence of 1 µM androstenedione. After 24 h of culture, medium was collected and analyzed for its content of estradiol-17ß (E2) and progesterone (P4). Medium E2 content markedly increased after incubation of COCs with androstenedione (17.52 ± 1.86 ng/ml to the androgen group; 0.32 ± 0.05 ng/ml to the non-androgen group). No significant difference in the P4 content was detected despite the presence of androstenedione (21.83 ± 1.61 ng/ml to the androgen group; 21.73 ± 1.67 ng/ml to the non-androgen group). Our data provide compelling evidence that bovine COCs steroidogenesis remains functional during culture in serum-supplemented medium and suggest that serum-induced decreased COCs estradiol secretion is caused by deficiency of an aromatizable androgen source.

Metabolic and cardiovascular impact of oral contraceptives in polycystic ovary syndrome.

Chronic anovulation, polycystic ovarian morphology and hyperandrogenism are the diagnostic criteria for polycystic ovary syndrome (PCOS). Metabolic disturbances are more common in PCOS women who are prone to develop metabolic syndrome and to present higher levels of some cardiovascular disease risk marker. Oral contraceptives are widely used in PCOS, but conflicting data have been reported regarding their impact on carbohydrate and lipid metabolism on PCOS women. This paper presents a critical evaluation of combined oral contraceptives (COCs) metabolic effect - carbohydrate metabolism and insulin sensitivity, lipid metabolism, haemostasis, body weight, arterial pressure and cardiovascular impact - on PCOS women. Because of the paucity of data on the impact of COCs on cardiovascular and metabolic parameters in PCOS patients, most of there commendations are based on studies involving ovulatory women. The use of low-dose COCs is preferable in PCOS, especially among patients with glucose intolerance, insulin resistance and uncomplicated diabetes mellitus. Although reported as a side effect of COCs, marked weight gain has not been confirmed among users. However, when arterial hypertension or elevated risk for thromboembolism is present, progestogen-only hormonal contraceptives should be used instead of COCs. Regarding dyslipidaemia, COCs reduce low-density lipoprotein and total cholesterol and elevate high-density lipoprotein and triglycerides, and therefore are not recommended for women with high triglycerides levels. The choice of a COC, which alleviates the PCOS-induced hyperandrogenism without significant negative impact on cardiovascular risk, is one of the greatest challenges faced by gynaecologists nowadays.

Parathyroid hormone secretion in women in late menopause submitted to EDTA-induced hypocalcemia.

OBJECTIVE: The physiological role of parathormone (PTH) in the maintenance of bone mass in humans has not been fully defined. The main objective of the present study was to evaluate basal and EDTA-stimulated PTH levels in young women (Group Y=30.9 years, N=7) and in women in late menopause (Group M=64.7 years, N=7) and their relationship to bone mineral density. METHODS: The PTH secretion test was performed by induction of hypocalcemia through intravenous administration of EDTA for 2h. Blood samples were collected every 10 min and used for ionic calcium and PTH measurements. During the basal period, an additional sample was collected for the determination of osteocalcin, FSH, and estradiol. A sample of early morning second voided urine was collected for analysis of deoxypiridinoline and creatinine as well as bone mass density (BMD) was determined by dual X-ray energy absorptiometry (DEXA). RESULTS: The aged patients presented lower femoral BMD (Y=0.860 g/cm(2) vs. M=0.690 g/cm(2), p<0.01), with four of them having a T score lower than -2.5 S.D. Basal, and during the EDTA infusion, PTH values were similar in both groups. However, among aged volunteers, the rise in PTH levels was higher for subjects with normal bone mass (NM: peak=236 pg/ml) than for subjects with osteoporosis (OM: peak=134.4 pg/ml). CONCLUSIONS: The present results suggest that PTH can have a modulating effect on the rate of bone loss during late menopause.

Comparison of fundamental voice frequency between menopausal women and women at menacme.

OBJECTIVE: To analyze comparatively the speaking fundamental frequency (F0) between women at menacme and women in the climacterium taking or not hormonal replacement therapy. METHODS: A controlled transverse study was conducted on 45 women divided into three groups of 15 women each: Group A (women aged 20-40 years with regular menstrual cycles taking no hormonal contraceptives), Group B (women aged 45-60 years with a duration of menopause of at least 2 years taking 1mg estradiol valerate +90 microg norgestimate per day in a continuous treatment scheme lasting at least 6 months), and Group C (women aged 45-60 years with a duration of menopause of at least 2 years taking no HRT for at least 6 months). The mean age for Groups A, B and C was 30.3, 54.5 and 56.5 years, respectively. The groups were analyzed comparatively regarding F0 values for the sustained vowels /e/ and /i/. RESULTS: Mean F0 for the sustained vowels /e/ and /i/ were 215.97 and 229.89 Hz, 206.21 and 221.79 Hz, 200.71 and 212.79 Hz for Groups A, B and C, respectively, with no significant differences between groups. CONCLUSIONS: Although there is evidence of a probable modulating effect of sex steroids on the larynx, in the present study no significant differences in speaking voice were observed regarding menopause or the use of HRT. The absence of such differences observed in F0 does not necessarily mean that there is no difference in vocal quality between these groups since F0 represents only a vocal parameter.

Eficácia e segurança de um novo sistema matricial para liberaçäo transdérmica de stradiol comparativamente ao sistema clássico de reservatório / An open, randomized assessment of the efficacy and safety of two transdermal estradiol patches for relief of climacteric symptoms

Estudo comparativo, aberto, randomizado, foi conduzido em 10 centros da América Latina (oito no Brasil, um na Argentina e um no Chile), para avaliar a eficácia e segurança de dois sistemas transdérmicos para liberação de estradiol. Um total de 182 pacientes foi aleatoriamente distribuído para receber o sistema matricial (Climaderm-Wyeth-Ayerst) ou sistema clássico do tipo reservatório (Estraderm TTS 50 - Ciba-Geigy). Os sistemas foram aplicados na região inferior do abdome em áreas alternadas, durante seis ciclos consecutivos de 28 dias. Os sistemas liberavam aproximadamente, 50gr de estradiol por dia. Em ambos os grupos houve, em relação ao pré-tratamento, decréscimo significativo do número diário de fogachos nos ciclos de um a seis, porém houve, em relação ao sistema matricial, melhora significativa nos ciclos 4 (p = 0,033) e 6 (p = 0,046). Houve também diferença significativa entre os grupos com relação à fraqueza nos ciclos 2 (p = 0,019) e 3 (p + 0,015), fadiga no ciclo 2 (p = 0,033), interrupções do sono no ciclo 6 (p + 0,048), nervosismo no ciclo 3 (p = 0,045) e escore total nos ciclos 2 (p = 0,030) e 3 (p = 0,041), a favor do sistema matricial e 18 ( 21,2 por cento) do grupo medicado com o sistema reservatório abandonaram o tratamento