Effects of estradiol and norethisterone on lipids, insulin resistance and carotid flow.

OBJECTIVES: To evaluate the lipid profile, insulin resistance and vasomotricity, and the interaction between these factors, in postmenopausal women receiving hormone therapy. METHODS: A prospective, randomized, double-blind study was carried out in which 77 postmenopausal women received one of the three treatment regimens: (A) 2mg oral micronized estradiol (E2) (n=25); (B) 2mg oral E2+1mg oral norethisterone acetate (NETA) (n=28); or C) placebo (n=24), daily for 6 months. Evaluations were carried out at baseline and at the end of treatment on lipid and lipoprotein profiles, homeostasis model assessment of insulin resistance (HOMA-IR) and pulsatility index (PI) of the internal carotid artery by Doppler ultrasonography. RESULTS: Mean increases of 15.6% and 2.4% and a reduction of 6.4% in high-density lipoprotein (HDL) levels were found for the E2, E2+NETA and placebo groups, respectively. Reductions of 9.5% and 3.7% and an increase of 12.1% in low-density lipoprotein (LDL), and reductions of 20.0% and 3.8% and an increase of 28.8% in the LDL:HDL ratio were found for the E2, E2+NETA and placebo groups, respectively (p<0.001 in all cases). Insulin levels and HOMA-IR decreased 12.8% and 12.3% in the E2 group and increased 12.9% and 16.0% in the E2+NETA group (p<0.05), respectively. Carotid PI following treatment was 1.18+/-0.23, 1.38+/-0.20 and 1.41+/-0.21 for the E2, E2+NETA and placebo groups, respectively (p=0.0006). CONCLUSIONS: Oral estrogen therapy led to an improvement in lipid profile, insulin resistance and carotid blood flow, which was cancelled when NETA was associated.

Síndrome da anovulação crônica hiperandrogênica e transtornos psíquicos / Hyperandrogenic chronic anovulation and psychologic disturbances

Os autores fazem uma revisão da síndrome dos ovários policísticos (SOP) com relação aos seus aspectos etiopatogênicos, clínicos, diagnósticos e terapêuticos, dando ênfase aos transtornos de ordem psíquica que freqüentemente acompanham esse distúrbiio. Tecem considerações sobre a importância não só de um efetivo tratamento médico, mas também de uma abordagem e um apoio psicológico, no sentido de melhorar ainda mais o bem-estar e a qualidade de vida dessas mulheres.

The authors have reviewed the main aspects of the polycystic ovary syndrome (PCOS) with respect to its etiopathogenic, clinical, diagnostic and therapeutic features, highlighting the psychological distresses that frequently arise in the syndrome. They also make considerations on the importance of an effective clinical treatment as well as on the approaches and psychological support, aiming to improve womenÆs well-being and quality of life.

Radicais livres e climatério / Free radicals and climacteric

Os autores atualizam os conhecimentos relativos aos radicais livres de oxigênio (RLO) como importantes mediadores da injúria celular, tecem consideraçöes a respeito da proteçäo cardiovascular exercida pelos estrogênios e do mecanismo da aterogênese, com ênfase para os aspectos fisiopatológicos da peroxidaçäo lipídica.

Progestogênios terapêutica de reposiçäo hormonal (TRH) no climatério / Progestogens therapeutic of hormonal replacement in climateric

Os autores tecem consideraçöes a respeito da utilizaçäo de progestogênios na TRH no climatério, salientando os riscos e benefícios. Por outro lado, expöem as doses terapêuticas recomendadas do vários progestogênios, assim como os esquemas de tratamento destes esteróides na TRH

Prolactinoma e gravidez: estudo evolutivo de 24 casos / Prolactinoma and pregnancy: a retrospective study of 24 cases

Säo estudados 24 casos da associaçäo de prolactinoma e gravidez, com estudo evolutivo da mesma no ciclo gravídico-puerpural. Tecem-se consideraçöes a respeito do comportamento dos tumores hipofisários na gestaçäo e comparam-se os resultados obtidos com os da literatura internacional. Propöe-se conduta nas pacientes portadoras de prolactinomas desejosas de gestaçäo, gestantes e puérperas