Dehydroepiandrosterone sulphate plasma levels in normal women and patients with benign breast disease.

Dehydroepiandrosterone sulphate plasma levels were measured in patients with benign breast disease and in healthy women. In addition the adrenal secretion of dehydroepiandrosterone sulphate was assessed by means of an ACTH stimulation test in some patients and control subjects. The results obtained demonstrate that dehydroepiandrosterone sulphate plasma levels of patients with benign breast disease overlap those found in controls and that the adrenal response to ACTH of patients with breast pathology does not differ from that of healthy women.

Endocrine aspects of benign breast disease.

The purpose of this study was to determine the levels of dehydroepiandrosterone sulfate (DHAS) in the plasma of women with benign breast disease (BBD) and in normal subjects. Possible changes in DHAS plasma levels and in its adrenal secretion under adrenocorticotrophin hormone (ACTH) were also investigated in women with BBD before and after bromocriptine therapy. Our results demonstrate that plasma levels of DHAS in women with BBD overlap with those found in controls. Prolactin (PRL) suppression in women with BBD receiving bromocriptine treatment was associated with a significant (p less than 0.02) decrease of baseline DHAS plasma levels and of stimulated ACTH response curve (p less than 0.02). These data suggest a possible relationship between PRL and DHAS secretion in women with BBD.

Prolactin secretion and dehydroepiandrosterone sulphate plasma levels in women with benign breast disease.

The purpose of the present investigation was to verify possible positive correlations between prolactin secretion and dehydroepiandrosterone sulphate levels in plasma of women with benign breast disease. Prolactin secretion was evaluated in terms of basal levels, maximum peak, percent increase above baseline levels, total integrated area, response area after TRH stimulation. No correlation was found between the parameters of prolactin secretion and dehydroepiandrosterone sulphate levels.

Hormonal profile in benign breast disease. Endocrine status of cyclical mastalgia patients.

Plasma levels of prolactin, before and after TRH stimulation, progesterone, estradiol, sex-hormone-binding-globulin, androstenedione, testosterone and dehydroepiandrosterone-sulphate were determined in a group of women with benign breast disease and in control group, in order to correlate a possible hormonal disorder to breast pathology. The hormonal pattern in the patients with benign breast disease was characterized by an increased responsiveness of lactotrophes to TRH stimulation and by higher levels of sex hormone binding globulin, probably sustained by an underlying hyperestrogenism.

Bromocriptine for treatment of benign breast disease. A double-blind clinical trial versus placebo.

Over the last few years bromocriptine has been used for treatment of mastodynia and benign breast disease, but with contradictory results. This double-blind clinical trial was performed to determine the efficacy of this prolactin inhibitor as compared with placebo. Subjective discomfort, clinical examination of the breast lesions, echomammography and breast thermography were evaluated before, during and after 3 months of treatment and in a further follow-up. Plasma levels of estradiol, progesterone and prolactin were measured over the same time. Significant reduction of mastodynia and significant improvement of the breast lesions were observed in the group given bromocriptine, though echomammography and breast thermography did not reveal any significant differences between the two groups. Plasma prolactin levels were significantly reduced by bromocriptine administration.

Loss of circadian rhythms of fetal behaviour in a totally adrenalectomized pregnant woman.

Fetal heart rate and fetal movements were recorded over a 24-hour interval in a totally adrenalectomized pregnant woman at term. Cortisol, ACTH, unconjugated estriol and 17 beta-estradiol were contemporaneously measured every 2 h in the maternal peripheral plasma. Owing to the substitution therapy the patient showed a loss of circadian variations of all the hormones investigated. Moreover, the circadian rhythms of fetal heart rate and fetal movements, usually present at term, were no longer evident. We can thus suggest that the circadian variations of plasma maternal cortisol could affect the alternations of fetal behaviour.

Modifications of ultradian and circadian rhythms of fetal heart rate after fetal-maternal adrenal gland suppression: a double blind study.

In order to verify whether fetal and maternal adrenal gland suppression induces effects on fetal behaviour, triamcinolone was administered to five healthy pregnant women at 35 weeks of gestation. Five patients of the same gestational age were used as control. Fetal heart rate (FHR) and fetal movements were recorded continuously over 2-h interval by means of cardiotocography. After 3 weeks (38 weeks of gestation) the recordings were repeated without drug administration. Cortisol, adrenocorticotropin hormone, 17 beta-estradiol and unconjugated estriol were measured at the same time every 2 h in maternal peripheral plasma. At 35 weeks we found a loss of circadian rhythms of the hormones investigated and modifications of ultradian and circadian patterns of FHR in the treated group with respect to the control. No differences in hormonal and biophysical parameters were found between the two groups after the end of treatment (38 weeks). These data suggest that the inhibition of fetal and maternal adrenal glands could cause modifications of FHR patterns.

Ovarian and peripheral androgen and oestrogen levels in post-menopausal women: correlations with ovarian histology.

Ovarian and peripheral plasma levels of oestrone (E1), oestradiol (E2), androstenedione (A) and testosterone (T) were assayed in 58 post-menopausal women who underwent hysterectomy and oophorectomy (35 for endometrial carcinoma and 23 for benign gynaecological diseases). No significant difference between the two groups was seen when they were matched for percentage of ideal weight. However, significant differences were found between the ovarian and peripheral levels of the four steroids investigated. To facilitate analysis of the data, 40 of these women were classified into three groups (1, 2 and 3) according to degree of stromal hyperplasia of the ovary. Group 1 comprised those with atrophic ovaries, group 2 those with slight stromal hyperplasia and group 3 those with moderate or marked stromal hyperplasia. Ovarian levels of A and T were significantly higher than peripheral levels in all three groups, but the ovarian/peripheral oestrogen differences were significant only in groups 1 and 2. The ovarian steroid levels in group 3 were significantly higher than those in groups 1 and 2 in the cases of E1 (P less than 0.01), E2 (P less than 0.001) and A (P less than 0.001), but not in that of T. It was concluded that ovaries showing marked stromal hyperplasia can produce significant amounts not only of androgens but also of E2, and hence that any evaluation of the hormonal pattern in post-menopausal women must also take into account the microscopic characteristics of the ovary.

Corpus luteum function during the early puerperium.

Progesterone and 17 beta-estradiol peripheral plasma levels have been determined during labor and after 1, 3, 6, 12, 24, 48, 72, 96, 120 and 144 h from delivery in a group of 7 women, whose corpus luteum had been removed at delivery and in a corresponding control group with intact corpus luteum. In both groups the results indicate a progressive fall of progesterone and 17 beta-estradiol, that is evident until 144 h for progesterone and 72 h from 17 beta-estradiol. The analysis of the two groups with the Student's t test has shown significantly lower levels in the group of women, whose corpus luteum had been removed, at the 6th h (p less than 0.01), 12th h (p less than 0.02) and 24th h (p less than 0.05) for progesterone and at 3rd h (p less than 0.01) and 6th (p less than 0.01) for 17 beta-estradiol. The significant difference for progesterone appearing later than for 17 beta-estradiol could be due to the fact that progesterone is also dismissed by the adipose tissue, where it is stored. A further statistical elaboration of the results, carried out by calculating the regression line and the transfer function, confirmed the different pattern in time of progesterone and 17 beta-estradiol plasma levels after delivery in the two groups of patients considered.

Evaluation of the feto-placental function by means of intraamniotic administration of dehydroepiandrosterone-sulphate.

It is well known that in pregnancy dehydroepiandrosterone-sulphate (DHEAS) (90% synthetized by the fetal adrenals, 10% by the maternal ones) is converted into estrogens mainly in the placenta. In order to evaluate the steroid metabolizing capacity of the placental enzymatic complex under load conditions, a test was devised based upon a rapid introduction of 200 mg of DHEAS into the amniotic compartment during the third trimester of gestation. The purpose of the present investigation was to establish the clinical utility of such a test in comparison with the simple urinary estrogen determination test.