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James H Pickar, Matthieu Boucher, Diana Morgenstern
OBJECTIVE: This review describes historical development of selective estrogen receptor modulators (SERMs) and their combination with estrogens, termed a tissue selective estrogen complex (TSEC), and considers the potential for future TSEC development. METHODS: This narrative review is based on literature identified on PubMed and the TSEC research and development experience of the authors. RESULTS: SERMs have estrogenic and antiestrogenic effects in various tissues; however, no single agent has achieved an optimal balance of agonist and antagonist effects for the treatment of menopausal symptoms...
March 12, 2018: Menopause: the Journal of the North American Menopause Society
Paolo Vercellini, Laura Buggio, Maria Pina Frattaruolo, Alessandra Borghi, Dhouha Dridi, Edgardo Somigliana
Available medical treatments for symptomatic endometriosis act by inhibiting ovulation, reducing serum oestradiol levels, and suppressing uterine blood flows. For this, several drugs can be used with a similar magnitude of effect, in terms of pain relief, independently of the mechanism of action. Conversely, safety, tolerability, and cost differ. Medications for endometriosis can be categorized into low-cost drugs including oral contraceptives (OCs) and most progestogens, and high-cost drugs including dienogest and GnRH agonists...
February 15, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Katherine Ward, Angela Deneris
Menopause-related symptoms frequently lead women to seek health care. Recommendations for prescribing hormone therapy have changed significantly since the publication of initial results from the Women's Health Initiative (WHI) study in 2002. The North American Menopause Society and the American College of Obstetricians and Gynecologists have newer guidelines based on long-term analyses of the WHI participants as well as emerging data from other clinical trials. Women with an intact uterus who are using systemic estrogen must also use a progestogen; however, there are 2 new selective estrogen receptor modulators on the market for use without a progestogen...
March 9, 2018: Journal of Midwifery & Women's Health
Clare Minahan, Hailey O'Neill, Nelie Sikkema, Sarah Joyce, Brianna Larsen, Surendran Sabapathy
We sought to determine whether oral contraception alters the gender-related differences observed in the exercise pressor reflex during isometric handgrip exercise. Fifteen men, fifteen normally menstruating women (WomenNM), and fifteen women taking monophasic oral contraceptives (WomenOC) completed two trials of a 3-min isometric handgrip exercise protocol performed at 30% of their maximal voluntary contraction: (1) where arterial occlusion was applied to the previously exercising arm during a 3-min recovery period (Occlusion trial); (2) where no arterial occlusion was applied during recovery (Control trial)...
March 2018: Physiological Reports
Adolf E Schindler
This concise report deals with the known effects of progestogen lack in early pregnancy with failure of implantation and blood supply to the placenta depending on proper trophoblast invasion, spiral artery remodeling, and vessel dilatation. The pathophysiology of preeclampsia will be outlined and the most recent data on the effect of dydrogesterone presented. Dydrogesterone appears to be able to reduce significantly the development of preeclampsia. The effect is related to begin with such prevention and this should be continued until 37th weeks of gestation which would also mean prevention of premature labor...
March 6, 2018: Gynecological Endocrinology
Clinton G Lauritsen, Abigail L Chua, Stephanie J Nahas
PURPOSE OF REVIEW: Menopause is a life-changing event in numerous ways. Many women with migraine hold hope that the transition to the climacteric state will coincide with a cessation or improvement of migraine. This assumption is based mainly on common lay perceptions as well as assertions from many in the healthcare community. Unfortunately, evidence suggests this is far from the rule. Many women turn to a general practitioner or a headache specialist for prognosis and management. A natural instinct is to manipulate the offending agent, but in some cases, this approach backfires, or the concern for adverse events outweighs the desire for a therapeutic trial, and other strategies must be pursued...
March 6, 2018: Current Treatment Options in Neurology
Anton Pottegård, Anne Broe, Tore B Stage, Kim Brøsen, Jesper Hallas, Per Damkier
The antibiotic dicloxacillin has been shown to induce drug-metabolizing CYP enzymes to a clinically relevant extent. In the present study, we investigated whether use of dicloxacillin confers an increased risk of unwanted pregnancy among oral contraceptive users. The study population comprised Danish women falling pregnant (1997-2015) during oral contraceptive use, defined as having filled a prescription for an oral contraceptive within 120 days both before and after the estimated date of conception. Data were analysed using a case-cross-over approach...
March 5, 2018: Basic & Clinical Pharmacology & Toxicology
Per Kempe, Daniel Eklund, Agnes Hallin, Mats Hammar, Tomas Olsson, Jan Brynhildsen, Jan Ernerudh
To prospectively study systemic in vivo immunological effects of sex hormones, using different phases of oral combined hormonal contraceptives (CHC), and the natural menstrual cycles in both healthy women and in women with multiple sclerosis (MS), blood samples from sixty female MS patients and healthy controls with and without CHC were drawn in high and low estrogenic/progestogenic phases. Expression of Th-associated genes in blood cells was determined by qPCR and a panel of cytokines and chemokines was measured in plasma...
March 1, 2018: Journal of Reproductive Immunology
Xia Yang, Da-Ni Zhong, Hui Qin, Pei-Rong Wu, Kang-Lai Wei, Gang Chen, Rong-Quan He, Jin-Cai Zhong
Caspase-3 is a vital executioner molecule during the apoptotic process. Numerous studies have revealed the close association of caspase-3 expression and breast cancer. Nevertheless, the prognostic value of caspase-3 expression for patients with breast cancer remains uncertain. To thoroughly analyze the prognostic effect of caspase-3 expression on the clinicopathological features and survival of breast cancer, we conducted this meta-analysis. With various search strategies, electronic databases were comprehensively searched...
February 2, 2018: Oncotarget
Daniela Angerame Yela, Patricia Magda Soares, Cristina Laguna Benetti-Pinto
OBJECTIVE:  To evaluate the impact of sexual function (SF) in the quality of life (QoL) of women with premature ovarian insufficiency (POI). METHODS:  Case-control study in which 80 women with POI were evaluated using estrogen plus progestogen therapy, compared with 80 women matched by age (±2 years) and presenting preserved gonadal function. Sexual function was evaluated using the Female Sexual Function Index (FSFI), and the QoL was evaluated using the World Health Organization's (WHO) QoL assessment instrument (WHOQoL-BREF)...
February 2018: Revista Brasileira de Ginecologia e Obstetrícia
Jorge Román Corona-Rivera, Lucina Bobadilla-Morales, Alfredo Corona-Rivera, Christian Peña-Padilla, Sandra Olvera-Molina, Miriam A Orozco-Martín, Diana García-Cruz, Izabel M Ríos-Flores, Brian Gabriel Gómez-Rodríguez, Gemma Rivas-Soto, J Jesús Pérez-Molina
We determined the overall prevalence of typical orofacial clefts (OFCs) and the potential risks for nonsyndromic cleft lip with or without palate (NSCL±P) in a University Hospital from west México. For the prevalence, 227 live born infants with typical OFCs were included from a total of 81,193 births occurred during the period 2009 to 2016 at the 'Dr. Juan I. Menchaca' Civil Hospital of Guadalajara (Guadalajara, Jalisco, Mexico). To evaluate potential risks, a case-control study was conducted among 420 newborns, including only those 105 patients with NSCL±P (cases), and 315 infants without birth defects (controls)...
February 19, 2018: Congenital Anomalies
Julie G Thorne, Elizabeth H Russell, Danielle Rumbolt, Mary Anne Jamieson
BACKGROUND: Abdominal pain, secondary amenorrhea and abnormal uterine bleeding (AUB) are common gynecologic presentations in adolescence. Rarely this can be associated with an acquired hematometra. Hematometra is a condition of retained blood or clot within the uterus. High dose progestogenic agents in this age group have been implicated in the accumulation of a hematometra without other explanation. CASES: We present 4 cases of hematometra following depomedroxyprogesterone acetate (DMPA) therapy in previously menstruating adolescents...
February 14, 2018: Journal of Pediatric and Adolescent Gynecology
Valentina Vernocchi, Maria Giorgia Morselli, Massimo Faustini, Gianfranco Gabai, Laura Da Dalt, Gaia Cecilia Luvoni
The present study evaluated changes of fecal sexual steroids in two female cheetahs (Geijsha and Duchessa) in Northern Italy throughout one year. Wet feces were collected daily from two sibling animals of the same age, housed with conspecific males and managed in the same conditions, and estrogens and progestogens concentrations were analyzed by radioimmunoassay (RIA). Evidence of ovarian activity based on regular fluctuation in estrogen excretion was demonstrated in both females. None of the animals was continuously cycling, as follicular activity was interrupted by anestrous periods, during the spring and early winter...
February 2, 2018: Animal Reproduction Science
Linda Speer
No abstract text is available yet for this article.
December 1, 2017: American Family Physician
Joann V Pinkerton, Andra H James
For women at elevated risk of thrombosis, clinicians are challenged to relieve menopausal symptoms without increasing the risk of thrombosis. Oral menopausal hormone therapy increases the risk of venous thromboembolism by 2-fold to 3-fold. Observational studies suggest less thrombotic risk with transdermal therapies and with progesterone over synthetic progestogens (progestins), but the data are limited. Beneficial nonpharmacologic therapies include cognitive behavioral therapy and clinical hypnosis, whereas beneficial nonhormonal pharmacologic therapies include selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors...
February 6, 2018: Clinical Obstetrics and Gynecology
Laurence R Gesquiere, Jeanne Altmann, Elizabeth A Archie, Susan C Alberts
OBJECTIVES: Interbirth intervals (IBIs) are a key metric of female reproductive success; understanding how they are regulated by environmental, social, and demographic factors can provide insight into sources of variance in female fitness. MATERIALS AND METHODS: Using 36 years of reproductive data on 490 IBIs for 160 wild female baboons, we identified sources of variance in the duration of IBIs and of their component phases: postpartum amenorrhea (PPA), sexual cycling, and pregnancy...
February 8, 2018: American Journal of Physical Anthropology
Xiaoyan Shen, Hong Chang, Dezhi Sun, Linxia Wang, Fengchang Wu
A broad number of natural and synthetic progestins are widely used in human and veterinary therapies. Although progestins exhibit adverse effects in aquatic organisms, information about environmental occurrence and fate have been limited to several compounds, hampering the accuracy of risk assessments of the compounds. In this study, a selective and sensitive analytical method was established to simultaneously determine 19 natural and 42 synthetic progestins in environmental waters, and the synthetic progestins included 19-nortestosterone, 17α-hydroxyprogesterone and progesterone derivatives...
February 1, 2018: Water Research
Laura Amendolagine, Tad Schoffner, Lynn Koscielny, Mandi Schook, Debra Copeland, James Casteel, Brianna Duff, Diana Koester
Although numbers of giant anteaters within North American facilities have been steadily increasing for the last 15 years, the population now exhibits an unstable age distribution with genetically valuable individuals nearing reproductive senescence. Contributing to this issue is the Association of Zoos and Aquariums (AZA) described lack of standardization of breeding introduction practices and high risk of female injury occurring during such pairings. This report describes the development of a successful breeding protocol at Cleveland Metroparks Zoo based on hormone monitoring and efficient communication between science and animal management teams that minimizes risk of female injury...
January 2018: Zoo Biology
Monica V Dragoman, Naomi K Tepper, Rongwei Fu, Kathryn M Curtis, Roger Chou, Mary E Gaffield
BACKGROUND: Combined oral contraceptives (COCs) containing various progestogens could be associated with differential risks for venous thromboembolism (VTE). OBJECTIVE: To evaluate the comparative risks of VTE associated with the use of low-dose (less than 50 μg ethinyl estradiol) COCs containing different progestogens. SEARCH STRATEGY: PubMed and the Cochrane Library were searched from database inception through September 15, 2016, by combining search terms for oral contraception and venous thrombosis...
February 1, 2018: International Journal of Gynaecology and Obstetrics
P Stute, L Wildt, J Neulen
Postmenopausal women with an intact uterus using estrogen therapy should receive a progestogen for endometrial protection. The debate on bioidentical hormones including micronized progesterone has increased in recent years. Based on a systematic literature review on the impact of menopausal hormone therapy (MHT) containing micronized progesterone on the mammary gland, an international expert panel's recommendations are as follows: (1) estrogens combined with oral (approved) or vaginal (off-label use) micronized progesterone do not increase breast cancer risk for up to 5 years of treatment duration; (2) there is limited evidence that estrogens combined with oral micronized progesterone applied for more than 5 years are associated with an increased breast cancer risk; and (3) counseling on combined MHT should cover breast cancer risk - regardless of the progestogen chosen...
January 31, 2018: Climacteric: the Journal of the International Menopause Society
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