PII: S0015-0282(00)00430-1

Abstract

I was surprised when I read Dr. Taskin’s letter to the editor. I think he misunderstood the goal of our article (1Sonmez A.S. Birincioglu M. Turkoz Y. Adam B. Lurie D. Chuong J.C. Effects of misoprostol on lipoprotein (a) levels of ovariectomized rats.Fertil Steril. 1999; 72: 518-521Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar). In our article, we tried to emphasize the effect of misoprostol (prostaglandin E1 analogue; Cytotec, Searle, United Kingdom) on lipoprotein (a) levels in postmenopausal state. However, Dr. Taskin in his letter to the editor, was mentioning about the interaction between sex steroids and prostaglandins (PGs). He was mistaken in his comments on Farker’s (2Farker K. Schweer H. Vollandt R. Nassr N. Nagel U. Seyberth H.W. et al.Measurements of urinary prostaglandins in young ovulatory women during the menstrual cycle and in postmenopausal women.Prostaglandins. 1997; 54: 655-664Crossref PubMed Scopus (4) Google Scholar) and Akgül’s articles (3Akgül C. Canbaz M. Vural P. Yildirim A. Geren N. Hormone replacement therapy and urinary prostaglandins in postmenopausal women.Maturitas. 1998; 30: 79-83Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar). Farker et al. (2Farker K. Schweer H. Vollandt R. Nassr N. Nagel U. Seyberth H.W. et al.Measurements of urinary prostaglandins in young ovulatory women during the menstrual cycle and in postmenopausal women.Prostaglandins. 1997; 54: 655-664Crossref PubMed Scopus (4) Google Scholar) reported significant differences concerning prostaglandin E2 (PGE2) and thromboxane B2 (TXB2) between young ovulatory women and postmenopausal women. But there was no significant difference between these groups concerning other PGs, and they conclude that sex hormones have not been shown to correlate with PGs and were not responsible for the difference in PG excretion in women of reproductive age and in women in the menopause. Akgül et al. (3Akgül C. Canbaz M. Vural P. Yildirim A. Geren N. Hormone replacement therapy and urinary prostaglandins in postmenopausal women.Maturitas. 1998; 30: 79-83Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar) reported that hormone replacement therapy caused a significant decrease in PGE2 levels in postmenopausal women. Both studies are about the interaction between PGs and sex steroids, but our study is about the interaction between PGE1 analogue and lipoprotein (a). A sham-operated group was not included in the study because our objective was to study the interaction between estrogen and lipoprotein (a). For this reason a sham-operated group was not necessary. All of the rats were ovariectomized, and we held a control group. We were asked if 7 days postovariectomy was sufficient for inducing menopausal state in rats. In our study, we started administering misoprostol 60 days after ovariectomy. Because this is enough time for inducing menopause, we did not measure the estrogen levels. It is very hard to administer misoprostol orally twice a day through an orogastric cannula for 60 days. This was the reason why we selected a small sample size in each group. All rats survived the trial, and we did not exclude any outliers from the data. When you are mentioning about the differences between groups, it is appropriate to use SEM, but if you are giving information about the group without comparing it with another group, then SD is used. I agree that clinical studies are necessary to support our findings.