Ovarian Hormone Concentrations Research Articles

Pharmacokinetic drug interactions between oral contraceptives and second-generation anticonvulsants.

Drug interactions between oral contraceptives (OCs) and traditional anticonvulsants have been well described. However, in the past decade, a number of new anticonvulsants have been developed, as well as modifications made in the composition of the OC preparations themselves. Additionally, anticonvulsants are increasingly employed in the therapy of nonseizure-related disorders, placing more women at risk of potential drug interactions that may lead to contraceptive failure. Second-generation anticonvulsants include felbamate, gabapentin, lamotrigine, oxcarbazepine, tiagabine, topiramate, vigabatrin and zonisamide. Most have been approved for adjunctive management of seizures refractory to therapy with traditional anticonvulsants. On the basis of available study data in women receiving concomitant OC preparations, gabapentin, lamotrigine, tiagabine and vigabatrin may be administered without significant pharmacokinetic interactions that potentially diminish contraceptive efficacy. However, additional or alternative contraceptive measures, including using OCs with higher estrogen content, are recommended when using felbamate, oxcarbazepine and topiramate, as these agents have demonstrated enzyme-inducing activity leading to reduced plasma steroid concentrations. The effects of zonisamide in women receiving OCs have yet to be reported. It is important to characterise the properties [e.g. substrate and enzyme activity (particularly cytochrome P450 3A4 induction)] of new anticonvulsants and recognise their potential to interfere with OCs. However, a pharmacokinetic interaction does not in itself indicate loss of OC efficacy. Contraceptive failure should be measured by changes in ovarian hormone concentrations, maturation of ovarian follicle(s) or ovulation.

The impact of intense training on endogenous estrogen and progesterone concentrations and bone mineral acquisition in adolescent rowers.

The effect of 18 months of training on the ovarian hormone concentrations and bone mineral density (BMD) accrual was assessed longitudinally in 14 adolescent rowers and 10 matched controls, aged 14-15 years. Ovarian hormone levels were assessed by urinary estrone glucuronide (E(1)G) and pregnanediol glucuronide (PdG) excretion rates, classifying the menstrual cycles as ovulatory or anovulatory. Total body (TB), total proximal femur (PF), femoral neck (FN) and lumbar spine (LS) (L2-4) bone mass were measured at baseline and 18 months using dual-energy X-ray densitometry. Results were expressed as bone mineral content (BMC), BMD and bone mineral apparent density (BMAD). Five rowers had anovulatory menstrual cycles compared with zero prevalence for the control subjects. Baseline TB BMD was significantly higher in the ovulatory rowers, with PF BMD, FN BMD and LS BMD similar for all groups. At completion, the LS bone accrual of the ovulatory rowers was significantly greater (BMC 8.1%, BMD 6.2%, BMAD 6.2%) than that of the anovulatory rowers (BMC 1.1%, BMD 3.9%, BMAD 1.6%) and ovulatory controls (BMC 0.5%, BMD 1.1%, BMAD 1.1%). No difference in TB, PF or FN bone accrual was observed among groups. This study demonstrated an osteogenic response to mechanical loading, with the rowers accruing greater bone mass than the controls at the lumbar spine. However, the exercise-induced osteogenic benefits were less when rowing training was associated with low estrogen and progesterone metabolite excretion.

Local increase of ovarian steroid hormone concentration in blood supplying the oviduct and uterus during early pregnancy of sows

Countercurrent transfer in the ovarian vascular pedicle elevates the concentration of steroid hormones in blood supplying the oviduct and periovarian part of the uterus during the estrous cycle in the pig. This study was conducted to determine whether during early pregnancy the arterial blood supply to the oviduct and uterus carries greater concentration of steroid hormone than systemic blood. The concentration of ovarian steroid hormones (progesterone, estradiol-17β, estrone, androstenedione and testosterone) was measured in 40 gilts on Days 12, 18, 25 or 35 of pregnancy. Silastic catheters were inserted: a) into the jugular vein, b) into the branch of uterine artery close to the ovary (proximal to the ovary) and c) into the branch of the uterine artery close to the cervix (distal to the ovary). On the day following surgery simultaneous blood samples from cannulated vessels were collected every 20 min for 3 hours. The concentration of steroid hormones was determined by radioimmunassay. The mean concentrations of studied hormones in branches of the uterine artery proximal and distal to the ovary were significantly greater than in the jugular vein (P<0.001) by 18 to 69% and 7 to 31%, respectively. The concentrations of hormones in proximal and distal to the ovary branch of the uterine artery were also significantly different (P<0.001). The increase in concentrations of the measured hormones did not differ considerably between investigated days of pregnancy. It is concluded that during maternal recognition of pregnancy, formation of the corpus luteum of pregnancy, implantation of the embryo and the placenta elongation the oviduct and uterus are supplied with locally elevated concentration of steroid hormones compared to systemic blood.

Urinary ovarian and gonadotropin hormone levels in premenopausal women with low bone mass.

We hypothesized that lower ovarian and gonadotropin hormone concentrations would be associated with lower levels of peak bone mineral density (BMD) in apparently normally menstruating women who did not exercise intensively and did not report anorexia or bulimia. This hypothesis was evaluated using a case-with-control study design (n = 65) which was nested within a population-based longitudinal study of peak bone mass (Michigan Bone Health Study) with annual assessment in women aged 25-45 years (n = 582). Cases were 31 premenopausal women with BMD of the lumbar spine, femoral neck, and total body less than the 10th percentile of the distribution, where controls were 34 premenopausal women with BMD between the 50th and 75th percentile. BMD was measured by dual-energy X-ray absorptiometry. In addition to their annual measurement, these 65 participants collected first-voided morning urine specimens daily through two consecutive menstrual cycles. The urine from alternating days of this collection was analyzed for estrone-3-glucuronide (E1G), pregnanediol glucuronide (PdG), testosterone, and follicle-stimulating hormone by radioimmunoassay and these values adjusted for daily creatinine excretion levels. Additionally, analyses of daily urine specimens for luteinizing hormone (uLH) was undertaken to better characterize the possible uLH surge. Cases had significantly lower amounts of E1G (p = 0.009) and PdG (p = 0.002) than did controls, whether amounts were characterized by a mean value, the highest value, or the area under the curve, and after statistically controlling for body size. Further, when B-splines were used to fit lines to the E1G and PdG data across the menstrual cycle, the 95% confidence intervals (CIs) about the line for the controls consistently excluded and excluded and exceeded the 95% confidence bands for the cases in the time frame associated with the luteal phase in ovulatory cycles. Likewise, 95% CIs for the LH surge in controls exceeded the fitted line for cases around the time associates with the LH surge. The cases and controls were not different according to dietary intake (energy, protein, calcium), family history of osteoporosis, reproductive characteristics (parity, age at menarche, age of first pregnancy), follicular phase serum hormone levels, calciotropic hormone levels, or by evidence of perimenopause. We conclude that these healthy, menstruating women with BMD at the lowest 10th percentile from a population-based study had significantly lower urinary sex steroid hormone levels during the luteal phase of menstrual cycles as compared with hormone levels in premenopausal women with BMD between the 50th and 75th percentile of the same population-based study, even after considering the role of body size. These data suggest that subclinical decreases in circulating gonadal steroids may impair the attainment and/or maintenance of bone mass in otherwise reproductively normal women.

Late Endocrine Effects of Ovarian Electrocautery in Women with Polycystic Ovary Syndrome

Objective: To examine the duration of the changes in endocrine indices produced by ovarian electrocautery in women with polycystic ovary syndrome (PCOS). Design: Long-term observational study. Setting: University hospital. Patient(s): Infertile women with PCOS. Intervention(s): Ovarian electrocautery was performed through the laparoscope. Blood was sampled before the operation and at defined intervals thereafter. After the establishment of regular cycles, sampling was performed 1 week before the menstrual period. Main Outcome Measure(s): The patients were observed before and at defined intervals for up to 20 years after ovarian electrocautery. Serum concentrations of hypophyseal and ovarian hormones were determined, including sex hormone-binding globulin (SHBG). Result(s): There was a clear shift from anovulation to ovulatory cycles and a significant decrease in androgens and gonadotropins. The concentration of SHBG increased. These effects lasted for many years; after 18–20 years, two thirds of the women were still ovulating. Conclusion(s): Ovarian electrocautery for PCOS normalizes ovarian function, including androgen production, and the results seem to be stable for 18–20 years.

Follicular waves and concentrations of steroids and inhibin A in ovarian venous blood during the luteal phase of the oestrous cycle in ewes with an ovarian autotransplant.

The dynamics of ovarian follicular development and the pattern of pituitary and ovarian hormone concentration were investigated during the luteal phase in ewes with autotransplanted ovaries. The follicles were measured by ultrasound and samples of ovarian and jugular venous blood were collected at intervals of 12 h. Blood samples were collected before and after a GnRH challenge (250 ng GnRH, i.v.) to allow the determination of basal and LH-stimulated concentration of ovarian steroids. Throughout the luteal phase, large antral follicles developed in three waves, each of which was preceded by a rise in the concentration of FSH (P < 0.05). The concentrations of oestradiol and androstenedione in the unstimulated and LH-stimulated samples were similar (P > 0.05) during the first 3 days of the luteal phase but differed thereafter, with the LH-stimulated being significantly higher than the basal concentrations (P < 0.05). In the first wave of follicular development the changes in follicular size were accompanied by an increase in the concentration of ovarian steroids and inhibin A. During the second follicular wave, although changes in follicle diameter were similar to the first wave (P > 0.05), the basal concentration of ovarian steroids and inhibin A remained unchanged throughout the period of emergence and demise of the large follicles. These results confirm that the development of large antral follicles during the luteal phase of the sheep occurs in successive waves that are associated with fluctuations in FSH secretion. However while the results strongly suggest that fluctuations in both inhibin A and oestradiol secretion control FSH during the first follicular wave, the cause of the FSH fluctuations associated with waves two and three is unclear. Final resolution of this issue may need to await the development of a specific assay for dimeric inhibin B.

R-125. Changes in the serum concentrations of ovarian hormones and ovarian artery blood flow rate after laparoscopic tubal sterilization

R-125. Changes in the serum concentrations of ovarian hormones and ovarian artery blood flow rate after laparoscopic tubal sterilization

Ovarian hormone concentrations and genital swelling patterns in female chimpanzees with Norplant implants

The purpose of this study was to assess the effects of Norplant implants on ovarian hormone secretion and genital swelling patterns in female chimpanzees. Urine samples were collected during one natural cycle before (n = 5 females) and one cycle ∼6 months following (n = 7 females) insertion of Norplant implants. Genital swelling data were recorded daily for all seven females. During Norplant treatment, two females exhibited minimal ovarian activity consistent with anovulation. Hormone data from five subjects indicated both follicular and luteal activity, suggesting that ovulation may have occurred during Norplant treatment. Among cycles presumed to be ovulatory, the concentration of estrone glucuronide did not differ from concentrations during the control phase. However, mean (F = 12.253, P = 0.001) and peak (F = 4.127, P = 0.003) concentrations of pregnanediol glucuronide were significantly lower during Norplant treatment. Cycle duration did not differ during Norplant treatment (F = 1.415, P = 0.200); however, duration of the total swelling phase (F = 3.311, P = 0.0011) and full swelling phase was shorter (F = 5.906, P = 0.011), whereas number of days with partial swelling increased (F = 2.635, P = 0.011). The results of this study indicate that Norplant provided effective contraception while not inhibiting ovarian hormone secretion or the expression of cyclic genital swelling in the majority of the chimpanzee subjects. Zoo Biol 16:209–223, 1997. © 1997 Wiley-Liss, Inc.

EndocrinologyComparison of salivary steroid profiles in naturally occurring conception and non-conception cycles

Oestradiol and progesterone profiles from naturally occurring conception and exposed non-conception cycles were compared to assess the impact of natural variation in concentrations of ovarian steroid hormones on female fecundity. In a prospective, longitudinal study, 24 women collected saliva samples twice daily and recorded intercourse for up to 1 year or until a pregnancy was clinically confirmed. Oestradiol and progesterone concentrations were measured by a salivary radioimmunoassay. Average mid-follicular oestradiol concentrations were significantly higher in conception than in non-conception cycles (12.6 +/- 1.7 versus 8.5 +/- 0.6 pmol/l, P < 0.01). A separate analysis, including only cycles from those women who contributed both conception and non-conception cycles, demonstrated an even more pronounced difference in mid-follicular oestradiol concentrations, not just for conception and non-conception cycles as groups (14.5 +/- 2.3 versus 6.5 +/- 0.7 pmol/l, P < 0.001), but also between the conception and average non-conception concentrations of individual women. Among these women, relative mid-follicular oestradiol concentration was highly correlated with the probability of successful conception. In addition, relative body weight was significantly positively correlated with mid-follicular oestradiol concentration. These findings indicate that variation in follicular development, reflected in variation in follicular oestradiol concentrations, is an important indicator of fecundity.

Effect of pituitary and ovarian hormones on human melanocytes in vitro.

Normal human melanocytes in culture became enlarged and dendritic after a 2-day incubation with either the pituitary (beta-MSH, a potent analog of alpha-MSH, ACTH, FSH and LH) or the ovarian (estradiol, estriol and progesterone) hormones. Under the same experimental conditions, pituitary hormones also increased both the tyrosinase activity and tyrosinase-related protein-1 (TRP-1) while ovarian hormones increased TRP-1 but not tyrosinase activity. The results suggest that pituitary and ovarian hormones possibly induce hyperpigmentation of the skin by stimulating the melanogenesis in epidermal melanocytes, and that estradiol and progesterone may be involved in the pathogenesis of melasma (chloasma) usually developing between early adulthood and menopause in which a high concentration of serum ovarian hormones was maintained.

Cyclical variation in paroxysmal supraventricular tachycardia in women

Summary Background Paroxysmal supraventricular tachycardia (SVT) in premenopausal women is often judged to be related to anxiety, and may be associated with the menstrual cycle. The aim of this study was to determine whether a cyclical variation of episodes of SVT exists and to correlate such variation with cyclical variation in plasma ovarian hormones. Methods 26 women (mean age 36 [SD 8]) years; with paroxysmal SVT were screened; those with regular menses who experienced at least three episodes of paroxysmal SVT in two consecutive 48-hour ambulatory ECG recordings were included. 13 patients (aged 32 [6] years) met these criteria. Patients underwent 48-hour ambulatory ECG monitoring and determination of plasma concentrations of oestradiol-17β and progesterone on day 7, 14, 21, and 28 of their menstrual cycle. Findings An increase in the number and duration of episodes of paroxysmal SVT was observed on day 28 as compared to day 7 of the menstrual cycle. A significant positive correlation was found between plasma progesterone and number of episodes and duration of SVT (5·6 [2·2] ng/mL; r=0·83, p=0·0004; and r=0·82, p=0·0005), while a significant inverse correlation was found between plasma oestradiol-17β and number of episodes and duration of SVT (155 [22] pg/mL; r=-0·89, p<0·0001; and r=-0·81, p=0·0007). Interpretation Women with paroxysmal SVT and normal menses exhibit a cyclical variation in the occurrence of the arrhythmia with their menstrual cycle. There is a close correlation between the episodes of paroxysmal SVT and the plasma concentrations of ovarian hormones. These data suggest that changes in plasma levels of ovarian hormones (and their interaction) may be of importance in determining episodes of arrhythmia in such patients. The mechanisms of these effects are unknown.

Suppression of plasma estradiol and progesterone concentrations by buthionine sulfoximine in female rats

Glutathione (GSH) is an important factor involved in the resistance of tumor cells to anticancer agents. Buthionine sulfoximine (BSO), a specific inhibitor of GSH synthesis, effectively decreases cellular GSH concentrations both in vitro and in vivo. Depletion of GSH by BSO sensitizes a variety of cancer cells to chemotherapeutic agents. Therefore, BSO has been on clinical trial as an anticancer adjuvant. For this purpose, it is important to understand the effect of BSO treatment not only on the sensitivity of tumor cells to anticancer agents, but also on the metabolism and function of normal tissues. The present study was undertaken to determine the effect of BSO treatment on GSH concentrations in the blood, liver, and ovary, and changes in concentrations of ovarian hormones and other important components in plasma. Female Sprague-Dawley rats, 90 days of age, were treated with 2.0 mmol/kg BSO in saline by intraperitoneal injection, twice daily for 7 days. This treatment depressed GSH concentrations in the blood, liver, and ovary by 95, 75, and 85%, respectively. Several blood components were measured. These included red blood cells, hemoglobin, ceruloplasmin, hematocrit, mean corpuscular volume and hemoglobin concentration, alkaline phosphatase, urea nitrogrn, creatine and creatinine, glucose, cholesterol, triglycerides, triiodothyronine (T 3), thyroxine (T 4), and hormones including estradiol, progesterone, and prolactin. BSO treatment significantly ( P < 0.05) elevated and lowered plasma concentrations of ceruloplasmin and urea nitrogen, respectively. More importantly, plasma concentrations of estradiol and progesterone were decreased markedly ( P < 0.05) in the BSO-treated animals. The hormonal results suggest that investigations on the role of BSO-induced GSH depletion in the treatment of malignancies both with and without hormone dependence in women should be undertaken.

Andrology: Failure of oestrogen induced luteinizing hormone surge in women treated with mifepristone (RU 486) every day for 30 days

It has been demonstrated previously that administration of the antiprogestin mifepristone (RU 486; 1-5 mg daily) inhibits or delays both the pre-ovulatory luteinizing hormone (LH) surge and ovulation. To investigate this mechanism, dynamic tests of pituitary ovarian function were performed in six healthy women before and during the administration of mifepristone (2 mg daily for 30 days). On day 9 of the control and treatment cycles, samples of blood were collected every 15 min over 12 h for measurement of LH concentration. After 10 h, the responsiveness of the pituitary was tested by the i.v. injection of 10 micrograms of gonadotrophin-releasing hormone (GnRH). On day 10 of the control and treatment cycles, two patches releasing 200 micrograms/day of oestradiol were applied to skin on the abdomen for 3 days. Blood was collected at 24, 48, 59, 72, 81 and 96 h after application of the oestrogen patches for the measurement of gonadotrophin and ovarian hormone concentrations. Follicular development continued in all women during their treatment with mifepristone, and ovulation was suppressed (four women) or delayed (two women). There was no significant difference in the basal concentration of LH between the control and treatment cycles (mean +/- SE; 5.5 +/- 0.4 versus 7.7 +/- 0.4 IU/l respectively), or in the frequency (interpulse interval, 101 +/- 12 versus 105 +/- 13 min respectively) and the amplitude (2.1 +/- 0.4 versus 2.6 +/- 0.4 IU/l respectively) of LH pulses. The response to GnRH was similar. On day 10, the basal concentrations of LH, follicle-stimulating hormone (FSH), prolactin, oestradiol and progesterone and the diameter of the dominant follicle (15.7 +/- 1.8 versus 13.3 +/- 1.9 mm) were similar during control and treatment cycles. In control cycles, there were significant increases in the concentrations of LH and FSH within 72 h of application of the oestrogen patches. During treatment cycles, concentrations of FSH and LH remained low, and were significantly lower than the values observed during control cycles (P < 0.006). We conclude that the antiprogestin mifepristone disrupts ovulation by inhibiting the positive feedback effect of oestrogens and, hence, prevents or delays the generation of a pre-ovulatory LH surge.

976-11 Cyclical Variation in the Occurrence of Paroxysmal Supraventricular Tachycardia in Female Patients

The aim of the present study was to assess the presence of cyclical variations of episodes of supraventricular tachycardia (SVT) in female patients (pts) and to correlate their occurrence with the cyclical variation in the plasma levels of ovarian hormones. The study population included 26 (mean age 36 ± 8) female pts with episodes of SVT. included in the study were those with at least 3 episodes of SVT in 2 consecutive ambUlatory ECG monitoring and regular menses (AEM). Thirteen patients (mean age 32 ± 6) met the study criteria and entered the study. Pts underwent 48 hour AEM and determination of plasma concentrations of estradiol 17 β and progesterone on day 7, 14,21 and 28 of their menstrual cycle. Day7 Day 14 Day 21 Day 28 Heart Rate 72 ± 9 73 ± 13 76 ± 9 76 ± 14 No episodes 28 25 36 49 * Duration 12 ± 14 12 ± 11 21 ± 14 27 ± 11 * Class Lawn &gt;2 3 3 2 9 * * p &lt; 0.05 Day 28 compared to day7 A significant positive correlation was found between plasma concentrations of progesterone and number and duration of SVT (r 2 = 0.81, P &lt; 0.05 and r 2 = 0.78. P &lt; 0.05, respectively) while a significant inverse correlation was found between plasma concentrations of estradiol 17 β and number an duration of SVT (r 2 = -0.91, P &lt; 0.05, r2 = 0.67, P &lt; 0.05, respectively). In conclusion female pts with SVT and normal menses exhibit a cyclical variation in the occurrence of the episodes of SVT with their menses and a close correlation between the episodes of SVT and the plasma concentrations of ovarian hormones. These data suggest that changes in plasma levels of ovarian hormones (and their balance) may be of importance in determining episodes of SVT in such patients.

Pharmacology of the human ovarian vein: responses to putative neurotransmitters and endothelin-1.

An investigation of excitatory vascular responses in the human ovarian vein, a blood vessel normally exposed to high concentrations of ovarian steroid hormones and capable of adaptation to circulatory changes associated with reproductive life. Pharmacological responses of surgical specimens of human ovarian vein to electrical field stimulation of sympathetic nerves, noradrenaline, alpha,beta-methylene adenosine 5'-triphosphate (alpha,beta-MeATP), endothelin-1 (ET-1), and 5-hydroxytryptamine (5-HT) were studied. Comparisons were made between in vitro pharmacological responses and the diagnostic category, age, smoking status, reproductive history and hormonal status of patients. Research laboratory. Maximal contractile responses in longitudinal preparations, expressed as a percentage of the response to potassium chloride 125 mmol l-1, were 28% (SE 7.2) to electrical field stimulation and 107% (SE 15.1) to noradrenaline. In ring preparations, maximal responses to various agents were: noradrenaline 93% (SE 10.2); 5-HT 79% (SE 8.0); alpha,beta-MeATP 48% (SE 8.4); and ET-1 87% (SE 10.1). pD2(-log EC50) values for noradrenaline were 5.82 (SE 0.21) in longitudinal preparations and 5.65 (SE 0.10) in ring preparations; for ET-1 in ring preparations these values were 7.88 (SE 0.74). Responses to sympathetic nerve stimulation were attenuated by the adrenoceptor antagonist phentolamine; any residual responses were blocked by desensitisation of P2-purinoceptors with alpha,beta-MeATP or the addition of suramin, indicating that noradrenaline and adenosine 5'-triphosphate may be co-transmitters in these nerves. pD2 values for 5-HT were 5.97 (SE 0.12) in specimens from unsterilised patients (n = 19) compared with 5.20 (SE 0.24) in specimens from those who had previously undergone sterilisation (n = 6) (P < 0.05). No other relation between clinical characteristics and pharmacological responses were detected and, in particular, there were no apparent changes associated with ageing or hormonal status. Three main conclusions may be drawn from this study: (1) adenosine 5'-triphosphate is a co-transmitter in sympathetic nerves in the human ovarian vein; (2) tubal sterilisation affects vascular responsiveness to 5-HT; and (3) ovarian steroid hormones are likely to influence sympathetic vascular control via effects on catecholamine and adenosine 5'-triphosphate synthesis, storage, release, degradation or re-uptake, rather than via effects on vascular smooth muscle receptors.

Ovarian function, tubal viability and pregnancy after tubo-ovarian transplantation in the rabbit.

A rabbit model was developed for microsurgical en-bloc vascularized tubo-ovarian allograft. Transplantation of tube and ovary from donors to tubo-oophorectomized recipients was technically successful in 50 rabbits. After surgery, animals were randomly allocated into two groups: animals in group A received cyclosporine for immunosuppression; animals in group B did not receive immunosuppressive therapy. In group A, 16 animals survived the transplant procedure and six animals became pregnant (38%). No pregnancies were obtained among animals in group B. In group A, plasma concentrations of ovarian and pituitary hormones were similar to those found in non-transplanted animals. Our results show firstly that tubo-ovarian transplantation is technically feasible, and secondly that cyclosporine improves not only tubal viability but also ovarian function after transplantation.

A PROSPECTIVE STUDY OF THE MENSTRUAL CYCLE AND SPINAL CORD INJURY

Sixty seven menstrual cycles were studied prospectively in a nonclinical sample of 20 women who had suffered a traumatic spinal cord injury (quadriplegia n = 13; paraplegia n = 7) at least 1 yr before assessment. Level of injury did not influence cycle length (mean +/- SE = 28.7 +/- 3 days), duration of menses (4.6 +/- 1 days) or serum concentrations of gonadotropins and ovarian hormones. Midluteal phase serum progesterone values were consistent with ovulation (progesterone = greater than 5 ng/ml) in 93% of the cycles in which endocrine measures were obtained; but the ability of basal body temperature pattern to predict serum progesterone was low (43%). Cyclic dysmenorrhea was reported by 13 women with injuries ranging from C5 to T12. These findings suggest that ovulatory menstrual cycles are common in women after traumatic spinal cord injury and support the need for contraception by those wishing to avoid pregnancy. Basal body temperature charts revealed potential problems in applying the symptothermal method of natural family planning to a population of women at risk for oral contraceptives.

Metabolic changes during treatment with two different progestogens

Two triphasic oral contraceptives containing the same amount of ethinyl estradiol in combination with gestodene or levonorgestrel were compared with respect to contraceptive effect, cycle control, and effects on lipid metabolism and coagulation. Serum concentrations of gestodene, levonorgestrel, ovarian and pituitary hormones, and sex hormone-binding globulin were measured. Thirty-three healthy women were randomized into two groups receiving either of the preparations. Before treatment and in the third and sixth cycles, blood sample were drawn in the morning while subjects were still in bed to obtain basal conditions. The contraceptive effect and cycle control were good with both preparations, and there were only a few minor side effects. Sex hormone-binding globulin was elevated twofold in the levonorgestrel group and threefold in the gestodene group. The gestodene concentration in serum varied more than the levonorgestrel concentration, but with correction for variations in sex hormone-binding globulin binding, less variability in gestodene and levonorgestrel concentrations were seen. High-density Iipoprotein2 cholesterol decreased in the levonorgestrel group but was unchanged in the gestodene group, whereas apolipoprotein A, increased in the gestodene group but not in the levonorgestrel group. Antithrombin III decreased in the gestodene group but was unchanged in levonorgestrel-treated women. Factor VII increased in both groups but more in the gestodene group. We conclude that gestodene has a positive influence on lipid metabolism, probably because of its lower androgenicity, and a slightly negative influence on coagultion. The latter, however, probably has no clinical relevance. (AM J OasTET GVNECOL 1990;163:374-7.) During the past 25 years, oral contraceptives (OCs) have been improved continuously with respect to de­ creasing the dose of total steroid content and the in­ troduction of new progestogens in an attempt to min­ imize adverse effects and provide contraception safety. Several epidemiologic studies l

Distribution Pattern of Concentrations of Ovarian Hormones in Peripheral Blood in Cows.

乳牛の末梢血液中卵巣ステロイドホルモン測定値の分布型を知る目的で,人工授精後0日,5~7日,9~11日,13~15日および卵胞のう腫牛のプロジェステロン(P)とエストロジェン(E)値およびE/P比を調べた。その結果,P,E値およびE/P比は,受胎群,不受胎群および卵胞のう腫群ともすべて対数正規型の分布を示した。したがって,これらのホルモン測定値は対数変換後の統計処理で,より正確な結果が得られることが明らかとなった。授精後15日までの血中ホルモン値を対数変換後の平均値でみると,Pは,受胎群が不受胎群に比べて6日目から高値となり10日目で有意差が見いだされた。Eは,受胎群では6日目から急に低下し,不受胎では9日目から低下したが,13~15日間では受胎群も不受胎群も同レベルの低値であった。E/P比は,13~15日間で受胎群が不受胎群に比べて有意に低下した。

Metabolic changes during treatment with two different progestogens

Two triphasic oral contraceptives containing the same amount of ethinyl estradiol in combination with gestodene or levonorgestrel were compared with respect to contraceptive effect, cycle control, and effects on lipid metabolism and coagulation. Serum concentrations of gestodene, levonorgestrel, ovarian and pituitary hormones, and sex hormone-binding globulin were measured. Thirty-three healthy women were randomized into two groups receiving either of the preparations. Before treatment and in the third and sixth cycles, blood sample were drawn in the morning while subjects were still in bed to obtain basal conditions. The contraceptive effect and cycle control were good with both preparations, and there were only a few minor side effects. Sex hormone-binding globulin was elevated twofold in the levonorgestrel group and threefold in the gestodene group. The gestodene concentration in serum varied more than the levonorgestrel concentration, but with correction for variations in sex hormone-binding globulin binding, less variability in gestodene and levonorgestrel concentrations were seen. High-density lipoprotein, cholesterol decreased in the levonorgestrel group but was unchanged in the gestodene group, whereas apolipoprotein A, increased in the gestodene group but not in the levonorgestrel group. Antithrombin III decreased in the gestodene group but was unchanged in levonorgestrel-treated women. Factor VII increased in both groups but more in the gestodene group. We conclude that gestodene has a positive influence on lipid metabolism, probably because of its lower androgenicity, and a slightly negative influence on coagultion. The latter, however, probably has no clinical relevance. (Am J Obstet Gynecol 1990;163:374-377.)