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Clin Obstet Gynecol 1999 Dec;42(4):883-94
University of Rochester, Department of Obstetrics & Gynecology, NY 14642-8668, USA.
Recent increase in the potential role for androgen supplementation in the menopause, as well as the availability of nontraditional, over-the-counter food supplements containing DHEA, currently touted for postmenopausal health, have raised the need for clinicians to have a working knowledge of both potential benefits and risks of androgen replacement as a supplement to traditional hormone replacement therapy. There is compelling evidence that androgen levels are reduced after bilateral oophorectomy. The degree of androgen reduction after natural menopause may be less, and the onset of this decrease more gradual in this population. A decrease in androgen levels has been proposed as one etiology for decreased libido, and there is some evidence to support androgen use in oophorectomized women suffering from diminished libido. Such evidence is mixed, however, in naturally menopausal women. Androgen replacement may provide additional relief of menopausal symptoms in some patients, but this evidence is also inconsistent. Initial studies seem to support a perceived enhancement in psychological well-being, but confirmatory, long-term studies are still needed. Available evidence suggests a positive impact on bone density with the use of some androgen preparations, but no consistent benefit from DHEA has been demonstrated. Although androgen therapy can induce decreases in HDL cholesterol levels, the clinical impact of this is not yet known. Currently, there is little support for the routine use of androgen supplementation in the menopause. Additionally, a number of adverse events may be associated with androgen use. Careful patient selection, with comprehensive evaluation to sort out other possible medical or psychological conditions, should be undertaken before the initiation of androgen replacement. Currently available preparations are limited in number and flexibility in dosing, but there is ongoing effort to develop new delivery systems and therapeutics so that options available in the future may allow for enhanced availability and efficacy.
PMID: 10572701, UI: 20038996
Rev Med Brux 1999 Sep;20(4):A386-91
[Article in French]
Hopital Erasme.
The clinical and biological syndromes of menopause, andropause, somatopause and adrenopause are presented successively. Various substitutive hormonotherapies (including melatonin) are considered according to their efficacy, risks and cost.
PMID: 10523929, UI: 99453454
Acta Obstet Gynecol Scand 1999 Aug;78(7):642-7
Department of Obstetrics and Gynecology, The National Hospital, Oslo, Norway.
OBJECTIVE: The purpose of this study was to investigate the hormonal changes during the menopausal transition in a non-clinical population. METHODS: Fifty-nine healthy Norwegian women participated in a five year prospective longitudinal study during the transition from pre- to post-menopause, starting one to four years before menopause, and ending one to four years postmenopausal. None of these women were given hormone replacement therapy (HRT). Blood samples were collected every 12 months and luteinizing hormone (LH), follicle stimulating hormone (FSH), steroid hormone binding globuline (SHBG), prolactin (PRL), estradiol (E2), estrone (E1), testosterone, androstendione, dehydroepiandrostendione-sulphate (DHEA-S), and thyroid stimulating hormone (TSH) were analyzed. RESULTS: The serum levels of FSH and LH, E2 and E1 profile essentially confirmed previous data obtained in cross-sectional studies. A continuous increase in serum FSH and LH and a concomitant fall in E2 and E1 were observed in all women before menopause and in the two postmenopausal years. Both androstendione and testosterone showed a decline three years before menopause. After the menopause, however, there were fluctuations in the testosterone levels. Androstendione correlated positively with both E2 and E1 and testosterone postmenopausally. Body mass index (BMI) did correlate with testosterone, but not with androstendione. BMI correlated negatively with SHBG. No correlation was found between BMI and E2, E1, FSH and LH. CONCLUSION: This longitudinal prospective study of hormonal changes during the transition from pre- to postmenopause indicates that not only estrogen hormonal changes, but androgen hormonal changes as well, precedes the menopause by several years.
Publication Types:
PMID: 10422913, UI: 99349776
J Am Geriatr Soc 1999 Jun;47(6):685-91
Department of Family and Preventive Medicine, University of California, San Diego, School of Medicine, La Jolla 92093-0607, USA.
OBJECTIVE: The purpose of this study was to determine whether endogenous steroid hormone levels are associated with depressed mood in community-dwelling older women. DESIGN: A cross-sectional population-based study. SETTING: Rancho Bernardo, California PARTICIPANTS: A total of 699 non-estrogen using, community-dwelling, postmenopausal women (aged 50 to 90 years) from the Rancho Bernardo cohort who were screened for depressed mood and had plasma obtained for steroid hormone assays in 1984-1987. MEASUREMENTS: Plasma levels of total and bioavailable (non-SHBG-bound) estradiol and testosterone, estrone, androstenedione, cortisol, dehydroepiandrosterone, and (DHEA) and its sulfate (DHEAS) were measured by radioimmunoassay. Mood and depression were assessed using the Beck Depression Inventory. RESULTS: Only DHEAS levels were significantly and inversely associated with depressed mood, and the association was independent of age, physical activity, and weight change (P = .0002). Age, sedentary lifestyle, and weight loss were positively associated with depressed mood. Alcohol intake, cigarette smoking, marital status, type of menopause, and season of testing were unassociated with depressed mood. A subset of 31 women with categorically defined depression had lower DHEAS levels compared with 93 age-matched nondepressed women (1.17 +/- 1.08 vs 1.57 +/- .98 micromol/L; P = .01). CONCLUSIONS: These results add to the evidence that DHEA/S is a neuroactive steroid and point to the need for careful long-term clinical trials of DHEA therapy in older women with depressed mood.
PMID: 10366167, UI: 99292289
Semin Reprod Endocrinol 1998;16(2):161-70
Department of Reproductive Medicine, University of California, San Diego, USA.
In recent years, there has been increasing interest in the potential of androgen replacement in menopausal women and specifically adrenal androgen replacement. There is unfortunately increasing unmonitored use of dehydroepiandrosterone (DHEA) among adults in the United States with only limited and preliminary human data. An extensive body of literature in laboratory animals exists to suggest DHEA used in extremely large doses has multifaceted effects; though the inapplicability of this data to humans is not appreciated, as the physiology of adrenal androgens in humans and a few primates is unique. Currently, there is much international and multidisciplinary interest in the physiology and use of DHEA "replacement" in men and menopausal women. The scientific community anxiously await the results of these investigations, but in the interim DHEA and/or DHEA-Sulfate (DHEAS) supplementation is not recommended as a therapeutic option in menopause outside of clinical trials.
PMID: 9711682, UI: 98377561
J Endocrinol Invest 1998 Jun;21(6):365-71
Department of Internal Medicine, University of Pisa, Italy.
To evaluate whether low DHEA-S levels are predictors of cortical origin, benignity and hormonal activity in incidentally detected adrenal masses, thirty-five patients with adrenal incidentalomas were studied. All patients were operated on and the diagnosis was histologically confirmed. Basal endocrine workup included plasma determination of cortisol before and after dexamethasone (1 mg overnight), plasma ACTH (08:00 h), 17-OH-progesterone, testosterone and potassium, standing plasma renin activity and aldosterone, supine and standing plasma noradrenaline and adrenaline. If necessary, we performed dexamethasone suppression tests at low (2 mg) and high (8 mg) doses, or the loperamide test (16 mg os) for evaluation of glucocorticoid activity and the glucagon test (1 mg i.v.) for exploring adrenal medulla function. Plasma DHEA-S was measured in all patients and the results were compared to those obtained in controls matched for age, sex and menopausal status. Suppression of DHEA-S was found in 11 out of 35 patients (31.5%). However, this hormonal finding occurred in 50% of the extracortical adrenal lesions, while in proven cortical adenomas (no. = 19) it was detected in only 5 patients (26.3%). Sensitivity, specificity, diagnostic accuracy and positive predictive value of low DHEA-S in indicating a cortical origin of the mass were 0.27, 0.0, 0.25, and 0.80. In malignancies (no. = 6) low DHEA-S levels were found in 1 out of 2 metastases and never in cortical carcinomas. Sensitivity, specificity, diagnostic accuracy and positive predictive value of low DHEA-S in indicating a benign form were 0.34, 0.83, 0.42, and 0.91. Six out of 19 patients with cortical adenomas showed signs of hypothalamic-pituitary adrenal (HPA)-axis dysfunction. Low DHEA-S levels were found in 50% of adenomas with HPA-axis abnormality and in 15.3% of adenomas without hormonal activity. Sensitivity, specificity, diagnostic accuracy, and positive predictive value of low DHEA-S levels in indicating hormonal activity of the mass were 0.50, 0.84, 0.73, and 0.60. Our data indicate that the association between low DHEA-S levels and adrenal incidentalomas is frequent. Low DHEA-S appears to be a poor predictor of hormonal activity with low sensitivity and specificity in respect of cortical origin and benignity of the mass. In conclusion, our results show that DHEA-S measurement does not offer relevant clinical information in the management of adrenal incidentalomas.
PMID: 9699128, UI: 98364284
Fertil Steril 1997 Nov;68(5):836-43 Published erratum appears in Fertil Steril 1998 Mar;69(3):606
Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, USA.
OBJECTIVE: To determine the effects of hormone replacement therapy (HRT) on dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), and cortisol (F) responses to treadmill exercise. DESIGN: Controlled clinical study. SETTING: Female volunteers in an academic research environment. PATIENT(S): Sixteen healthy, postmenopausal women (7 were receiving HRT, 9 were not). INTERVENTION(S): Blood samples were taken from an intravenous catheter before, during, and after 30 minutes of treadmill exercise following an overnight fast. A second session was conducted one month later for the same subjects using the same blood sampling protocol without exercise. MAIN OUTCOME MEASURE(S): Serum DHEA, DHEAS, and F concentrations. RESULT(S): The HRT and untreated DHEA area under the curve (AUC) for the exercise trials was significantly greater than that for the control trials. The untreated, but not the HRT, DHEAS AUC for the exercise trials was significantly greater than that for the control trials. The HRT and untreated F AUC for the exercise trials was significantly greater than that for the control trials. The AUC for the HRT exercise trials was significantly higher than the untreated exercise trials for DHEA and F, but not DHEAS. CONCLUSION(S): Data suggest that treadmill exercise elevates DHEA, DHEAS, and F levels in postmenopausal women and that HRT enhances the DHEA and F responses.
PMID: 9389812, UI: 98051251
J Clin Endocrinol Metab 1997 Oct;82(10):3498-505
Clinical Endocrine Research Unit, CHUL Research Center, Quebec, Canada.
The effect of 12-month dehydroepiandrosterone (DHEA) replacement therapy has been evaluated in 14 60- to 70-yr-old women who received daily applications of a 10% DHEA cream. Vaginal epithelium maturation was stimulated by DHEA administration in 8 of 10 women who had a maturation value of zero at the onset of therapy, whereas a stimulatory effect was also seen in all three women who had an intermediate vaginal maturation index before therapy. The estrogenic effect of DHEA observed in the vagina was not observed in the endometrium, which remained atrophic in all women. Most interesting, the bone mineral density significantly increased at the hip from 0.744 +/- 0.021 to 0.759 +/- 0.025 g/cm2 after 12 months of treatment (P < 0.05). These changes in bone mineral density were associated with a significant 20.0% decrease (P < 0.01) in plasma bone alkaline phosphatase and a 28% decrease in the urinary hydroxyproline/creatinine ratio. A 2.1-fold increase over the control value (P < 0.01) in plasma osteocalcin was concomitantly observed. The present data describe for the first time a series of medically important beneficial effects of DHEA therapy in postmenopausal women through transformation of the precursor steroid DHEA into androgens and/or estrogens in specific peripheral intracrine tissues without significant adverse effects. The stimulatory effect on the vaginal epithelium in the absence of stimulation of the endometrium is of particular interest because it eliminates the need for progestin replacement therapy. On the other hand, the stimulatory effect on bone mineral density accompanied by an increase in serum osteocalcin, a marker of bone formation, suggests stimulation of bone formation by the androgenic action of DHEA, a finding of particular interest for both the prevention and treatment of osteoporosis.
PMID: 9329392, UI: 97469975
Clin Endocrinol (Oxf) 1996 Nov;45(5):577-87
MRC Reproductive Biology Unit, Edinburgh, UK.
OBJECTIVE: The impact of the menopause on androgen production is poorly understood. We have investigated the impact of the menopause, as well as other factors such as age, body mass index (BMI) and cigarette smoking, on ovarian and adrenal androgen levels in women aged 40-60 years. DESIGN: Cross-sectional study of blood hormones sampled weekly over one month in volunteer 40-60-year-old women. SUBJECTS: One hundred and forty-one women, aged between 40 and 60, recruited from community sources (non-clinical), not using hormone replacement or steroidal contraceptives, and with a current sexual partner. Fifty were categorized as premenopausal (ovulating), 37 as perimenopausal and 54 as post-menopausal. MEASUREMENTS: The following variables were assessed; menopausal status (based on menstrual history and pattern and plasma progesterone), age, BMI, smoking, oestradiol (E2), oestrone (E1), LH, FSH, total testosterone (TT), androstenedione (A), SHBG, free androgen index (FAI), dihydroepiandrosterone (DHEA), dihydroepiandrosterone sulphate (DHEAS) and cortisol. RESULTS: are based on multiple regression analysis. TT was positively related to A, BMI and LH. A was negatively related to age and FSH, and positively to DHEA, DHEAS and premenopausal status. SHBG was negatively related to BMI and positively to E1 and non-smoking. DHEA and DHEAS were negatively related to age and were higher in smokers. Both E1 and E2 were related to menopausal status and to FSH. Surprisingly, E2 was negatively related to BMI. CONCLUSIONS: A variety of factors influence androgen production in this age group. Whereas it is difficult to predict the effect of menopause on androgen levels, LH stimulation of post-menopausal interstitial cells, modulated by a variety of factors including nutrition, and smoking, are likely to be relevant.
PMID: 8977755, UI: 97132300
Int J Fertil Menopausal Stud 1996 Jul-Aug;41(4):412-22
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.
In recent years, much attention has been directed at the potential of androgen replacement in the menopausal woman. Testosterone (T) replacement, in various forms, is widely used. However, evidence is lacking for a profound T deficiency state with natural menopause. Data confirming efficacy are also scant, and side effects have been demonstrated with prolonged therapy. The adrenal androgens, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S), also in contradistinction to T, decline substantially with age. Preliminary studies involving replacement of physiologic levels of DHEA have demonstrated some potential benefits: enhancement of the immune system and enhancement of the growth hormone axis. However, long-term trials have not been performed to date, so this modality of androgen replacement remains in the realm of clinical investigation. Ovarian and adrenal androgen replacement in menopausal women, while theoretically appealing, remains imperfect to date and should be used judiciously, if at all.
PMID: 8894799, UI: 97050071
Tumori 1996 Jan-Feb;82(1):45-7
BioTeZ Berlin-Buch GmbH, Berlin, Germany.
Antiestrogens, particularly tamoxifen, are effective in the treatment of pre- and postmenopausal women suffering from all stages of breast cancer. Unfortunately, many patients become resistant to tamoxifen during therapy, which allows the tumor to progress. Thus, a preclinical recognition of tumor progression, i.e. by monitoring serum hormone levels, could be worthwhile. The serum levels of dehydroepiandrosterone sulfate and estradiol of postmenopausal women with advanced breast cancer treated by the new antiestrogen droloxifene were therefore checked. However, only non-significant changes in the hormone levels during droloxifene therapy were observed, and no relation was found between hormone levels and the course of the disease, success or exhaustion of droloxifene application, or development of tumor progression. Our data do not confirm earlier findings reported in the literature that measurement of hormones seems to be suitable for an early indication of tumor progression during an antiestrogen therapy before its clinical manifestation.
PMID: 8623503, UI: 96201220
J Endocrinol 1995 Aug;146(2):359-63
Department of Oncology, Haukeland University Hospital, Bergen, Norway.
Plasma levels of oestradiol (Oe2), oestrone (Oe1) oestrone sulphate (Oe1S), androstenedione, testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), sex hormone-binding globulin (SHBG) and the gonadotrophins (FSH and LH) were determined in 20 postmenopausal women with breast cancer treated with the anti-oestrogen droloxifene (3-hydroxytamoxifen). Plasma oestrogens were measured before and after 3, 6 and 12 months of therapy. The other hormones were measured before and after 6 months of therapy. Droloxifene treatment had no significant influence on plasma levels of Oe2. Plasma levels of Oe1 and Oe1S increased during treatment (mean increase of 11.9-15.9% and 24.5-69.4% respectively after different time-intervals on treatment). The Oe1S/Oe1 and Oe1S/Oe2 ratios increased by mean values of 13.8-45.2% and 25.9-52.4% respectively. Plasma SHBG increased significantly by a mean value of 73.9%, while FSH and LH fell non-significantly by 19.7% and 20.4% respectively. Plasma levels of testosterone, androstenedione, DHEA and DHEAS all increased during treatment, but none of these alterations were of statistical significance. While the influence of droloxifene on plasma SHBG resembled that which is seen during treatment with tamoxifen, its influence on plasma oestrogens and the gonadotrophins seems to be different. Possible explanations of such differences and the clinical implications of alterations in plasma hormones during treatment with droloxifene are discussed.
PMID: 7561649, UI: 96030716
Geburtshilfe Frauenheilkd 1994 Jun;54(6):321-31
[Article in German]
Abteilung fur Gynakologische Endokrinologie und Fertilitatsstorungen, Universitats-Frauenklinik Heidelberg.
In 136 women with a median age of 78 (60-98) years the serum concentrations of FSH, LH, prolactin, estradiol-17 beta, testosterone and DHEA-S were determined completed by GnRH and ACTH stimulation tests in a subgroup. This resulted in median values for FSH of 15.8 ng/ml, LH 6.4 ng/ml, prolactin 6.9 ng/ml, estradiol 16 pg/ml, testosterone 270 pg/ml and 306 ng/ml for DHEA-S. No correlation with age in this population was found for gonadotropins as well as the other hormones for an age level of up to 98 years. Determination of multiple general clinical and laboratory parameters demonstrate the significance particularly in a geriatric group of patients to consider these patient characteristics when interpreting the serum hormone levels. In summary, the results of this prospective study underline the importance for health, of the secretion of gonadotropic and sexual hormones even at a very advanced age.
PMID: 8088487, UI: 94374638
Am J Obstet Gynecol 1993 Dec;169(6):1536-9
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38163.
OBJECTIVE: This study tests the hypothesis that dehydroepiandrosterone or its metabolic products are immunomodulatory in postmenopausal women with relative adrenal androgen deficiency. STUDY DESIGN: A prospective, randomized, double-blind, crossover study of 11 subjects with 3-week treatment arms separated by a 2-week washout period was performed. Immunologic evaluation at the beginning and end of the treatment arms consisted of flow cytometry to delineate T-cell populations, in vitro T-cell mitogenic response and cytokine production, and natural killer cell cytotoxicity. Statistical analysis was based on a split-plot design with analysis of variance with repeated measures. RESULTS: Dehydroepiandrosterone supplementation decreased CD4+ (helper) T cells and increased CD8+/CD56+ (natural killer) cells. Although T-cell mitogenic and interleukin-6 responses were inhibited, natural killer cell cytotoxicity increased dramatically. CONCLUSIONS: These data provide the first in vivo evidence in human for an immunomodulatory effect of dehydroepiandrosterone. The salutary immune changes could account for clinical and experimental evidence of antioncogenic effects of this steroid. This study provides a strong rationale for further clinical studies on dehydroepiandrosterone supplementation in adrenal androgen-deficient states.
PMID: 8267058, UI: 94091426
J Clin Endocrinol Metab 1993 Jun;76(6):1542-7
Department of Medicine, Maine Medical Center, Portland 04102.
Previous studies of adrenal androgens and estrogens in critical illness were limited by measuring only selected sex steroids and by including men (who have confounding simultaneous changes in gonadal steroids). We evaluated relationships between changes in serum levels of cortisol (F), androgens, estrogens, and gonadotropins in 20 postmenopausal women with acute critical illness to determine if changes in adrenal androgens and estrogens paralleled gonadal axis suppression or adrenal stimulation. Two patterns of changes in sex steroids were observed. Admission serum levels of androstenedione (delta 4-A), estradiol, and estrone, like F, were increased compared to healthy controls (P < 0.0001). delta 4-A and estrone then decreased toward normal by day 5 in parallel with cortisol (r = 0.56 and 0.60). In contrast, admission serum dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S) were not elevated and testosterone (T) was decreased in our patients compared to controls (P < 0.0005) in parallel with serum gonadotropin levels. Serum levels of DHEA and T continued to decrease by day 5 in parallel with gonadotropins. We conclude that in agonadal patients with acute critical illness, serum levels of DHEA-S and T are selectively decreased in relation to F, delta 4-A, and estrogens. The decreased serum T levels suggest inhibition of 17 beta-OH-dehydrogenase and/or increased aromatization to estradiol. The marked increase in serum estrogen levels also suggests increased aromatization. The absence of increases in DHEA and DHEA-S suggest enhanced activity of 3 beta-hydroxysteroid dehydrogenase and/or inhibition of C17,20-lyase activity of P-450c17. The clinical significance of this marked increase in the ratio of estrogens to androgens in acute illness requires further investigation.
PMID: 8501162, UI: 93273848
Endocrinol Metab Clin North Am 1992 Dec;21(4):921-31
Department of Internal Medicine, University of Texas Medical Branch, Galveston.
Many changes in the neuroendocrine axis occur with healthy normal aging in humans. Women cease ovarian follicle maturation and menstrual cycles entering the estrogen-deficient state termed menopause. Although not without risk, estrogen and progesterone replacement in postmenopausal women has been shown to ameliorate the complications of lowered estradiol concentrations, such as hot flushes and osteoporsis, while improving the risk of cardiovascular complications. Aging men have lowered serum free and total testosterone concentrations and may experience a less well defined symptom complex termed andropause. Both signs and symptoms of thyroid disease and interpretation of thyroid function tests are difficult in aging humans. Specifically, TSH secretion is diminished in aging so that suppressed serum TSH concentrations are indicative of but not specific for hyperthyroidism. Cortisol secretion is not altered in aging, although serum concentrations of DHEA-S are lower. Prolactin concentrations are increased in both men and women, with the increase being more pronounced in men. The clinical significance of this increase has not yet been determined. Finally, elderly humans are more likely to develop difficulties with fluid and electrolyte balance. Although some alterations in AVP secretion have been shown in the elderly, plasma concentrations are similar in young and elderly subjects. Other mechanisms, such as decreased glomerular filtration rate and a decreased sensitivity of the thirst mechanism in response to hypertonicity, may be important contributors to fluid and electrolyte imbalances.
PMID: 1486882, UI: 93137891
Maturitas 1988 Dec;10(4):297-306
Department of Obstetrics and Gynaecology, Karolinska Institutet, Huddinge University Hospital, Sweden.
Serum concentrations of dehydroepiandrosterone sulphate (DHAS) were determined in 590 healthy women aged 20-87 yr. Simultaneous assays of dehydroepiandrosterone (DHA) were performed in 417 of the women. DHA and DHAS levels correlated negatively with age while the DHA/DHAS ratio proved to be unrelated to age. When values for 60 healthy men in the age range 20-84 yr were compared with those obtained in 60 randomly-selected healthy women who were exactly age-matched, the DHAS levels were found to be significantly lower and the DHA/DHAS ratios significantly higher in the women. These results might be of use in establishing normal clinical ranges for serum DHA, DHAS and the DHA/DHAS ratio in women.
PMID: 2976116, UI: 89143218
Reproduccion 1982 Apr-Jun;6(2):49-59
Two groups of postmenopausal women were seen at monthly intervals during a three-month trial of continuous therapy with oral unconjugated oestrogens. Ten women in the first group were administered daily Hormonin No. 1 containing oestriol (E3) 0.135 mg, oestradiol (E2) 0.3 mg and oestrone (E1) 0.7 mg. Eight women in the second group received Hormonin No. 2 containing E3 0.27 mg, E2 0.6 mg and E1 1.4 mg. E1, E2, E3 and dehydroepiandrosterone (DHA) as well as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured by radioimmunoassay. Maturation index of vaginal smears and clinical effects were also evaluated. Oral replacement therapy with these unconjugated oestrogens produced a significant elevation of E1 (p less than 0.05) and E2 (p less than 0.05) to values corresponding well with the premenopausal range measured in our laboratory. Postmenopausal levels of FSH and LH showed only a moderate but significant decrease (p less than 0.05). There was consistent relief of vasomotor symptoms. One case of endometrial focal adenomatous hyperplasia uncovered during the period of treatment was transformed to functional secretory endometrium after an appropriate course with progestogens. Oral administration of unconjugated oestrogens and periodic withdrawal bleeding induced with a progestational agent seems to be an effective method of replacement therapy in postmenopausal women.
PMID: 6216132, UI: 83054372
Cancer Res 1981 Sep;41(9 Pt 1):3360-3
The 24-hr mean plasma concentrations of dehydroisoandrosterone (DHA) and dehydroisoandrosterone sulfate were measured in 11 women with primary operable breast cancer, ages 31 to 78 years, and in 37 normal women, ages 21 to 75 years. In contrast to the marked and progressive decline of DHA and dehydroisoandrosterone sulfate concentration with age in the normal women, the concentrations of both steroids were age invariant in the cancer patients. The premenopausal patients had subnormal plasma DHA and dehydroisoandrosterone sulfate levels, while the post menopausal patients had supranormal levels. Since the plasma DHA/androsterone ratio was normal in the premenopausal patients and significantly elevated in the postmenopausal patients, it is postulated that the subnormal plasma adrenal androgen levels in the premenopausal patients were due principally to diminished production of these steroids, while the elevated plasma levels in the postmenopausal patients were due principally to slowed metabolic removal. Reports in the literature that DHA inhibits the development of breast cancer in mice suggest that the subnormal plasma DHA levels in premenopausal breast cancer may have clinical significance.
PMID: 6455194, UI: 81258397
Arzneimittelforschung 1971 Apr;21(4):543-5
PMID: 4252311, UI: 71181875
Z Geburtshilfe Perinatol 1970 Jun;172(3):255-61
PMID: 4252698, UI: 71192134