Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
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Gynecol. Endocrinol. · Jul 2007
Magnesium ion inhibits spontaneous and induced contractions of isolated uterine muscle.
Magnesium sulfate, mainly used in obstetrics to treat eclamptic convulsions, is currently questioned as to its clinical tocolytic effect. We aimed to study the relaxant action (if any) of magnesium sulfate on in vitro pregnant and non-pregnant myometrium. ⋯ The present in vitro study suggests a possible benefit of Mg2+ in the inhibition of spontaneous myometrial contractility, but not of uterine-induced hyperactivity.
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Mifepristone is a progesterone antagonist that has been studied for a number of clinical applications. It is a well-known abortifacient that is effective for both first- and second-trimester medical abortion when used with a prostaglandin analog. ⋯ Other applications including treatment for fibroids, endometriosis and various cancers have been explored. However, its association with abortion limits the applications of mifepristone in many of these areas.
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Gynecol. Endocrinol. · Jun 2006
The effect of medroxyprogesterone acetate on estrogen-dependent risks and benefits--an attempt to interpret the Women's Health Initiative results.
The results of the two arms of the Women's Health Initiative (WHI) study allow a comparative assessment of the contribution of the progestogen component to the changes in risk of cardiovascular disease and cancer during treatment of postmenopausal women with conjugated equine estrogens and medroxyprogesterone acetate (CEE/MPA). However, the high proportion of older and overweight or obese women compromises any conclusions, since we estimate that 50% of the women would have the metabolic syndrome. In overweight postmenopausal women with hyperinsulinemia, the risk of breast cancer is elevated and cannot be increased further by hormone replacement therapy (HRT). ⋯ MPA has been demonstrated to upregulate the thrombin receptor, the thrombin-induced production of tissue factor and procoagulatory activity in the vessel wall owing to its glucocorticoid activity. In contrast, CEE alone reduced non-significantly the risk of CHD in women aged 50-59 years, suggesting that primary prevention is possible if estrogen replacement therapy is initiated early. As clinical studies on the effect of different progestogens combined with estrogens are scarce, a possible superiority of progestogens other than MPA remains to be proven.
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Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The aim of the present study was to determine the clinical characteristics of Sheehan's syndrome in 20 patients (mean age 60.15 +/- 3.41 years) with typical obstetric history. The mean duration between time of diagnosis and date of the last delivery was 26.82 +/- 2.52 years (range 2-40 years). ⋯ Total or partially empty sella was revealed in all patients by magnetic resonance imaging. Diabetes insipidus was not found in any patient. We found that lack of lactation in the postpartum period and early menopause seemed the most important clues for diagnosis of Sheehan's syndrome, and inadequate prolactin and gonadotropin responses to stimulation tests were the most sensitive diagnostic signs in patients with severe postpartum hemorrhage.
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Gynecol. Endocrinol. · Feb 2006
Comparative StudyThe CYP17 MspA1 polymorphism is not associated with an increased risk of uterine leiomyomas in a Japanese population.
The CYP17 gene is thought to be a candidate gene for susceptibility to hormone-related diseases. A single (T?C) nucleotide polymorphism in the promoter region of CYP17 is speculated to influence its transcription. The present study was conducted to investigate the possible association between uterine leiomyomas and CYP17 gene polymorphism in a Japanese population. ⋯ Women carrying the A2 allele were not at an increased risk of uterine leiomyoma compared with those carrying the A1 allele in unaffected controls (odds ratio, 1.26; 95% confidence interval, 0.92-1.72) and those carrying the A1 allele in population controls (odds ratio, 0.99; 95% confidence interval, 0.72-1.36). No significant difference in allele frequencies were found between leiomyoma cases and controls. These findings suggest that CYP17 gene polymorphism is unlikely to be associated with an increased risk of uterine leiomyomas in a Japanese population.