Search PubMed⌕ Search

Biomedical subjects

J González-Merlo

Publications and source records attributed to J González-Merlo.

At least 19 recordsLinked to original sources
PubMed1995

Circulating hormone levels in menopausal women receiving different hormone replacement therapy regimens. A comparison.

OBJECTIVE: To measure and compare plasma levels of sex hormones after the administration of different hormone replacement therapy (HRT) regimens. STUDY DESIGN: Ninety women with natural menopause were randomized into this comparative study. Eighty-five women completed one year of follow-up. Patients were randomly assigned to five groups. The first received 0.6 mg/d of conjugated equine estrogen (CEE) cyclically (n = 15). The second received 50 micrograms/d of transdermal estradiol (E2) cyclically (n = 17), and the third received 0.6 mg/d of CEE continuously (n = 17). All these groups also received 2.5 mg of medroxyprogesterone acetate (MPA) sequentially for the last 12 days of HRT, while the fourth therapy group received 0.625 mg/d of CEE and 2.5 mg/d of MPA continuously (n = 19). The fifth group constituted a treatment-free control group (n = 22). Levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2, estrone (E1), prolactin (PRL), testosterone (T), androstenedione (A4), dehydroepiandrosterone sulfate (DHEA-S) and sex hormone binding globulin (SHBG) were determined prior to HRT and during the last week of the 6th and 12th months of HRT, between days 21 and 24 of estrogen administration. RESULTS: After HRT we found decreases in FSH, LH and PRL levels, increases in E2, E1 and SHBG, and no modifications in T, A4 and DHEA-S plasma levels. There were no significant differences between the treatment groups in FSH, LH, E2, PRL, T, A4 or DHEA-S. E1 and SHBG were significantly higher in the groups with oral HRT. CONCLUSION: All the observed changes in hormone levels are to be expected after HRT except for the decrease in PRL levels. Finally, although MPA dosage was not the focus of the present study, our results suggest that the dosage of 2.5 mg/d of MPA in sequential regimens is clearly inadequate to protect the endometrium from hyperplastic changes.

Adult↗
PubMed1995

Postmenopausal hormone replacement therapy with low-dose medroxyprogesterone acetate. Endometrium, plasma lipids, lipoproteins and apolipoproteins.

Several studies have demonstrated that the use of estrogens in postmenopausal women has a protective effect against cardiovascular disease; however, this beneficial effect may be counteracted when concomitant progestogens are administered. We investigated the influence of hormone replacement therapy (HRT) with lower doses of medroxyprogesterone acetate (MPA) (2.5 mg/d) on the endometrium and on the plasma levels of lipids, lipoproteins and apolipoproteins. All the studied HRT regimens induced favorable changes in the levels of plasma lipids, lipoproteins and apolipoproteins, which may play an important role in the prevention of cardiovascular disease. The dosage of 2.5 mg/d of MPA is clearly inadequate to protect the endometrium from hyperplastic changes with sequential regimens, but probably this dosage is safe when MPA is administered continuously.

Adult↗
PubMed1994

Relationship between skin collagen and bone changes during aging.

There is evidence that skin collagen content and bone mass are influenced by estrogen deficiency, both of them declining in the years following menopause. The aim of our study was to analyze the relationship between changes in skin collagen content and bone mass during aging. A total of 76 nulliparous women who had been admitted for surgery of non-malignant processes were studied. All subjects were arranged into five age-groups (from 20 to 60 years). Bone mineral density was measured by dual photon absorptiometry and expressed in g/cm2 as the mean of the second to fourth lumbar vertebrae. Additionally, in all patients skin biopsies were taken from a non-sun exposed site in the lower abdomen (4 cm above the pubic symphysis) and osteocalcin levels were determined. Collagen decreased significantly with age after the 40s (P < 0.001) and after menopause (P < 0.001). Changes in bone mass were closely related to those detected in collagen (r = 0.586; P < 0.0001). In conclusion, our data suggest that bone mass and skin collagen decline in parallel with aging and that the hypoestrogenism developing in postmenopausal years has a significant effect on skin collagen content. Nevertheless, the question of whether osteoporosis is an intrinsic collagen disorder remains to be demonstrated.

Adult↗
PubMed1993

Effects of oophorectomy and hormone replacement therapy on pituitary-gonadal function.

The purpose of this study was to determine how oophorectomy and different hormone replacement therapy (HRT) regimens using low doses of medroxyprogesterone acetate (MPA, 2.5 mg/day) influence the pituitary-gonadal axis function. Ninety (90) women, who had had regular menses prior to surgery, completed a 1-year follow-up period. Patients were assigned to 5 groups. The first (n = 16) received 0.625 mg/day conjugated equine oestrogens (CEE) cyclically, the second (n = 20) 50 micrograms day transdermal oestradiol (E2) cyclically and the third (n = 15) 0.625 mg/day CEE continuously. These 3 groups also received 2.5 mg MPA sequentially for the last 12 days of HRT administration. The fourth group (n = 20) received 0.625 mg/day CEE and 2.5 mg/day of MPA continuously, while the fifth (n = 19) constituted a control group. After oophorectomy all patients showed increases in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, and decreases in those of E2, oestrone (E1), prolactin (PRL), sex-hormone-binding globulin (SHBG), androstenedione (delta A4) and testosterone (T). No changes were detected in dehydroepiandrosterone sulphate (DHEA-S) levels. After HRT, decreases in FSH, LH and PRL levels and increases in those of E2, E1 and SHBG were observed, but no changes were seen in T, delta A4 or DHEA-S plasma levels. As the differences that were found cannot be attributed to the presence of ovaries, it is reasonable to assume that they were perhaps due to the treatment. All these changes, with the exception of a decrease in PRL levels, are therefore to be expected after HRT.

Estradiol↗
PubMed1993

Effects of oophorectomy and hormone replacement therapy on plasma lipids.

The aim of this study was to determine the effects on plasma lipids and lipoproteins of oophorectomy and various hormone replacement therapy (HRT) delivery systems using low doses of medroxyprogesterone acetate (MPA, 2.5 mg/day). A total of 90 women completed the 1-year follow-up period. Patients were randomly assigned to five groups. The first (n = 16) received 0.625 mg/day conjugated equine oestrogens (CEE) cyclically, the second (n = 20) 50 micrograms/day transdermal oestradiol cyclically and the third (n = 15) 0.625 mg/day CEE continuously. These three groups also received 2.5 mg MPA sequentially for the last 12 days of HRT administration. The fourth group (n = 20) received 0.625 mg/day CEE and 2.5 mg/day MPA continuously, while the fifth (n = 19) constituted a treatment-free control group. After oophorectomy patients showed increases in low-density lipoprotein (LDL), apolipoprotein B and the atherogenic index, whereas after HRT patients exhibited falls in plasma LDL, apolipoprotein B and the atherogenic index and increases in high-density lipoprotein (HDL) and apolipoprotein A1. No significant changes in total cholesterol were observed after surgery or treatment and decreased levels of triglycerides were detected only in the transdermal treatment group.

Apolipoproteins↗
PubMed1993

Bone mineral density in surgically postmenopausal women receiving hormonal replacement therapy as assessed by dual photon absorptiometry.

A total of 118 postmenopausal women who had undergone hysterectomy and bilateral oophorectomy were invited to participate in this study. Patients were randomly allocated to one of four study groups which received, respectively, conjugated equine oestrogens (CEE) 0.625 mg/day over a 25-day cycle each month (n = 28); transdermal 17 beta-oestradiol 50 micrograms/day over a 24-day cycle each month (n = 28), CEE 0.625 mg/day every day of the month (n = 32) and no treatment the control group (n = 30). All the treated patients also received 2.5 mg/day medroxyprogesterone acetate sequentially for the last 12 days of each cycle. Dual photon absorptiometry was performed before therapy commenced and repeated after 1 year in all four groups. The three therapeutic regimens induced increases in bone mass, whereas a significant decrease was observed in the control group (P < 0.05).

Absorptiometry, Photon↗
PubMed1993

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.

Animals↗
PubMed1992

The effect of hormone replacement therapy on postmenopausal bone loss.

Eighty-four postmenopausal women who were randomly allocated to one of four groups, completed a 1 year follow-up. The first group (n = 20) received 0.625 mg/day conjugated estrogens cyclically (CE; 25 days/month). The second (n = 23) received 0.625 mg/day of CE continuously, and the third (n = 17) received 50 micrograms/day of transdermal 17 beta-estradiol cyclically (24 days/month). All these groups also received 2.5 mg of medroxiprogesterone acetate sequentially for the last 12 days of hormone replacement therapy, while the fourth group (n = 24) constituted a treatment-free control group. Dual photon absorptiometry was carried out before therapy and was repeated after 1 year. Serum calcium, phosphate and osteocalcine levels, and the urinary calcium/creatinine and hydroxyproline/creatinine ratios, were measured prior to treatment and 6 and 12 months thereafter. All treatment groups showed an increase in bone mineral content. This increase was higher in the continuous CE treatment group (4.4%, P less than 0.05) and in transdermal group (7.1%, P less than 0.01). Concomitant biochemical effects at 6 and 12 months, reduction in urine calcium and hydroxyproline, reduction in blood calcium, phosphate and osteocalcine, were compatible with the observed effects on bone mineral.

Bone Density↗
PubMed1992

Hormone replacement therapy and changes on pituitary function.

The aim of this study is to know how the pituitary function is affected by several delivery systems of estrogen replacement therapy. 116 menopausal women (54 natural and 62 surgical) were placed into three groups that received replacement therapy and in one control group. We determined prolactine (PRL), gonadotropins and 17 beta-estradiol (E2). We found a decrease in gonadotropin levels in treated patients with a natural menopause, and an increase in gonadotropin levels in the groups treated with conjugated estrogens in surgical menopausal women. 17 beta-E2 was found to be increased in all treated groups, mainly in the continuous therapy group (P less than 0.05). PRL was found to be decreased in patients treated with conjugated estrogens (oophorectomized and not oophorectomized) (P less than 0.05). Although these differences can not be attributed to the presence of the ovaries, we think that they may be the result of the treatment.

Adult↗
PubMed1992

Skin collagen changes related to age and hormone replacement therapy.

A total of 76 nulliparous women who had been hospitalized for minor operations, classified according to age group (by decade from 20s to 60s) and 118 postmenopausal women randomly allocated to one of four groups were studied. In all, 312 skin biopsies were taken from the lower abdomen at 0 and 12 months and the skin collagen changes noted. Collagen content decreased significantly with age beyond the 40s (P < 0.001) and after the menopause (P < 0.01). The decrease was preventable by the use of hormone replacement therapy. All the therapeutic regimens induced increases in skin collagen content, whereas in the control group a significant decrease was observed (P < 0.05).

Adult↗
PubMed1986

Early luteal function following danazol therapy for endometriosis.

The luteal phase of 20 infertile women with endometriosis who were treated with danazol (600 mg daily for 6 months) was studied by basal body temperature, plasma progesterone (P), oestradiol (E2) and prolactin (PRL) determination, and endometrial biopsy, in any one of the first three cycles after discontinuation of danazol. All endometrial specimens were noted to be fundal samples and were clearly progestational after danazol therapy. Abnormal secretory phases were detected in three patients, as in the pre-danazol control cycles. Moreover, plasma levels of P, E2 and PRL in post-danazol cycles were similar to those found in control cycles and fell within the normal range in all cases except for one patient having hyperprolactinaemia. In conclusion, our study shows that endometrial inadequacy is not the cause of the increased fetal wastage previously reported among proximally conceived pregnancies after danazol therapy for endometriosis.

Abortion, Spontaneous↗
PubMed1985

The endometrial biopsy for diagnosis of luteal phase deficiency.

We studied endometrial luteal phase in specimens from 660 biopsies done in 300 patients from our infertility clinic. A minimum of two (240 women) or three (60 women) endometrial biopsy specimens from separate cycles were taken regardless of the previous histologic findings in all patients. Statistical analysis of results by the McNemar and the Cochran Q tests for the significance of changes leads us to conclude that a minimum of two, and even three, endometrial biopsy specimens are needed for diagnosis of luteal phase deficiency.

Biopsy↗
PubMed1984

Endometrial biopsy inadvertently taken in the cycle of conception.

Endometrial data, plasma progesterone levels and the outcome of pregnancy were analyzed in 22 infertility patients from whom endometrial biopsies had been inadvertently taken in early pregnancy. We found 22.7% (5 cases) of defective endometria in association with normal plasma progesterone levels (available in four patients). Daily plasma progesterone during the first 21st postovulatory days in the cycle of conception is reported in one of our patients. Fourteen of the 22 women delivered normal infants at term, 1 woman had a hydatidiform mole and 7 women aborted (31.8%). The relevance of endometrial biopsy in the cycle of conception and its influence on the outcome of pregnancy are discussed.

Abortion, Spontaneous↗
PubMed1983

Sequential evaluation of general immunocompetence in gynecologic cancer.

A sequential evaluation of general immunocompetence was performed in 70 previously untreated patients with gynecologic cancer. Immunologic evaluations were made prior to any therapy and repeated every 3-4 months for 3 years or until patients died of disease. Cell-mediated immunity was investigated by delayed hypersensitivity to intradermal skin test antigens (STA) and by contact sensitization to 2,4-dinitrofluorobenzene (DNFB). Serum immunoglobulin determinations were performed to evaluate humoral immunity. Compared with age-matched controls, there was impairment of cell-mediated response to both STA and DNFB in patients with locally invasive and disseminated cancer but not in those with preinvasive cancer. There was a progressively impaired reactivity with clinical progression of disease independently of histological type of neoplasm. Sequential evaluations revealed that variations in immune reactivity occurred that also correlated with the patient's clinical course. Significant changes in immunoglobulin levels, an increase in IgG and IgA, and a decrease in IgM, were observed in the cancer groups as compared with age-matched healthy female controls. However, neither initial values nor sequential determinations of immunoglobulins were related to the clinical course of gynecologic cancer.

Adult↗
PubMed1983

Dehydrogesterone treatment of endometrial luteal phase deficiency after ovulation induced by clomiphene citrate and human chorionic gonadotropin.

Twenty infertile patients being treated with clomiphene citrate (CC) and human chorionic gonadotropin (hCG) for induction of ovulation, with a defective endometrial secretory pattern despite normal plasma levels of progesterone, estradiol, and prolactin, were entered into treatment plans on a random basis involving the following: CC-hCG plus dehydrogesterone (group 1), and CC-hCG (group 2). Success rates were similar in both groups (20% and 30%, respectively), based on a corrected endometrial defect during the second treated cycle. It is concluded that progestational agents are of low therapeutic value in endometrial luteal phase deficiency induced by CC.

Adult↗
PubMed1983

Luteal phase evaluation after clomiphene-chorionic gonadotrophin-induced ovulation.

Fifty infertile patients treated with clomiphene and hCG for induction of ovulation were studied with plasma progesterone measurement and endometrial histology. Five patients (10%) presented defective endometria and low plasma progesterone in spite of biphasic BBT charts with normal luteal phase length. Forty-five patients (90%) had significantly higher plasma progesterone concentrations than those found in a control group of fertile women, but a defective endometrial secretory pattern occurred in 19 of these 45 patients (42.3%). These data suggest the need for monitoring the response to clomiphene by endometrial histology in addition to BBT and plasma progesterone, or for supplemental therapy to overcome the endometrial luteal phase deficiency in clomiphene-treated cycles.

Adult↗