PubMed · 14378564
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C DODDS. 1955. Synthetic oestrogens.. https://doi.org/10.1093/oxfordjournals.bmb.a069465
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The title molecule, C(26)H(30)O(3), shows a novel chemical rearrangement of the substituents at position 17, i.e. an alpha-orientation of the hydroxy group and a beta-orientation of the bulky benzyl moiety. The packing arrangement consists of coils formed by O(2)...O(3) hydrogen bonds along the c axis. The compound shows complete loss of oestrogenic activity, and neither does it exhibit an antagonistic effect.
Oestrogens induce the development of female reproductive tissues. Endogenous human oestrogens include oestradiol, oestrone and oestriol. Oestrogen signalling in target tissues is dependent on the tissue concentration of oestrogen and the interaction of oestrogen receptors with an array of cell-specific co-regulator proteins. The diverse mechanisms of oestrogen signalling are complex and incompletely understood. In puberty, oestrogen is derived from both gonadal and peripheral sources. Originally, oestrogen was only thought to drive feminization in females; now, oestrogen is known to be important for pubertal development of males as well. Oestrogen is required for normal maturation of the neuroendocrine-gonadal axis and bone in both sexes, and a variety of other tissues are also responsive to oestrogen. Abnormal puberty can be associated with either excessive or inadequate oestrogen production. Girls deficient in oestrogen should receive replacement in physiological doses. Aromatase inhibitors and anti-oestrogens may prove to be useful therapeutic tools in some types of abnormal puberty.
OBJECTIVE: To determine how gynecologists in the United States prescribe pessaries. STUDY DESIGN: A 34-question (long) survey was sent to 2,000 gynecologists. Those who did not respond were then sent a five-question (short) survey. RESULTS: Nine hundred forty-seven (47.3%) long and short questionnaires were returned. Eighty-six percent of gynecologists prescribe pessaries. Most received minimal or no training in pessaries in their residencies. The most common pessaries used were the ring and doughnut. Uterine prolapse was treated most often with the Gellhorn and doughnut pessaries. The cube and Gellhorn pessaries were thought to be the most effective for vaginal vault prolapse. The Gehrung and ring pessaries were thought to be most effective for correction of cystocele. However, the ring pessary was considered the easiest to use. Follow-up visits were most often performed at one week, one month and then every three months. Estrogen was used in most cases. CONCLUSION: Most gynecologists prescribe pessaries. The ring pessary is used most often and is deemed the easiest to use. Pessaries are thought to work for all pelvic organ prolapse defects but are thought to be less effective for posterior defects. Follow-up of patients differs from manufacturers' recommendations.