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PubMed1982

Evaluation of ovarian function after tubal sterilization.

Many women appear to experience menstrual disturbances after tubal sterilization. In this study the ovarian function in such women was investigated. Serial measurements of FSH, LH, estradiol and progesterone were performed throughout the study cycle in 23 previously sterilized patients, 14 with menstrual disturbances (group I--symptomatic) and 9 with normal cycles (group II--asymptomatic). A group of 28 parous women served as controls. Among 23 patients, luteal phase progesterone was elevated in 19, and in 4 it was undetectable (anovulatory). All four anovulatory patients belonged to group I. Anovulatory cycles were also characterized by tonic elevated LH levels. Mean midluteal progesterone values were lower in group I (8.5 ng/ml) than in group II (13.8 ng/ml) and in the controls (16.5 ng/ml). Mean midluteal progesterone was lower than 10 ng/ml in 78% of group I, 44% of group II and 15% of the control patients.

Adult↗
PubMed1982

Ovulation detection in the human.

The importance of predicting human ovulation for either optimizing or avoiding conception has been considered from an endocrine, morphological and clinical view point. Of the biochemical markers in peripheral blood, a knowledge of the LH peak is the most clearly defined, with a two to four fold increase above baseline levels for a relatively short 24-30 hour preovulatory period. Ovulation is considered to occur 28-36 hours after the beginning of the LH rise or 8-20 hours after the LH peak. Daily assessment of the rise in preovular oestrogen reflects Graafian follicle development but the rise is less distinct and spread over 3-4 days with marked day to day fluctuations. LH induces a marked reduction in oestrogen production some 12 hours prior to ovulation and at the same time induces a two to three fold increase in progesterone production above baseline levels. While these changes in themselves are not great enough for day to day discrimination, a knowledge of their reciprocal relationship may be. The preovular rise in FSH is relatively small compared to LH and the radioimmunoassay technique has not generally been refined to be as rapid and reliable. Monitoring the day to day growth of the preovular follicle ultrasonically is both linear and potentially predictable but there is a wide range of its final diameter (17-26 mm) prior to ovulation making prediction inaccurate. With further refinements in ultrasonic resolution, detection of intrafollicular changes of the cumulus oophorus and granulosal cell layer configuration and thickness may give a closer prediction of the time of ovulation. At a clinical level a knowledge of menstrual cycle length in association with body messages which herald ovulation are useful and may forewarn that ovulation in terms of days is approaching. Such markers as preovulation pain, the detection of periovular cervical mucus and the change in physical character and position of the cervix are reliable signs of preovulation for many well motivated and informed women for either promoting or avoiding conception. A knowledge of the basal body temperature is not a prospective guide to ovulation, but once the thermal shift is established in association with loss of periovular mucus symptoms, the fertile period can be considered to have passed. Because we do not have a precise and simple marker of human ovulation, it is necessary that the most suitable marker of pre- or postovulation is chosen for the particular need in a given individual.

Body Temperature↗
PubMed1980

[Immunofluorescent analysis of intracellular localization of estrogen and progesterone in normal human endometrial cells (author's transl)].

Intracellular localization and the heat-dependent redistribution of estrogen and progesterone in human endometrial cells have been investigated by a fluorescent steroid-antibody technique. The dispersed endometrial cells were incubated with 5 X 10(-8) M estradiol-17 beta and progesterone in TC medium 199 containing 10% calf serum for 1--3 hr at 4 degrees C or 37 degrees C. An indirect immunofluorescent technique using FITC-labeled anti-rabbit IgG and steroid antibodies raised from rabbits immunizing with estradiol-6-oxime-BSA and progesterone-3-oxime-BSA was applied to the smear specimens. In normal endometrial cells in both proliferative and secretory stages, specific fluorescences to estradiol and progesterone were generally observed in the cytoplasm after incubation with the steroids at 4 degrees C for 1 hr. When these cells were incubated with the steroids at 37 degrees C for 1 hr, cytoplasmic and predominant nuclear fluorescences were detected, whereas the 3 hr-incubation at 37 degrees C resulted in disappearance of cytoplasmic fluorescence, remaining nuclear fluorescence alone. These fluorescences were remarkedly eliminated when endometrial cells were incubated with diethylstilbestrol and R-5020 prior to the incubation with estradiol and progesterone, respectively. These results indicate that the fluorescent steroid-antibody technique used in this study enables us to visualize subcellular localization of estradiol and progesterone possibly bound to receptors in each endometrial cell.

Endometrium↗
PubMed1982

Sex hormone levels and intestinal absorption of estradiol and D-norgestrel in women following bypass surgery for morbid obesity.

A report of reduced serum levels of progestins, following oral administration after jejunoileal bypass, promoted the present investigation of the absorption of D-norgestrel and estradiol following different types of intestinal bypass surgery for morbid obesity. A group of non-operated obese patients served as control. Apart from significantly higher gonadotrophin levels, which could be attributed to periovulatory sampling in the non-operated group, there was no significant differences in basal levels of estradiol, estrone, conjugated estrone, androstendione, testosterone, and progesterone. The operation did not influence the pattern of the menstrual cycle. Following a single oral dose of 4 mg micronized estradiol and 125 microgram D-norgestrel, serum levels of estradiol and estrone were equal in the three groups. serum D-norgestrel was equal in the two operated groups, but was significantly higher in the bypass group with 1:3 jejunoileal ratio, compared with the non-operated group. Further, a significant negative correlation between peak levels and weight was found. It is suggested that one year following bypass surgery, obesity - but not intestinal bypass - might be associated with reduced serum levels of exogenous sex steroids following oral administration.

Adult↗
PubMed1982

Functional life span of the corpus luteum gravidarum: an estimation from the mode of fluctuation of serum hormones after artificial termination of pregnancy and succeeding exogenous hCG administration.

Concentrations of estradiol (E2), progesterone (P), 17-hydroxyprogesterone (17-OHP), hCG and hPL were measured by radioimmunoassay in sera obtained serially from 35 subjects who received artificial termination of pregnancy and 24 of them were administered 10,000 IU of hCG 3 to 5 days later when endogenous hCG had sufficiently decreased. The subjects were operated respectively at 4-11 weeks (Group A) and 12-23 weeks (Group B) of gestation. In Group B, all the hormones declined promptly showing a hyperbolic pattern. In contrast, E2, P and 17-OHP in Group A revealed a significant delay of decline although hCG and hPL decreased as fast as hormones in Group B. When hCG was administered, P and 17-OHP showed a trend to elevate in Group A, but they showed a trend to decline in Group B. When compared in percentage value, the statistically significant difference is proved in 17-OHP between the two groups. The significant delay of E2, P and 17-OHP and the significant elevation of 17-OHP in Group A as compared with Group B were clearly demonstrated. Since 17-OHP is mainly of luteal origin, these findings seem to confirm that the corpus luteum gravidarum functions as far as 11 weeks of gestation and then involutes.

Abortion, Induced↗
PubMed1981

Endocrine profile of patients with post-tubal-ligation syndrome.

The endocrine profile of the midluteal phase was assessed in 29 patients with the post-tubal-ligation syndrome, consisting of pain, bleeding and premenstrual tension. Compared to normal controls, the patients had a high serum estradiol and a low serum progesterone level. This abnormal luteal function may be responsible for the symptoms observed and may also explain the failure to conceive following successful reversal of tubal ligation. It is recommended that patients seeking sterilization reversal be screened for abnormal luteal function preoperatively. Selection of sterilization procedures that minimize alteration in luteal function should be given high priority.

Adult↗
PubMed1981

[Studies on estradiol occupied and unoccupied receptors in human endometrial cytosol and nucleus: steroid receptors throughout the menstrual cycle and in cases of oral contraceptives administration (author's transl)].

Occupied and unoccupied estradiol (E3) receptors were investigated by exchange assay in cytosol and nuclear extract of human endometrium. Cytosol E2 and progesterone (P) unoccupied receptors and nuclear occupied E2 receptor were measured throughout the menstrual cycle and in the tissues from patients administered oral contraceptives. Sedimentation profiles of these receptors were also studied; and following results were obtained: 1) No occupied E2 receptor was observed in cytosol and almost all of those were of unoccupied type. In nuclear extract, only 0-25% of receptor was of unoccupied type and the other receptor was of occupied type. 2) Highest binding activities of cytosol E2 and P receptors were found in late proliferative phase. Maximum binding sites (Bm) were 630 and 380 f mol/mg protein and dissociation constant (Kd) was 8.9 +/- 0.7 and 4.7 +/- 0.4 x 10(-10) M, respectively. In nuclear extract, binding peaks were observed in late proliferative and late secretory phase. Bm was 1.5 f mole/microgram DNA and Kd was 12.7 +/- 1.0 x 10(-10) M.

Adult↗
PubMed1978

Investigations of hormones during early abortion induced by prostaglandin F2alpha and 15(S)-methyl-PGF2alpha.

In early pregnancy up the 7th week of pregnancy PGF2alpha was infused and 15(S)-methyl-PGF2alpha was applied i. m. to induce menstruation in 20 or 19 cases, respectively. In the tested form of application 15(S)-methyl-PGF2alpha is effective in 89 per cent of the cases and in 74 per cent complete abortion was achieved. PGF2alpha produced bleeding in 80 per cent only and complete abortion in 55 per cent. The differences in these two groups were not statistically significant. The steroid hormones estradiol and progesterone decrease in a successful application of PGs for induction of abortion and reach a value of 75 per cent at the onset of bleeding. The LH concentration in plasma becomes smaller too. In some cases there is a temporary increase in hormones shortly after starting treatment. The results could indicate that the considerable decrease in hormones before the onset of bleeding might be caused by an alteration of the corpus luteum, which is effective during early pregnancy.

Abortion, Induced↗
PubMed1981

Steroid hormone accumulation in human breast cyst fluid.

Elevated concentrations of peptide hormones have been described previously in human breast fluid. In the current study, the levels of cortisol, progesterone, testosterone, dihydrotestosterone, androsterone, androsterone sulfate, dehydroisoandrosterone, dehydroisoandrosterone sulfate, estradiol, estrone, estradiol sulfate, and estrone sulfate were measured. The levels of the four 17-ketosteroids and the two estrogen sulfates were markedly elevated over the plasma level, while that of the other compounds was the same or only slightly higher than the plasma levels of the same compounds.

Androgens↗
PubMed1975

[Plasma concentrations of LH and of sex steroids during the normal menstrual cycle and during contraceptive treatment].

The authors have studied the long-term effects of combined oestrogen-progestogen on the secretion of gonadotrophins and on ovarian function. Estimation of the radio-immune levels of the plasma concentrations of the pituitary luteinizing hormone (LH), of oestradiol (E2), of progesterone (P) and of 20 alpha hydroxyprogesterone (20 alpha OHP) and of testosterone (T) served as a base for this study. A test cycle and 8 cycles in which a combination of 50 micrograms of ethinyl-oestradiol and 0.5 mg of norgestrel were administered were studied in 4 normal volunteer women. A pituitary stimulation test using 50 micrograms of gonadotrophin "releasing factor" (LH-RH) was given during the 7th cycle. Ovarian stimulation using human menopausal gonadotrophins (HMG) was given during the 8th cycle of treatment in 3 of the women and in 3 other subjects. Pituitary secretion of LH and ovarian secretion of E2 and P are partially inhibited. Pituitary response to the injection of LH-RH stays normal but 5 out 6 patients had no response to stimulation by gonadotrophins. These results allow us to conclude that the lowering of production of gonadotrophins during treatment with combination oestrogen and progestagens is responsible for inhibition of ovarian activity, and that there is a delay before the latter respond to stimulation by either endogenous or exogenous gonadotrophins.

Adult↗
PubMed1975

[Effect of the steroid sex hormones on the LH and FSH responses to LHRH in the normal subject].

In man both basal gonadotrophin levels and the pituitary responses to LHRH remained relatively constant throughout life. In women the pituitary sensitivity varied in the menstrual cycle due to the typical cyclic variation of oestradiol and progesterone. The max delta LH increase to 100 mug LHRH was observed in the periovulatory period (183 +/- 41 mU/ml); it was also significantly higher in the luteal (49 +/- 7 mu/ml) than in the early follicular phase (18 +/- 3 mU/ml). The effect of exogenous sex steroid hormones taken as contraceptive drugs was then studied in 15 women. Significantly lower LH and FSH basal values as well as responses to LHRH were observed in 8 normal women under oral combined contraceptives. Conversely, in 7 women under oral sequential contraceptives, basal LH and FSH remained in the normal range. The LH-FSH responses were increased and delayed when these tests were performed during the period of estrogen treatment. Thus, with combined oral contraceptives, constant and high levels of estrogens and progesterone not only inhibit the LH peak, but also decrease the basal LH-FSH levels and responses to releasing hormone. Conversely, with sequential oral contraceptives, the low level of estradiol does not inhibit these responses and even enhances them. In menopausal women both basal and gonadotrophin responses to LHRH were increased indicating an important pituitary reserve. In menstruating women a significant estradiol increase is observed 2 and 4 hours after a 100 mug LHRH injection, both during the follicular and the luteal phases whereas progesterone increases only in the luteal phase. In men, testosterone was found to increase 4 hours after a 100 mug LHRH injection. These studies show that in normal subjects, sex steroid hormones are important regulators of the sensitivity of the pituitary responsiveness to releasing hormone.

Contraceptives, Oral, Combined↗