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Hormone replacement therapy: reassessing the risks and benefits.

Although the association between postmenopausal hormone use and breast cancer has not been clarified, there is nothing indefinite about the survival advantage conferred by hormone replacement therapy. Cardiovascular and fracture-related deaths so outnumber breast cancer deaths that even women with family histories of the latter are likely to benefit from low-potency estrogen replacement.

Contraindications↗

Sex hormone binding globulin and transcortin in human and baboon males.

TeBG and transcortin were identified in serum from adult male baboons. TeBG values were higher than the TeBG concentration in adult men. The relative competitive abilities of three natural steroids, a synthetic androgen and two synthetic estrogens, for binding sites on TeBG occupied by radioactive DHT were compared. At a 10-fold molar excess, using both baboon and human TeBG, DHT and T were the most effective competitors; E2 was intermediate and DES a very poor one. Using gel filtration, the transcortin concentrations (mg/L) in two baboons were 16.8 and 27.4; the normal range for men is 23--45. The serum transcortin value of a third baboon, determined by equilibrium dialysis, was 0.41 micron/L (21.5 mg/L). Competition studies, using both techniques, showed that progesterone has a slightly higher affinity for baboon transcortin than cortisol and that a synthetic progestin does not bind to transcortin. Plasma binding capacity for synthetic steroids should be tested before they are used for studies on specific tissue receptors contaminated with serum.

Animals↗

Estrogenic and progestational activity of 7alpha-methyl-19-nortestosterone, a synthetic androgen.

Synthetic androgens exhibit estrogenic/antiestrogenic and progestational activities in addition to their androgenic effects. To investigate the pharmacological action of the synthetic androgen, 7alpha-methyl-19-nortestosterone (MENT), we examined its action in female rodents. The criteria employed for estrogenic/antiestrogenic effects were, uterine weight increase, vaginal cornification, induction of progesterone receptors (PR) synthesis and stimulation of peroxidase activity in the uteri of ovariectomized rats and mice. MENT increased uterine weight in a dose dependent manner, but did not cause vaginal cornification or stimulate PR synthesis in the uterus. The uterotropic activity of MENT was 200-fold lower than that of estradiol. Estrogen receptor (ER) bound [3H]-E2 was displaced by E2 and MENT with ED50 values of 70 pg and 250 ng, respectively, a 3,500 fold difference in their binding affinity. The low binding of MENT to ER, in contrast to its relatively high uterotropic action, suggested that receptors other than ER may be involved in its action on the uterus. The progestational activity of MENT in immature rabbits using the McPhail index assay was comparable to that of progesterone. Binding affinities of MENT and progesterone to PR were also comparable. However, the action of MENT on the uterus does not seem to be a progestational effect since mifepristone, an antiprogestin, had no effect on MENT-induced uterine growth. Specific androgen receptors (AR) in uterine cytosol were demonstrated. The involvement of AR in MENT action was confirmed by using an antiandrogen (flutamide) and an antiestrogen (ICI-182) in ovariectomized mice. Although MENT did not block the uterotropic effect of E2, it inhibited the E2-induced cornification of vaginal epithelium, induction of uterine PR synthesis and increase in uterine peroxidase activity in ovariectomized rats. The antiestrogenic effect of MENT was also blocked by flutamide. These results suggest that the uterotropic and antiestrogenic effects of androgens are mediated via AR. It is concluded that the increase in uterine weight caused by MENT is attributable to its anabolic effects.

Animals↗

Synthesis, antifertility activity, and protein binding affinity of 7(8 leads to 11 alpha)abeo steroids.

A series of 7(8 leads to 11 alpha)abeo steroids was synthesized by a modification of the previously described total synthesis of this class of compounds and evaluated for biological activity. In general, there was a marked reduction in the relative binding affinities of these compounds for the rabbit uterus estrogen and progestin receptor proteins. None of the compounds which were subjected to uterotropic, antiuterotropic, postcoital, progestational, antiprogestational, or antiandrogenic assays showed any significant activity.

Animals↗