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Effects in vitro of medroxyprogesterone acetate on steroid metabolizing enzymes in the rat: selective inhibition of 3 alpha-hydroxysteroid oxidoreductase activity.

The effects of 6 alpha-methyl-17 alpha-acetoxy-4-pregnene 3,20-dione (MPA) on the activity of different steroid metabolizing enzymes in vitro were investigated in several organs in the rat. MPA seems to be a potent inhibitor of 3 alpha-reduction of 17 beta-hydroxy-5 alpha-androstan-3-one (Dht) in homogenates of the testis, ovary, epididymis, prostate, kidney and the adrenal glands. In testicular homogenates MPA acts like a competitive inhibitor of the 3 alpha-reduction of Dht, with Ki of 0.42 [microM]. MPA seems to be a selective inhibitor of 3 alpha-hydroxysteroid oxidoreductase in numerous organs. Steroid metabolizing enzymes like 5 alpha-reductase, 7 alpha-hydroxylase, 3 beta-hydroxysteroid oxidoreductase and 17 beta-hydroxysteroid oxidoreductase were not inhibited by MPA under the conditions of incubation employed in these studies.

17-Hydroxysteroid Dehydrogenases↗

Antitumor effects of combination toremifene and medroxyprogesterone acetate (MPA) in vitro and in vivo.

The estrogen (ER) and progesterone (PgR) receptor levels in various gynecological tumors were measured. The same tumors were exposed in vitro to toremifene, MPA or their combination and the growth of the tumors was followed by measuring the adenosine triphosphate (ATP) within the cells by a simple bioluminescence assay. Altogether 34 clinical samples were studied. DMBA-induced mammary tumors bearing rats were treated in vivo with toremifene, MPA and their combination. About half of the ovarian cancers and 6 out of the 7 adenocarcinomas of uteri contained ER. The ovarian tumors were PgR rich in 25% and adenocarcinomas of uteri in 6 out of the 7 cases. When compared to control toremifene (concentration 1 mumol/l) was able to decrease the number of living cells to 50% or less in 9/34 samples, MPA (concentration 10 mumol/l) in 17/34 samples, and the combination in 25/34 samples. In five cases the antitumor effect of the combination was synergistic. In two cases signs of weak antagonism were seen. In vivo the antitumor effect of toremifene and MPA was clearly synergistic against DMBA-induced cancers. The effect was dose-dependent and at sufficiently high doses it was possible to eradicate the tumors and cure the animals.

9,10-Dimethyl-1,2-benzanthracene↗

The effects of depo-medroxyprogesterone acetate (DMPA) on copulation-related and agonistic behaviors in an island colony of stumptail macaques (Macaca arctoides).

This study examined the effects on copulation-related and agonistic behaviors of repeated DMPA (depo-Provera) treatment of adult females in a heterosexual island colony of stumptail macaques (Macaca arctoides). Comparison of mean rates revealed a decrease in male approach to females and dominant male following of females after they were treated with DMPA. As treatment did not affect female genital present, female approach or follow of males, we conclude, consistent with earlier results, that DMPA primarily reduced female sexual attractiveness. DMPA treatment was also consistently associated with increased female agonistic behavior (i.e., low-level threat, bite, and fear grimace), with aggression directed primarily at subadults, juveniles, and infants. Treatment did not alter dominance relationships. These data suggest that DMPA treatment is associated with increased low-key contact aggression.

Aggression↗

Phase II trial of medroxyprogesterone acetate in advanced ovarian cancer: an EORTC Gynecological Cancer Cooperative Group Study.

Progestin therapy of ovarian carcinoma in the past has been reported to lead to varying response rates. A multicenter phase II study of high-dose MPA was conducted in 53 patients with epithelial ovarian cancer who had received adequate trials of conventional therapy with cytotoxic agents. Forty-one patients were included for response and toxicity evaluations. Only one partial response has been recorded with a duration of 20 weeks. Stabilization of disease was observed in 7 patients. The present investigation shows that MPA given at the present high dose is not effective in patients extensively pretreated with chemotherapy.

Adenocarcinoma↗

Bone mineral density in long-term depot medroxyprogesterone acetate acceptors.

The study of bone density in long-term DMPA users is reported. The aims were to study and compare bone density in long-term DMPA users with intrauterine device (IUD) users. Fifty current users of DMPA with a minimum 36 months previous use were compared to 50 current IUD users as control. The bone mineral density was measured by dual energy x-ray absorptiometry (DEXA) at the non-dominant distal and ultradistal forearm. Serum estradiol was measured by microparticle enzyme immunoassay technique in both groups. Age, income, weight, height, BMI, and parity of both groups were matched. The mean bone mineral density of distal forearm in DMPA and IUD users was 0.48 +/- 0.05 g/cm2 in both groups. The mean bone mineral density of ultradistal forearm was 0.38 +/- 0.06 g/cm2 in DMPA users and 0.4 +/- 0.05 g/cm2 in IUD users. No differences in mean bone mineral density of distal and ultradistal forearm between DMPA and IUD users was demonstrated (95% CI -0.02, 0.02 and -0.04, 0.001, respectively). However, the serum estradiol levels were significantly different between DMPA and IUD users (95% CI -122, -68.1). From this study, it is suggested that long-term DMPA use should not have any adverse effect on bone density even if it reduces serum estradiol.

Absorptiometry, Photon↗