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The relationship between congenital defects and the use of exogenous progestional "contraceptive" hormones during pregnancy: a 20-year review.

This review of 20 years of medical literature on the occurrence of congenital defects among offspring of women who ingested "progestational" or contraceptive hormones during pregnancy emphasizes the need for additional studies with carefully selected control groups. Other problems encountered in interpreting the existing literature, including the use of imprecise definitions, confusing nomenclature and inadequate clinical information, are also discussed.

Abnormalities, Drug-Induced

[Effect of long-term progestational treatment on the course of endometrial adenocarcinoma].

Author studied the effect of prolonged--6-8 month--treatment with Hormofort on the cells of adenocarcinoma of the endometrium. Light- and electronmicroscopic studies show, that after the treatment with progestative hormones cells of the adenocarcinoma seems significantly regrediate and simultaneously clinical remission can be observed. These data suggest, that progestative-norsteroids seems to elicit "cytostatic" effect on the endometrical tumour cells.

Adenocarcinoma

Importance of progesterone in DNA synthesis of pregnancy-dependent mammary tumors in mice.

Hormone responsiveness of pregnancy-independent mammary tumors in SHN mice and pregnancy-dependent tumors in GR/A mice and in F1-hybrids between these strains was studied. Force-bred female mice with palpable mammary tumors were given subcutaneous injections of several hormones singly or in combination twice daily from 1 day before to 1 day after parturition. One group received a graft of three pituitary glands under the kidney capsule (3AP) during days 12-14 of pregnancy. One day after parturition, the in vivo incorporation of 3H-thymidine into DNA of normal and neoplastic mammary glands was determined as the index of DNA synthesis. Plasma prolactin in some groups of GR/A mice was assayed by radioimmunoassay. In GR/A mice, estradiol benzoate (EB: 0.5 mug X 2/day) or 3AP had no effect on either normal glands or tumors, despite an increase in plasma prolactin level. Progesterone (P:100 or 1,000 mug X 2/day) significantly increased DNA synthesis of both normal and neoplastic glands when compared to the controls, while the plasma prolactin level in this group was low. The administration of human placental lactogen (HPL: 100 mug X 2/day) stimulated DNA synthesis of normal glands only. P plus HPL promoted DNA synthesis of tumors more than P alone, but not P plus EB. While DNA synthesis of the tumors of SHN was never affected by these hormone treatments, the hormone responsiveness of tumors of F1-hybrids was almost the same as that of GR/A mice; the effect of P was prominent. Correlation of DNA synthesis between pregnancy-dependent mammary tumors and normal glands was significant only in groups treated with P alone or in combination with other hormones.

Animals

Prolactin oversuppression.

Patients with primary infertility due to hyperprolactinemic corpus luteum insufficiency and oligomenorrhea were treated with Bromocriptin. Suppression of serum prolactin for up to four menstrual cycles resulted in a normalisation of the length of the cycle(32 vs 28 days) as well as of luteal progesterone secretion. In addition, ovulation occurred earlier after than before treatment (on day 14 vs day 18). When, however, prolactin concentrations reached levels of less than 120 muU/ml (3 ng/ml), which were observed during the 5th and 6th treatment course, reappearance of shortened luteal phase occurred probably due to oversuppression of prolactin. Premenstrual spottings were observed too. The data presented indicate that minimal prolactin is required for normal follicular maturation and luteal development. On the other hand, the gonadostat may be susceptable to the dopaminergic stimulus of Bromocriptin to a different extent as oversuppression of prolactin is not observed in hyperprolactinemic anovulatory syndromes. Thus, treatment with Bromocriptin requires a continuous monitoring of serum prolactin as well as individual treatment regimens.

Bromocriptine

Gonadotropin, prolactin, and steroid hormone levels after discontinuation of oral contraceptives.

Serum levels of LSH, LH, estradiol, progesterone, and prolactin were measured daily for 2 months in six women after discontinuation of combination oral contraceptives. The initial LH peak occurred from 21 to 28 days after ingestion of the last tablet. Apart from variable prolongation of the follicular phase in the first postcontraceptive cycle, the patterns and levels of all hormones were indistinguishable from those found in normal ovulatory subjects. These results indicate that after a variable brief interval following discontinuation of oral contraceptive steroids, their suppressive effect on the hypothalamic-pituitary-ovarian axis disappears. This initial recovery results in completely normal endocrine function.

Adult

The significance of galactorrhea in patients with normal menses, oligomenorrhea, and secondary amenorrhea.

Thyroid-stimulating hormone and prolactin (PRL) were measured in a group of 149 women with galactorrhea. Three of these patients were found to have primary hypothyroidism. In the remaining 146 patients, the PRL assay was correlated with the menstrual history and the results of hypocycloidal polytomography. Sixty-two per cent of these patients had hyperprolactinemia and 35 per cent had abnormal tomograms. Nine patients with abnormal x-rays had normal prolactin levels. None of the patients with normal menses and normal PRL was found to have an abnormal x-ray. Fourteen of the 15 patients with PRL levels greater than 200 ng. per milliliter had abnormal tomograms. Almost 70 per cent of patients with secondary amenorrhea and low estrogen status had abnormal x-rays. In patients with oligomenorrhea and secondary amenorrhea with normal estrogen status, it was not possible to differentiate between patients with normal or abnormal tomograms based on the level of serum PRL. Polytomography remains the single most important diagnostic test in establishing the presence of a pituitary tumor.

Adolescent

Current concepts of prolacting physiology in normal and abnormal conditions.

Currently the physiology and pathophysiology of pituitary prolactin secretion are under intensive investigation. Development of sensitive, specific radioimmunoassays for hPRL and improved roentgenographic techniques have increased the diagnostic acumen for incipient pituitary microadenomas. Several modalities of treatment are available at the present time which can result in improvement in the clinical symptoms of the amenorrheagalactorrhea syndromes. Eponymic classification of amenorrhea-galactorrhea syndromes should be discarded and appropriate diagnostic studies initiated to determine the etiology of the inappropriate breast secretion and/or elevated serum hPRL level.

Adenoma

Hormone-dependent mammary tumors in strain GR/A mice. II. Preneoplastic and neoplastic properties.

In a series of transplant experiments, we investigated interactions between normal, ductal phase, and tumorous phase mammary tissues in GR/A mice, with particular respect to growth regulation. Transplants from hormone-dependent mammary tumors (HDT) transplanted into mammary fat pads already containing normal mammary ducts usually could not be located subsequently or, at best, displayed minimal growth. Growth regulation was also normal when two HDT transplants, placed in a single gland-free fat pad in nonpregnant hosts, produced ductal outgrowths displaying mutual avoidance behavior in which ducts did not touch and were normally spaced. A normal and HDT transplant in a single gland-free fat pad also showed identical, normal regulatory behavior. In contrast, HDT transplants in pregnant hosts or in hosts receiving exogenous hormone therapy displayed altered growth patterns in which neighboring tumors touched and eventually fused. When surrounded by normal tissues, the HDT continued to proliferate and often appeared to overgrow and engulf normal elements. We concluded that HDT tissues grown in nonpregnant hosts fully responded to those short-range regulatory influences characteristic of normal morphogenesis. When exposed to hormones of pregnancy, however, these interactions changed, and HDT tissues exhibited many characteristics of ductal carcinomas.

Animals

Potent inhibitory effect of a new antiestrogen (RU 16117) on the growth of 7,12-dimethylbenz[a]anthracene-induced rat mammary tumors.

At the daily dose of 24 mug for a period of 4 weeks, RU 16117 (11alpha-methoxyethinyl estradiol), a new antiestrogen, led to 65% reduction of the number of already established dimethylbenz[a]anthracene (DMBA)-induced mammary tumors in female Sprague-Dawley rats. Not only the tumor number but also the tumor size was reduced by RU 16117 in a manner similar to that seen after ovariectomy. The absence of an inhibitory effect of doses of 0.1 to 12.5 mug 17beta-estradiol (E2) per day, a dose-range which covers the low estrogenic activity of the RU 16117 doses used, suggested that the inhibitory effect of RU 16117 was not due to its estrogenic activity. Decreased levels of receptors for E2, progesterone, and prolactin were found in the tumors remaining after ovariectomy; treatment with the dose of RU 16117 sufficient to inhibit tumor growth (24 mug) had a similar inhibitory effect on the levels of E2 and prolactin receptors. These data suggested that a reduction of hormone receptor levels in the tumor tissue could be a mechanism by which RU 16117 acts as a potent inhibitor of the growth of DMBA-induced mammary carcinoma.

9,10-Dimethyl-1,2-benzanthracene