Alcohol effects on luteinizing hormone releasing hormone-stimulated anterior pituitary and gonadal hormones in women

Plasma luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, estradiol (E2) and progesterone were measured in 24 normal, adult women before and after i.v. administration of 100 micrograms luteinizing hormone releasing hormone (LHRH; Factrel) and p.o. ingestion of an alcohol (0.694 g of alcohol per kg b.wt.) or placebo solution. Twelve subjects were studied during the early follicular phase of the menstrual cycle and 12 subjects were studied during the midluteal phase of the menstrual cycle. During each menstrual cycle phase, six subjects received placebo solution and six subjects received alcohol solution administered under double-blind conditions. Mean peak blood alcohol levels of 113 to 122 mg/dl were measured 45 to 60 min after initiation of alcohol intake. LHRH stimulated a significant increase in LH after both alcohol (P less than .0001) and placebo (P less than .0001) administration, and this LH increase was equivalent during the follicular and the luteal phases of the menstrual cycle. LHRH also stimulated a significant increase in FSH levels after both alcohol and placebo intake during the follicular and luteal phases of the menstrual cycle (P less than .0001). There were no significant differences in LHRH-stimulated FSH between the alcohol and placebo conditions. Plasma prolactin levels also increased significantly after LHRH administration during the follicular and luteal phases of the menstrual cycle (P less than .0001). There were no significant differences in prolactin response to LHRH administration between the alcohol or placebo conditions during the follicular and luteal phases of the menstrual cycle. Plasma E2 levels did not increase significantly after LHRH administration and placebo alcohol during the follicular phase of the menstrual cycle.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of risperidone on gonadal axis hormones in schizophrenia

OBJECTIVE: To investigate the effects of risperidone on the hypothalamo-pituitary-gonadal (HPG) axis of chronic schizophrenic male inpatients medicated regularly. METHODS: Subjects included six inpatients who were diagnosed according to the Diagnostic and Statistical Manual, Fourth Edition, criteria for schizophrenia, and were termed treatment-refractory. Each patient gave informed consent for the research involved in this study. The neuroendocrine studies were done before and during risperidone administration. Patients took a mean dose of risperidone 9.5 mg/d for a mean period of 64.2 days. Psychotic symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). RESULTS: Prolactin (PRL) increased significantly during risperidone administration. However, luteinizing hormone, follicle-stimulating hormone, and testosterone did not show significant difference between blood concentrations before and during risperidone administration. Scores of the BPRS total, thought disturbance factor, and tension decreased significantly during risperidone administration. Throughout the study, none of the patients experienced clinically significant problems associated with elevated PRL concentrations including gynecomastia and/or sexual dysfunction. CONCLUSIONS: Addition of risperidone produced significant improvement of psychotic symptoms in treatment-resistant schizophrenic patients, and an increase in basal blood PRL concentrations, but not in basal blood HPG axis hormone concentrations. This preliminary result warrants further double-blind evaluation with a larger sample.     

Chronic alcohol effects on anterior pituitary and ovarian hormones in healthy women

The effects of chronic alcohol intake on menstrual cycle status and hormonal function were studied in 26 healthy, adult women under controlled research ward conditions. Women were classified as heavy, social or occasional alcohol users on the basis of the actual number of drinks consumed during 3 consecutive weeks of alcohol availability. Heavy, social and occasional users drank an average of 7.81 ( +/- 0.69), 3.84 ( +/- 0.19) and 1.22 ( +/- 0.21) drinks/day, respectively. This drinking pattern was highly consistent with subjects' self-reports of alcohol use before the study. No evidence of menstrual cycle dysfunction or abnormality in reproductive hormone levels was found in the occasional drinkers or in two of the social drinkers who consumed less than an average of three drinks/day. In contrast, 50% of the social drinkers who consumed more than three drinks/day and 60% of the heavy drinkers had significant derangements of menstrual cycle and reproductive hormone function. The major abnormality found in social drinkers was anovulatory cycles, and three of the five women who were heavy drinkers had persistent hyperprolactinemia. These findings suggest that alcohol-related menstrual cycle and reproductive hormone dysfunction may be more prevalent among women who are social and heavy drinkers than has been assumed previously.     

补肾健脾化瘀法对围绝经期性激素及血脂影响的临床研究

目的观察补肾健脾化瘀法对围绝经期妇女性激素及血脂的影响。方法选择围绝经期患者377例。按随机数码表按就诊先后随机单盲,分中药组及西药组。中药组(n=188)口服补肾壮骨冲剂治疗。西药组(n=189)应用结合型雌激素加安宫黄体酮治疗。主要观察治疗前后血脂[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)]、性激素[雌二醇(E2)、卵泡刺激激素(FSH)、促黄体生成素(LH)]等指标及症状体征积分的变化。结果①脱失情况比较:中药组治疗2年后脱失53例;西药组治疗脱失96例,两组比较有明显差别(P<0.01)。②有效率比较,两组比较无明显差别(P>0.05)。③症状总评分比较,两组治疗后症状总评分均有明显减少,中药组(P<0.01),西药组(P<0.05);组间比较中药组优于西药组(P<0.01)。④性激素和血脂比较:与治疗前相比,差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。结论补肾健脾化瘀法中药治疗围绝经期妇女,能纠正紊乱的血脂、性激素各项指标,疗效与雌激素替代疗法相当,具有无副作用、服用方便、经济等优点。     

The behavioral and neuronal effects induced by repetitive nociceptive stimulation are affected by gonadal hormones in male rats

The role of gonadal hormones in inducing long-term modifications in response to transient nociceptive stimuli was investigated in adult male rats. Three weeks after gonadectomy or sham surgery, animals were randomly divided into groups to be exposed to sham (only a prick in the dorsal hind paw) or formalin treatment (50 microl, 5% s.c. in the dorsal hind paw) once a week for the following 3 weeks. In gonadectomized animals the formalin-induced responses (licking, flexing and jerking of the injected paw) did not differ from those of intact animals after the first formalin injection. However, their levels were higher after the second or third injections. Indeed, in intact animals the formalin-induced responses progressively decreased, being significantly lower after the third injection than after the first; in gonadectomized animals, the formalin-induced responses did not change with repetition of the formalin treatment. In intact rats, c-Fos expression in the paraventricular nucleus of the thalamus and arcuate nucleus of the hypothalamus remained at control levels or decreased in animals injected two or three times with formalin; in gonadectomized rats, c-Fos expression increased with repetition of the noxious stimulation, reaching the highest levels in animals injected three times with formalin. These results show that male gonadal hormones have an inhibitory, adaptive effect on the behavioral and neuronal responses to repeated nociceptive stimulation.     

Effect of gonadal steroid hormones on formalin‐induced temporomandibular joint inflammation

We have recently demonstrated that gonadal steroid hormones decrease formalin‐induced temporomandibular joint nociception in rats. Given that the attenuation of inflammation is a potential mechanism underlying this antinociceptive effect, we evaluated the effect of gonadal steroid hormones on formalin‐induced temporomandibular joint inflammation. Plasma extravasation, a major sign of acute inflammation, and neutrophil migration, an important event related to tissue injury, were evaluated. Formalin induced significantly lower temporomandibular joint plasma extravasation and neutrophil migration in proestrus females than in males and in diestrus females. Since estradiol serum level is high in proestrus females and low in diestrus females and in males, these findings suggest that the high physiological level of estradiol decreases temporomandibular joint inflammation. Estradiol but not progesterone administration in ovariectomized females significantly decreased formalin‐induced plasma extravasation and neutrophil migration, an effect that was blocked by the estrogen receptor antagonist ICI 182780. Plasma extravasation and neutrophil migration were not affected by orchiectomy, but testosterone or estradiol administration in orchidectomized males significantly decreased them. The androgen receptor antagonist flutamide blocked the anti‐inflammatory effect of testosterone while ICI 182780 blocked that of estradiol in males. Previous intravenous administration of a nonspecific selectin inhibitor significantly decreased formalin‐induced temporomandibular joint nociception and neutrophil migration in males, revealing a potent and positive correlation between temporomandibular joint nociception and inflammation. Taken together, these findings demonstrate a pronounced anti‐inflammatory effect of estradiol and testosterone in the temporomandibular joint region and suggest that this effect may mediate, at least in part, the antinociceptive effect of these hormones.     

Early effects of ethinyloestradiol and norethisterone treatment in post-menopausal women on bone resorption and calcium regulating hormones

The early effects of sex steroid therapy were assessed in 28 normal post-menopausal women, 18 treated with ethinyloestradiol and 10 with norethisterone. There was a reduction in the fasting urinary excretion of both calcium and hydroxyproline with both treatments, indicating reduced bone resorption. This was apparent after 1 week of therapy but became more marked after 3 weeks. These changes were not accompanied by any changes in plasma levels of calcitonin or parathyroid hormone. Patients receiving ethinyloestradiol showed a marked increase in plasma 1,25-dihydroxyvitamin D (1,25-(OH)2D) concentration but this was explicable entirely in terms of increased plasma levels of vitamin D binding protein. There was no change in the free plasma level of 1,25(OH)2D. Patients treated with norethisterone showed no increase in plasma concentrations of 1,25(OH)2D. We conclude that both ethinyloestradiol and norethisterone have a rapid and similar effect in reducing bone resorption. This is not mediated via the plasma levels of the calcium regulating hormones.     

Effectiveness of antidepressant treatments in pre-menopausal versus post-menopausal women: A pilot study on differential effects of sex hormones on antidepressant effects

The incidence or recurrence of major depression is greatly increased in women during the transition to and after menopause and hormonal changes occurring during these periods are thought to play an important role in depressive recurrence. It has been also suggested that a chronic hypoestrogenic state may reduce the response to antidepressant drugs, but whether or not, and the extent to which hormonal changes related to menopause influence the response to antidepressant drugs, is yet to be determined. Thirty-nine female patients (n = 17 in pre-menopause; n = 22 in post-menopause) with major depressive disorder (MDD) based on DSM-IV criteria, who were not on hormonal replacement therapy, participated in the study in order to prospectively evaluate the effect of menopausal status and its hormonal correlates on the effectiveness of antidepressant treatment for 6 weeks. The Hamilton Depression Rating Scale-17 item (HAMD), the Montgomery–Åsberg Depression Rating Scale (MADRS) and the Clinical Global Impression Severity scale (CGI-S) were administered at baseline, week 1, week 3, and week 6. The CGI-I scale was also assessed at weeks 1, 3, and 6. After controlling for age, age at onset, baseline symptom severity, antidepressant dosage and hormonal levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), post-menopausal women showed a poor response to antidepressants over 6 weeks of treatment, compared to the response of pre-menopausal women. Old age and high levels of FSH were also associated with the efficacy of antidepressants in post-menopausal women. In conclusion, sex hormones are known to interact with serotonergic, noradrenergic and dopaminergic systems. Despite methodological limitations, our study suggests that menopausal status and old age are predictors of a poor response to antidepressant treatment. Furthermore, the FSH may interfere with the mechanism of action of the antidepressant agents. Hence, larger, randomized and controlled trials are warranted to expand our understanding of this area.     

抗生殖免疫抗体及性激素与子宫内膜异位症发病的关系研究

目的 探讨患者抗生殖免疫抗体及性激素的变化与子宫内膜异位症(endometriosis,EMS)发病的关系.方法 回顾性分析268例EMS患者(其中年龄＞35岁组的EMS患者90例;年龄≤35岁组的EMS患者178例)和200例非子宫内膜异位症患者(其中年龄＞35岁组的非子宫内膜异位症患者72例,为同龄对照组;年龄≤35岁组的非子宫内膜异位症患者128例,为同龄对照组)的临床资料.用化学发光免疫分析法检测两组患者血清卵泡刺激素(follicle-stimulating homone,FSH)、黄体生成素(homone,LH)、睾酮(testosterone,T)、雌二醇(estradiol,E2)孕酮(progesterone,P)和泌乳素(prolactin,PRL)水平;采用酶联免疫法检测抗卵巢抗体(anti-ovarian antibodies,AOAb)、抗心磷脂抗体(anticardiolipin antibody,ACL)、抗子宫内膜抗体(anti-endometrial antibodies,EMAb)水平.结果 年龄＞35岁组和年龄≤35岁组EMS患者的P、PRL水平均高于同龄对照组,差异有统计学意义;年龄＞35岁组的EMS患者LH水平也显著高于同龄对照组,差异也有统计学意义(P＜0.05).其他激素各项指标比较,差异无统计学意义(P＞0.05).年龄＞35岁组和年龄≤35岁组EMS患者的抗生殖免疫抗体AOAb、ACL、EMAb阳性率明显高于同龄对照组,差异有统计学意义(P≤0.05).结论 ENS患者存在抗生殖免疫抗体变化,高孕激素、高泌乳素水平可能与EMS发病有关.     

Sex differences in pain and analgesia: the role of gonadal hormones.

There is now strong evidence for sex differences in pain and analgesia. These differences imply that gonadal steroid hormones such as estradiol and testosterone modulate sensitivity to pain and analgesia. The goal of this review is to present an overview of gonadal steroid modulation of pain and analgesia in animals and humans, and to describe mechanisms by which males' and females' biology may differentially predispose them to pain and to analgesic effects of drugs and stress. Evidence is presented to demonstrate that sex differences in pain and analgesia may be both quantitative and qualitative in nature. Current research suggests that sex-specific management of clinical pain will be a reality in the not-so-distant future.     

Alcohol treatment for women in rural areas

Alcohol abuse problems are as prevalent in rural areas as they are in more urban settings. Despite the similarity in incidence, providing alcohol abuse treatment services is more challenging in rural versus urban settings. There are unique barriers to offering treatment to women in rural locations that are not present in metropolitan locales. These barriers are related to economics, existing health care providers and services, environmental considerations, cultural norms, and personal perceptions. In this article, treatment challenges that are specifically relevant to women in rural areas are explored along with a new three-tiered treatment delivery model. (J Am Psychiatr Nurses Assoc [2002]. 8, 37-43.)     

Alcohol effects in the elderly

Alcohol is a potent drug and must be included in the medication history of the patient. The physician must be alert to the possibility of alcohol abuse by the elderly, in whom typical clues may not be present. Alcohol has a greater dose-related effect in elderly persons because of their decreased total body water, which leads to persistently higher blood alcohol levels. Alcohol causes unique kinds of brain damage, a fact that may aggravate the clinical symptoms of dementia such as Alzheimer's disease, but there is no convincing proof of premature aging because of alcohol abuse. Alcohol potentiates the sedating effects of many drugs acting on the CNS. This is especially serious in elderly patients, and they should be cautioned concerning the use of alcohol and drugs.     

Female gonadal hormones differentially modulate cocaine-induced behavioral sensitization in Fischer, Lewis, and Sprague-Dawley rats

Evidence suggests the existence of genetic differences in cocaine sensitization in male rats. The present study was undertaken to investigate cocaine sensitization in female rats of genetically distinct inbred (Fischer 344 and Lewis) and outbred (Sprague-Dawley) strains. All female rats were bilaterally ovariectomized and randomly assigned to one of four experimental groups: 1) estradiol benzoate group, 2) progesterone group, 3) estradiol benzoate-plus-progesterone group, and 4) ovariectomized group. Additional controls included sham-operated female rats, female rats that received a single oil injection, and female rats that received repeated oil injections. To determine gender-related differences in the acute and chronic effects of cocaine, data obtained from female rats were compared with those from strain- and weight-matched male rats. Estradiol benzoate-plus-progesterone female rats showed greater locomotor effect in response to an acute dose of cocaine and had more robust sensitization in response to repeated cocaine than did male rats. The bilateral removal of ovaries abolished cocaine sensitization. In all strains of rats studied, progesterone alone did not alter the ovariectomy-induced attenuation of cocaine behavior, but estrogen alone restored cocaine-induced behavioral sensitization. There were significant strain effects on the degree of gonadal hormonal-induced modulation of cocaine sensitization in female rats. Female Lewis rats were extremely sensitive to repeated-cocaine effects, whereas the Fischer 344 female rats showed only marginal effects. The Sprague-Dawley rats ranked intermediate in their behavioral sensitivity. The present study strongly supports the hypothesis that female rats are more sensitive to both acute and chronic behavioral effects of cocaine than are male rats and that the effects are strain dependent. It also shows that estrogen plays an important role in the increased sensitivity of female rats to cocaine sensitization. Together, these data indicate significant interactions between ovarian steroid hormones and genetic factors in cocaine-induced behavioral effects.     

Gender and gonadal hormone effects on vagal modulation of tonic nociception.

We studied the influence of gender and gonadal hormones on modulation of tonic nociception exerted by vagal activity. In male rats, subdiaphragmatic vagotomy resulted in significantly reduced nociceptive behavior during phase 2 of the formalin test. Whereas gonadectomy alone had no effect, it completely eliminated the suppressive effect of subdiaphragmatic vagotomy; however, sex hormone replacement with either testosterone or dihydrotestosterone did not restore the ability of subdiaphragmatic vagotomy to suppress nociceptive behavior. These results suggest that, in males, a gonad-dependent but androgenic gonadal hormone-independent mechanism contributes to pronociceptive effects of vagal afferent activity. Although neither gonadectomy nor subdiaphragmatic vagotomy alone affected the response to formalin in females, gonadectomy plus vagotomy resulted in significantly reduced nociceptive behavior during phase 2. Reconstitution with 17 beta-estradiol implants in gonadectomized females not only prevented suppression of nociceptive behavior seen with gonadectomy plus vagotomy, but also led to increased nociceptive behavior in the interphase between phases 1 and 2. However, placement of 17 beta-estradiol implants in gonad-intact females had no effect on formalin-induced nociceptive behavior. The finding that estrogen produced an increase in nociceptive behavior in gonadectomized female rats after vagotomy but not in normal female rats (with intact gonads and subdiaphragmatic vagus) suggests that the interaction between estrogen and nociceptive afferent activity is suppressed by vagal function. In conclusion, a nonandrogenic action of testicular function in male rats and estrogen in females seems to influence the effect of vagal activity on formalin-induced nociceptive behavior.