OBJECTIVETo observe the clinical efficacy of warming Shen, enhancing Yang, invigorating qi, and nourishing blood method (WSEYIQNBM) combined artificial cycle therapy in treatment of premature ovarian failure (POF) patients of Shen yang deficiency syndrome (SYDS).

METHODSTotally 96 POF patients of SYDS were randomly assigned to the treatment group and the control group, 48 in each group. Patients in the treatment group were treated with WSEYIQNBM combined artificial cycle therapy, while those in the control group were treated with Western medicine artificial cycle therapy. One month constituted 1 course, a total of 3 courses. The menstruation and main symptoms were observed before and after treatment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were detected before and after treatment.

RESULTSThe total effective rate was 85.43% in the treatment group, higher than that of the control group (79.17%, P < 0.05). Besides, better effect in improving Chinese medical symptoms was obtained in the treatment group (P < 0.05).

CONCLUSIONPOF patients' serum hormone levels and clinical symptoms could be improved by WSEYIQNBM combined artificial cycle therapy.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; administration & dosage ; therapeutic use ; Female ; Humans ; Phytotherapy ; Primary Ovarian Insufficiency ; diagnosis ; drug therapy

Transmasculine individuals, considering whether to undergo total hysterectomy with bilateral salpingectomy, have the option to have a concomitant oophorectomy. While studies have evaluated hormone changes following testosterone therapy initiation, most of those patients have not undergone oophorectomy. Data are currently limited to support health outcomes regarding the decision to retain or remove the ovaries. We performed a retrospective chart review of transmasculine patients maintained on high-dose testosterone therapy at a single endocrine clinic in Vancouver, British Columbia, Canada. Twelve transmasculine individuals who underwent bilateral oophorectomy and had presurgical and postsurgical serum data were included. We identified 12 transmasculine subjects as controls, who were on testosterone therapy and did not undergo oophorectomy, but additionally matched to the first group by age, testosterone dosing regimen, and body mass index. There was a statistically significant decrease in the estradiol levels of case subjects postoophorectomy, when compared to presurgical estradiol levels (P = 0.02). There was no significant difference between baseline estradiol levels between control and case subjects; however, the difference in estradiol levels at follow-up measurements was significant (P = 0.03). Total testosterone levels did not differ between control and case subjects at baseline and follow-up (both P > 0.05). Our results demonstrate that oophorectomy further attenuates estradiol levels below what is achieved by high-dose exogenous testosterone alone. Correlated clinical outcomes, such as impacts on bone health, were not available. The clinical implications of oophorectomy versus ovarian retention on endocrinological and overall health outcomes are currently limited.
Female ; Humans ; Testosterone/therapeutic use* ; Retrospective Studies ; Ovariectomy ; Hysterectomy/methods* ; Estradiol

OBJECTIVETo investigate the clinical efficacy of integrative traditional Chinese and Western medicine on polycystic ovarian syndrome (PCOC).

METHODSSixty-three patients with polycystic ovarian syndrome were randomly allocated into 2 groups, 31 patients orally administered with diane-35 in the Western medicine group (WMG) and 32 patients treated with conventional controlled medicine plus modified Yougui Pill in the integrative medicine group (IMG). Changes of relevant hormones and clinical syndromes in patients were detected before treatment, after 3 cyclic treatment and at the 6th cycle after treatment.

RESULTSThe levels of relevant hormones and the indexes of B-ultrasonic were obviously improved after treatment in the two groups. But 6 cycles after treatment, these changes restored to the baseline as those before treatment in WMG, while maintained in IMG (P < 0.01). What's more, the normalization of menstruation, ovulation and pregnancy rate in IMG were significantly higher than those in WMG (P < 0.01).

CONCLUSIONDiane-35 combined with modified yougui pill in treating polycystic ovarian syndrome not only shows marked short-term effect, but could consolidate the curative effect.

Adult ; Androgen Antagonists ; therapeutic use ; Cyproterone Acetate ; therapeutic use ; Drug Administration Schedule ; Drug Combinations ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Ethinyl Estradiol ; therapeutic use ; Female ; Humans ; Phytotherapy ; Polycystic Ovary Syndrome ; drug therapy ; Tablets

BACKGROUNDThe successful end-point of in vitro fertilization (IVF) treatment is for a woman to give live birth. This outcome is based on various factors including adequate number of retrieved eggs. Failure to recruit adequate follicles, from which the eggs are retrieved, is called a "poor response". How to improve the clinical pregnancy rates of poor responders was one of the tough problems for IVF.

METHODSThe study involved 51 patients who responded poorly to high dose gonadotropin treatment in their previous cycles at our reproductive center, between April 2010 and February 2012. The previous cycle (group A) received routine long protocol; the subsequent cycle (group B) received modified super-long down-regulation protocol. The primary outcome of the study was the number of oocytes fertilized. The increase in the pregnancy rate was the secondary outcome. Differences between the groups were assessed by using Student's t test and c(2) test where appropriate.

RESULTSThe patients' average age was (36.64 ± 3.85) years. The mean duration of ovarian stimulation cycles of the group A patients was longer than those of the group B patients. The total dose of follicle-stimulating hormone (FSH) was significantly lower in the subsequent cycle. The peak value of serum estradiol on human chorionic gonadotrophin (hCG) day was lower in group A as compared with group B. The number of metaphase II oocytes recovered was significantly higher in group B. The cleavage rate in group A was significantly lower than in group B, 49 patients in group B reached embryo transfer stage, while 46 patients in group A reached this stage. Patients in group B received significantly more embryos per transfer as compared with group A. More pregnancies and more clinical pregnancies with fetal heart activity were achieved in group B.

CONCLUSIONSThis comparative trial shows that poor responder women undergoing repeated assisted reproduction treatment using modified super-long down-regulation protocol achieve more oocytes, leading to higher fertilization rate, compared to women receiving routine long protocol. Our study also showed that clinical pregnancy rate was significantly improved.

Adult ; Chorionic Gonadotropin ; therapeutic use ; Embryo Transfer ; Estradiol ; blood ; Female ; Fertilization in Vitro ; methods ; Follicle Stimulating Hormone ; therapeutic use ; Humans ; Male ; Ovulation Induction ; methods ; Pregnancy

OBJECTIVETo observe the effect of Bushen Peiyuan Principle (BSPY, a TCM principle for tonifying Kidney and nourishing primordial energy) in treating patients with postmenopausal coronary heart disease (PCHD) instead of hormone treatment.

METHODSTwenty-five healthy women, who were monepaused for over 5 years but without CHD complication were allocated in Group A, 25 patients with PCHD complication suffered from estrogen contraindications such as embolism, hysteromyoma and mammary adenoma, were arranged in Group B, and 25 patients of PCHD without above-mentioned complications were divided into Group C. Group B and C was treated with BSPY and hormone replacement therapy respectively, and the drugs for hypolipidemics were withdrawn 1 month before the study. All the patients were observed for 3.5 months, with their blood levels of estradiol (E2) and lipids determined before and after treatment.

RESULTSBefore treatment, the level of E2 in the two treated groups was lower than that in the normal group significantly (P < 0.01), and the parameters of blood lipids were abnormal in them. These abnormalities were improved after treatment significantly (P < 0.05 or P < 0.01). The level of E2 raised significantly (P < 0.01) after treatment in patients of Group C, with withdrawal vaginal bleeding presented in 90% of less than 56 years in age. In the Group B after treatment, level of E2 showed a slight rising and withdrawal vaginal bleeding was not found but with improvement of symptoms and signs better than that in Group C.

CONCLUSIONUsing BSPY in treating PCHD displayed significant adjustment on disturbance of blood lipid spectrum and improvement on clinical manifestations. As compared with the therapeutic effect of hormone replacement therapy, the risk of carcinogenesis caused by endometrial hyperplasia could be avoided because the blood level of E2 is only slightly increased by BSPY.

Coronary Disease ; blood ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; blood ; Female ; Humans ; Middle Aged ; Phytotherapy ; Postmenopause ; Progesterone ; therapeutic use

OBJECTIVETo observe the effect of estrogen and progestin on the blood levels of nitric oxide and angiotensin II in aid of the application of hormone replacement therapy in postmenopausal women.

METHODSThe serum nitric oxide and plasma angiotensin II levels in postmenopausal women were determined before and 3 months after oral intake of estradiol valerate 1 mg/day (n = 10) or estradiol valerate, 1 mg/d plus medroxyprogesterone acetate, 2 mg/d (n = 30).

RESULTSThe serum nitric oxide levels of postmenopausal women were significantly increased by 3 months of oral estradiol valerate 1 mg/d (P < 0.05), whereas the plasma levels of angiotensin II tended to decrease. The positive correlation between the increases of nitric oxide and the changes of estradial 3 months after oral intake of estradiol valerate 1 mg/d was significant. Compared with the baseline, no significant changes were observed in both serum nitric oxide levels and plasma angiotensin II levels 3 months after oral intake of estradiol valerate, 1 mg/d plus medroxyprogesterone acetate, 2 mg/d (P < 0.05).

CONCLUSIONSThe vascular functions can be improved through increasing the serum nitric oxide level after 3-month oral intake of estradiol valerate, 1 mg/d in postmenopausal women, and estradiol valerate plus medroxyprogesterone acetate intake may attenuate the beneficial effects.

Adult ; Angiotensin II ; blood ; Estradiol ; analogs & derivatives ; therapeutic use ; Estrogen Replacement Therapy ; Female ; Humans ; Medroxyprogesterone Acetate ; therapeutic use ; Middle Aged ; Nitric Oxide ; blood ; Postmenopause ; blood

Cardiovascular disease continues to be the leading cause of morbidity and mortality among the postmenopausal women. Several randomized clinical trials to determine whether hormone replacement therapy (HRT) has a cardioprotective role and several others are currently underway. The results' however were controversial. During the past 3 years, a number of randomized clinical trials have investigated the role of HRT in primary and secondary prevention of clinical and anatomical manifestations of atherosclerosis and the clinical results suggest that HRT can not decrease cardiovascular events or slow down the development of atherosclerosis in women with established coronary heart disease (CHD). In contrast, HRT has been showed to possibly effective in women without CHD as primary prevention.
Arteriosclerosis ; prevention & control ; Coronary Disease ; prevention & control ; Double-Blind Method ; Estradiol ; therapeutic use ; Estrogen Replacement Therapy ; Female ; Humans ; Medroxyprogesterone ; therapeutic use ; Middle Aged ; Postmenopause

OBJECTIVETo observe the changes of urinary deoxypyridinoline crosslink/creatinine (UDpd/Cr) in rats after OVX and intervention by estrogen and bisphosphonate and investigate the possible application of deoxypyridinoline in osteoporosis diagnosis and treatment.

METHODS40 female 6-month-old virginal Wistar rats were divided into 5 groups, ovariectomized or sham ovariectomized. (1) Ovxb (n = 8): sacrificed at 6 weeks after OVX; (2) Sham (n = 8): sham ovariectomized; (3) Ovxe (n = 8): sacrificed at 14 weeks after OVX; (4) O + E (n = 9):OVX + 17 beta estradiol [20 micrograms/(kg.d) ih]; (5) O + C (n = 7):OVX + cimadronate [0.2 mg/(kg.d)]; Treatment started 6 weeks after OVX and lasted 8 weeks. Rats in group 2-5 were sacrificed at 14 weeks after OVX. Urinary and serum biochemical parameters were measured, pQCT scanning of femur, bone biomechanical test in femur were determined.

RESULTSOVX resulted in increasing of UDpd/Cr 133.3% (P < 0.01). The ratio of UCa/Cr also increased in OVX groups but without any significant compared with Sham (P > 0.05). UDpd/Cr were reduced by 54.6% and 51.8% (P < 0.01) in O + E, O + C group respectively compared with Ovxe. The significant negative correlationships were found between UDpd/Cr and bone mass, BMD and biomechanic characteristics.

CONCLUSIONSUDpd/Cr ratio is a sensitive bone resorption marker, a marked changes were observed when the rats ovariectomized or treated with estradiol and cimadronate. There were best correlation between UDpd/Cr and bone mineral density and bone biomechanic characteristics. It is fair to apply UDpd/Cr ratio for osteoporosis diagnosis and treatment.

Amino Acids ; urine ; Animals ; Bone Density ; Creatinine ; urine ; Diphosphonates ; therapeutic use ; Estradiol ; therapeutic use ; Female ; Osteoporosis ; drug therapy ; urine ; Ovariectomy ; Rats ; Rats, Wistar

BACKGROUNDOur earlier studies indicate that melatonin inhibits the proliferation of prolactinoma and induces apoptosis of pituitary prolactin-secreting tumor in rats. Melatonin has also been shown to induce apoptosis and to reduce the production of ATP in breast tumor cells. This study analyzed the levels of the four mitochondrial respiratory complexes and the production of ATP and also the effects of melatonin treatment of prolactinoma.

METHODSIn the in vivo study, mitochondria were harvested from control pituitaries or prolactinoma collected from the pituitaries of melatonin- and 17-β-estradiol (E2)-treated male rats. In the in vitro study, prolactinoma cells mitochondria were harvested. Activities of the four mitochondrial respiratory complexes were assayed using fluorometer. ATP production of prolactinoma cells was estimated using bioluminescent methods.

RESULTSElevated levels of four mitochondrial respiratory complexes activities and ATP production were recorded in prolactinoma cells. Moreover, in both in vivo and in vitro studies, melatonin inhibited the activities of mitochondrial respiratory complexes and the production of ATP in prolactinoma cells.

CONCLUSIONSThere is a link between mitochondrial function increase and tumorigenesis. Melatonin induces apoptosis of pituitary prolactin-secreting tumor of rats via the induction of mitochondrial dysfunction and inhibition of energy metabolism.

Adenosine Triphosphate ; metabolism ; Animals ; Estradiol ; therapeutic use ; Male ; Melatonin ; therapeutic use ; Mitochondria ; drug effects ; metabolism ; Prolactin ; metabolism ; Prolactinoma ; drug therapy ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the effect of combined continued estrogen and progestin replacement therapy on knee osteoarthritis (OA) symptoms of postmenopausal women.

METHODSSixty-four postmenopausal women with radiological knee OA and symptoms aged 45-75 were divided into treatment group and control group. They were given estradiol velerate (E2V) 1.0 mg/d and medroxyprogestetone acetate (MPA) 2 mg/d (treatment group) or placebo (control group) for 6 months. Calcium 400 mg/d were given to all cases. Then 0-100 mm visual analon scale (VAS) was used to evaluate the severity of knee pain at baseline and after 1, 3, 6 month of treatment.

RESULTSSignificant differences on pain at night and tenderness around knee were seen in the treatment group compared with the control group after 1 months of treatment (P = 0.036 and 0.035, respectively). The improvement of pain at night, during walk and morning stiffness between the two groups showed significant difference after 6 months (P = 0.026, 0.027, and 0.011, respectively).

CONCLUSIONCombined estrogen and progestin replacement therapy can relieve the knee OA symptoms of postmenopausal women.

Aged ; Double-Blind Method ; Estradiol ; therapeutic use ; Estrogen Replacement Therapy ; Female ; Humans ; Medroxyprogesterone Acetate ; therapeutic use ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Postmenopause ; Prospective Studies