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

This study aimed to evaluate the efficacy of random-start controlled ovarian stimulation (COS) in cancer patients for emergency fertility preservation. In this retrospective comparative study, 22 patients diagnosed with cancer and 44 infertile women undergoing conventional in vitro fertilization (IVF) were included. In cancer patients, ovarian stimulation was started on the day of referral, irrespective of their menstrual cycle date. The control group was selected by age matching among women undergoing conventional IVF. COS outcomes were compared between groups. The number of total and mature oocytes retrieved and the oocyte maturity rate were higher in the random-start group than in the conventional-start group. However, duration of ovarian stimulation was longer in the random-start group (11.4 vs. 10.3 days, P = 0.004). The addition of letrozole to lower the estradiol level during COS did not adversely affect total oocytes retrieved. However, oocyte maturity rate was lower in cycles with letrozole than in cycles without letrozole (71.6% vs. 58.2%, P = 0.019). Our study confirms the feasibility and effectiveness of random-start COS in cancer patients.
Cryopreservation ; Estradiol/blood ; Female ; Fertility Preservation/*methods ; Fertilization in Vitro ; Humans ; Infertility, Female/surgery ; Neoplasms ; Nitriles/therapeutic use ; Oocyte Retrieval/*methods ; Ovulation Induction/*methods ; Retrospective Studies ; Triazoles/therapeutic use

This study aimed to evaluate the efficacy of random-start controlled ovarian stimulation (COS) in cancer patients for emergency fertility preservation. In this retrospective comparative study, 22 patients diagnosed with cancer and 44 infertile women undergoing conventional in vitro fertilization (IVF) were included. In cancer patients, ovarian stimulation was started on the day of referral, irrespective of their menstrual cycle date. The control group was selected by age matching among women undergoing conventional IVF. COS outcomes were compared between groups. The number of total and mature oocytes retrieved and the oocyte maturity rate were higher in the random-start group than in the conventional-start group. However, duration of ovarian stimulation was longer in the random-start group (11.4 vs. 10.3 days, P = 0.004). The addition of letrozole to lower the estradiol level during COS did not adversely affect total oocytes retrieved. However, oocyte maturity rate was lower in cycles with letrozole than in cycles without letrozole (71.6% vs. 58.2%, P = 0.019). Our study confirms the feasibility and effectiveness of random-start COS in cancer patients.
Cryopreservation ; Estradiol/blood ; Female ; Fertility Preservation/*methods ; Fertilization in Vitro ; Humans ; Infertility, Female/surgery ; Neoplasms ; Nitriles/therapeutic use ; Oocyte Retrieval/*methods ; Ovulation Induction/*methods ; Retrospective Studies ; Triazoles/therapeutic use

Aged ; Alkaline Phosphatase ; blood ; Calcium Gluconate ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; blood ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; drug therapy ; Phytotherapy

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 investigate the effects of long-term hormone replacement therapy (HRT) on the breasts of postmenopausal women using mammary ultrasonography.

METHODSAn open randomized clinical study was designed. The percutaneous estradiol gel was used in a cyclic regimen combined with micronized progesterone (MP) or medroxyprogesterone acetate (MPA). Sixty healthy women (natural menopause for 1 to 5 years) were recruited and divided into four groups according to the dosage of estrogen and two kinds of progestin. All were given for 25 days per month. Mammary ultrasonography was used to observe breast glandular section thickness, breast duct width, the morphology of lobular unit and the blood flow of color Doppler imaging at baseline and every year from the second to seventh year of HRT. The serum estradiol was also measured from the 15th to 25th day of the cycle. Breast pain was recorded by the subjects.

RESULTS(1) The breast glandular section thickness after HRT was larger than that of before HRT. The breast glandular section thickness became larger gradually over time while the breast duct width became smaller over time. The breast duct width of the fifth year of HRT was significantly different from that of the sixth year (P < 0.05). (2) Twenty-two persons had new breast structure changes after HRT, and the accumulated incidence was 41.5%. New solid lesions formation occurred in five subjects (8.3%) and new cyst formation occurred in one subject (1.7%). After the second year of HRT, the serum estradiol level of the subjects with breast structure changes was higher than that of without breast structure changes and in the sixth year of HRT, and the difference was significant (P < 0.05). After the second year of HRT, the breast glandular section thickness of the subjects with breast structure changes was larger than that of without breast structure changes and in the fifth and sixth year of HRT, the difference was significant (P < 0.05). (3) After HRT, the serum estradiol level of subjects with mastalgia was higher than that of without mastalgia and in the second and sixth follow-up year, the difference was significant (P < 0.05).

CONCLUSIONSThere is an increasing trend of the percentage of glandular tissues of the breast after HRT. There is an increasing trend of the serum estradiol level and the breast glandular section thickness among the subjects with the breast structure changes; there is an increasing trend of the serum estradiol level among the subjects with mastalgia. Mammary ultrasonography can be used to monitor breast structure changes and breast lesions during HRT.

Aged ; Breast ; pathology ; Estradiol ; therapeutic use ; Estrogen Replacement Therapy ; adverse effects ; Female ; Humans ; Medroxyprogesterone Acetate ; therapeutic use ; Menopause ; Middle Aged ; Time Factors ; Ultrasonography, Mammary

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