We have gone through decades using hormone replacement therapy (HRT). The first problem encountered was increased endometrial cancer and solved by addition of progesterone. Now we are facing cardiovascular complications and how could we solve in the use of HRT. Research in vitro with HUAR and HUVEC and clinically seemed to show that small physiological doses might be the solution in protection of CVD.
Aged ; Estrogen Replacement Therapy ; adverse effects ; methods ; Female ; Humans ; Middle Aged ; Postmenopause

Animals ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Estrogen Replacement Therapy ; Female ; Humans ; Ovulation Induction ; methods ; Phytotherapy ; Primary Ovarian Insufficiency ; drug therapy ; genetics

OBJECTIVETo evaluate the efficacy and safety of Kuntai Capsule (KC) and hormone replacement therapy (HRT) in treating menopause syndrome by Meta-analysis.

METHODSRandomized controlled trials were electronically retrieved from PubMed, EMbase, The Cochrane Library, CBM, CNKI, Chinese Doctoral Dissertation Full Text Database, Chinese Outstanding Masters' Dissertation Full Text Database, and VIP database, Wanfang Database, and some other related papers were manually checked. All papers were assessed according to the Cochrane Handbook for Systematic Reviews of interventions and then effective data were analyzed by RevMan 5.0.2 Software.

RESULTSEight randomized control trials involving 675 patients were included. Results of Meta-analysis showed that there was no statistical difference in the Kupperman Menopausal Scores [MD = 1.91, 95% CI (-0.31, 4.12)] and the effective rate of Kupperman Menopausal Scores [OR = 1.37, 95% CI (0.66, 2.85)] between the KC group and the estrogen replacement therapy group (P > 0.05). Compared with the KC group, the E2 level [MD = -12.8, 95% CI (-22.85, -2.76)] and the FSH level [MD = 17.96, 95% CI (3.03, 32.88)] could be significantly improved in the estrogen replacement therapy group. Compared with the estrogen replacement group, KC could significantly reduce the total incidence of adverse reactions [OR = 0.41, 95% CI (0.24, 0.73)], the incidence of breast distending pain [OR = 0.65, 95% CI (0.42, 1.00)], and the incidence of vaginal bleeding [OR = 0.26, 95% CI (0.17, 0.40) ] (P < 0.05).

CONCLUSIONSThe current limited evidence showed that, when compared with the estrogen replacement therapy group, KC could also improve climacteric symptoms. It was inferior to the estrogen replacement therapy group in improving in vivo hormone levels. But it was superior in reducing the incidence of adverse reactions, breast distending pain, and vaginal bleeding.

Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Estrogen Replacement Therapy ; adverse effects ; methods ; Female ; Humans ; Menopause ; drug effects ; Phytotherapy ; adverse effects ; methods

Alzheimer's disease(AD) is one of the most common causes of mental deterioration in elderly individuals, accounting for around 45~60% of the overall cases of dementia over 65 years of age. Although there is presently no "cure" for AD, a large number of potential therapeutic interventions have emerged to correct cholinergic dysfunctions. Currently, cholinergic therapy, particularly cholinesterase inhibition, represents the most realistic approach to the symptomatic treatment of AD. Modest efficacy for mild to moderate AD has been shown in well-designed clinical trials for tacrine, donepezil, rivastigmine, and galantimine. Among other treatment options, estrogen replacement therapy in postmenopausal women is under active investigation, but recent studies showed somewhat disappointing results. Epidemiological and clinical data suggest that nonsteroidal anti-inflammatory drugs are beneficial in the treatment and prevention of AD. But prednisone and COX-2 inhibitor, celecoxib showed no clinical benefit in recent studies. Alpha-tocopherol and gingko biloba showed some beneficial effect in delaying the progression of AD and enhancing cognitive functions. Immunization with beta amyloid peptide was considered to be the only method to prevent and halt disease progression in patients with AD. Recently, phase II clinical trial using synthetic beta amyloid peptide (AN-1792) was discontinued because some patients showed neuro-inflammation which may be caused by autoimmune responses.
Aged ; alpha-Tocopherol ; Alzheimer Disease* ; Amyloid ; Autoimmunity ; Celecoxib ; Cholinesterases ; Cognition ; Dementia ; Disease Progression ; Estrogen Replacement Therapy ; Female ; Ginkgo biloba ; Humans ; Immunization ; Methods ; Prednisone ; Rivastigmine ; Tacrine

Plants of the genus Taraxacum, commonly known as dandelions, are used to treat breast cancer in traditional folk medicine. However, their use has mainly been based on empirical findings without sufficient scientific evidence. Therefore, we hypothesized that dandelions would behave as a Selective estrogen receptor modulator (SERM) and be effective as hormone replacement therapy (HRT) in the postmenopausal women. In the present study, in vitro assay systems, including cell proliferation assay, reporter gene assay, and RT-PCR to evaluate the mRNA expression of estrogen-related genes (pS2 and progesterone receptor, PR), were performed in human breast cancer cells. Dandelion ethanol extract (DEE) significantly increased cell proliferation and estrogen response element (ERE)-driven luciferase activity. DEE significantly induced the expression of estrogen related genes such as pS2 and PR, which was inhibited by tamoxifen at 1 μmol·L(-1). These results indicated that DEE could induce estrogenic activities mediated by a classical estrogen receptor pathway. In addition, immature rat uterotrophic assay was carried out to identify estrogenic activity of DEE in vivo. The lowest concentration of DEE slightly increased the uterine wet weight, but there was no significant effect with the highest concentration of DEE. The results demonstrate the potential estrogenic activities of DEE, providing scientific evidence supporting their use in traditional medicine.
Animals ; Breast Neoplasms ; drug therapy ; metabolism ; Cell Proliferation ; drug effects ; Estrogen Replacement Therapy ; methods ; Female ; Gene Expression ; drug effects ; Humans ; MCF-7 Cells ; Phytoestrogens ; metabolism ; Phytotherapy ; Plant Extracts ; pharmacology ; therapeutic use ; Plant Leaves ; Rats ; Receptors, Estrogen ; metabolism ; Selective Estrogen Receptor Modulators ; pharmacology ; Taraxacum ; Uterus ; drug effects

OBJECTIVES: Ovarian hormones have been shown to regulate body weight, intra-abdominal fat accumulation and plasma level of cytokines. The aim of this study was to investigate the effect of estrogen replacement therapy on visceral adipose tissue, plasma level of apelin, lipid profiles, and glucose in ovariectomized (OVX) rats. METHODS: Thirty female Wistar rats were divided into OVX (n = 20) and sham (n = 10) groups. OVX rats were subdivided into estrogen replacement therapy (OVX+est; n = 10) receiving 17 β-estradiol valerates (30 µg/kg, s.c., 5 day/week, for eight weeks), and vehicle control group receiving sesame oil same as experiment group (OVX+ses oil; n = 10). After the treatments, all groups were sacrificed and blood samples were collected, visceral fats were taken from the abdominal cavity and weighed immediately. Apelin were measured using enzyme-linked immunosorbent assay kits. Lipid profiles and glucose were measured using the enzymatic colorimetric method. Data were analyzed with one-way analysis of variance and (P < 0.05) determined as the statistical significance level. RESULTS: After eight weeks, body weight, body mass index (BMI), visceral fat, apelin and lipid profiles (P < 0.01) were increased significantly in OVX rats compared to sham group. Treatment with estrogen leads to significant reduction in body weight and BMI (P < 0.05), there was no significant change in serum apelin level in OVX+est rats compared to OVX+ses. CONCLUSIONS: These results suggest that estradiol replacement therapy successfully attenuated some of the metabolic syndrome components, and apelin does not probably stand as a mediator of these physiological functions.
Abdominal Cavity ; Animals ; Blood Glucose* ; Body Mass Index ; Body Weight ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Estradiol ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Glucose ; Humans ; Intra-Abdominal Fat* ; Methods ; Plasma ; Rats* ; Rats, Wistar ; Sesame Oil ; Valerates

PURPOSE: To investigate the effects of estrogen on the expression of the alpha1 receptor and nitric oxide synthase (NOS) in rat urethra and bladder after oophorectomy. MATERIALS AND METHODS: Forty-five mature female Sprague-Dawley rats (aged 10-11 weeks, 235-250 g) were randomly assigned to one of three groups: control group, oophorectomy group (Opx), or oophorectomy and estradiol replacement group (Opx+ Est). The degree of expression of alpha1 receptor (alpha1A and D) and NOS (neuronal NOS [nNOS] and endothelial NOS [eNOS]) in bladder and urethral tissues was investigated by using immunohistochemical staining and Western blotting. RESULTS: In the bladder, the expression rates of alpha1 receptor (alpha1A and alpha1D) increased in the Opx group but decreased in the Opx+Est group. These changes were not statistically significant. The alpha1A and alpha1D receptor of the urethra decreased in the Opx group but increased in the Opx+Est group. These changes were not statistically significant. In the bladder and urethra, the expression rates of nNOS and eNOS significantly increased in the Opx group but decreased in the Opx+Est group (p<0.05). CONCLUSIONS: These data suggest that estrogen depletion increases NOS and alpha1 receptor expression in the rat bladder. However, these changes could be restored by estrogen replacement therapy.
Animals ; Collagen/metabolism ; Estradiol/analogs & derivatives/blood/pharmacology ; Estrogen Replacement Therapy/*methods ; Female ; Muscle, Smooth/pathology ; Nitric Oxide Synthase/*metabolism ; Ovariectomy ; Rats, Sprague-Dawley ; Receptors, Adrenergic, alpha-1/*metabolism ; Urethra/drug effects/*metabolism/pathology ; Urinary Bladder/drug effects/*metabolism/pathology

OBJECTIVETo compare the clinical outcome of 4 protocols of frozen-thawed embryo transfer cycle to select the optimal endometrial preparation method for frozen-thawed embryos transfer.

METHODSA retrospective analysis of the 4 clinical protocols was conducted including natural cycle, down-regulated hormone replacement treatment (HRT) cycle, hMG cycle and natural cycle+hCG in endometrial preparation for 419 frozen-thawed embryos transfer cycle, and the clinical pregnancy rate, implantation rate, early abortion rate, ectopic pregnancy rate , ongoing pregnancy rate and delivery rate were compared between the 4 protocols.

RESULTSThere was no significant difference between the 4 groups with different clinical protocols in age, duration of infertility, reason of infertility, number of embryo transferred and endometrial thickness. The 4 protocols differed little in the implantation rate, clinical pregnancy rate, biochemical pregnancy rate, early abortion rate, ectopic pregnancy rate, ongoing pregnancy rate and delivery rate in the four clinical protocols.

CONCLUSIONThe 4 clinical protocols for frozen-thawed embryos transfer all have favorable clinical outcome, and choice of a specific protocol should be made according to the a comprehensive consideration of the individual conditions of the patient.

Adult ; Chorionic Gonadotropin ; therapeutic use ; Cryopreservation ; methods ; Embryo Implantation ; Embryo Transfer ; methods ; Endometrium ; drug effects ; Estrogen Replacement Therapy ; Female ; Gonadal Steroid Hormones ; therapeutic use ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Infertility, Female ; therapy ; Luteinizing Hormone ; therapeutic use ; Middle Aged ; Ovulation Induction ; methods ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies

OBJECTIVETo investigate the effects of long-term low dose hormone replacement therapy (HRT) on postmenopausal women in hormone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy (MRS) parameters.

METHODSA total of 182 postmenopausal women aged 50-87 years were chosen at Peking Union Medical College Hospital and assigned to HRT group and control group. The volunteers of HRT group had taken low dose hormone [estradiol (E2) 0.5-1.0 mg and progesterone 0.5-2.0 mg, once a day] for 4-33 years. The concentrations of E2, progesterone, and testosterone were measured using enzyme-linked immunosorbent assay (ELISA). The gene types of apolipoprotein E (ApoE) were measured by polymerase chain reaction, and the subjects with susceptible genes (ApoE epsilon3/epsilon4) of Alzheimer's disease (AD) were screened. Their hippocampus volumes and MRS parameters were obtained through magnetic resonance imaging (MRI), and results in two groups were analyzed by statistical method.

RESULTSCompared with control group, the concentrations of E2 at each age stage in HRT group were significantly higher (P < 0.05) except the 80-89 years old subgroup; yet, there were no statistical differences in the concentrations of progesterone and testosterone between the two groups. There was no obvious difference in ApoE subtypes distribution between the two groups. The results of hippocampus MRI for the subjects with susceptible genes ApoE epsilon3/epsilon4 (HRT group 14 cases, control group 11 cases) showed that the ratio of bilateral hippocampus volume to whole brain volume in HRT group (0.406 +/- 0.028) was significantly higher than control group (0.369 +/- 0.031, P < 0.05). The results of 1H MRS for the subjects with susceptible genes ApoE epsilon3/epsilon4 (HRT group 12 cases, control group 11 cases) showed that the N-acetylaspartate/total creatine at the area of hippocampus in HRT group (1.54 +/- 0.08) were significantly higher than control group (1.45 +/- 0.13, P < 0.05).

CONCLUSIONSFor postmenopausal women, long-term low dose HRT can maintain the physiological concentration of E2 in plasma. Furthermore, the hippocampus MRI performed on those with ApoE epsilon3/epsilon4 genes shows that long-term low dose HRT can prevent hippocampus atrophy, which is beneficial to maintain the brain function and prevent AD.

Aged ; Aged, 80 and over ; Alzheimer Disease ; prevention & control ; Apolipoprotein E3 ; genetics ; Aspartic Acid ; analogs & derivatives ; metabolism ; Creatine ; metabolism ; Dose-Response Relationship, Drug ; Estradiol ; administration & dosage ; metabolism ; Estrogen Replacement Therapy ; Female ; Hippocampus ; metabolism ; Humans ; Magnetic Resonance Spectroscopy ; instrumentation ; methods ; Middle Aged ; Postmenopause ; metabolism ; Progesterone ; administration & dosage ; metabolism ; Testosterone ; metabolism