E. Friedrich

Effects of 0.5 mg. of lynestrenol daily on hypothalamic-pituitary-ovarian function

This study was undertaken to investigate the effect of daily ingestion of 0.5 mg. of lynestrenol on some parameters of the hypothalamic-pituitary-ovarian axis. Daily plasma concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol-17-beta (estradiol; E2-17beta), and progesterone (P) were determined by specific radioimmunoassays during one control and one treatment cycle of seven normally ovulating women. One of the volunteers was followed throughout 84 days of treatment. The following changes were observed during medication: (1) the midcycle FSH/LH peak was abolished, with a trend toward reduced LH values during the second half of the treatment cycles; (2) progesterone was significantly, though variably, reduced whereas estradiol showed little difference between control and treatment cycles; (3) during prolonged treatment two difference cyclic response patterns were observed in the same individual. It is concluded that daily administration of 0.5 mg. of lynestrenol exerts a profound effect at the central level, which contributes to the satisfactory contraceptive efficacy of this compound. A hypothetic blockade of estradiol receptors at the pituitary and/or hypothalamic level is discussed.

Therapy of androgenetic symptomatology with cyproterone acetate and ethinyl estradiol

ZusammenfassungDer Therapieerfolg einer Kombination von Cyproteronazetat und Äthinylöstradiol wurde bei 103 Frauen untersucht. Akne und Seborrhoe sprachen in 91,7 bzw. 93,3% am besten an. Beim Hirsutismus wurde eine komplette Remission oder teilweise Verbesserung in 75,3% beobachtet. Unter Therapie änderte sich das Körpergewicht in 51,9% nicht, während 24,7% der Patientinnen eine Gewichtszunahme und 23,4% eine Gewichtsabnahme aufwiesen. Die Zykluslänge war vor und nach Therapie in 35,8% unverändert, eine Verbesserung wurde in 54,7% festgestellt. Nur in 3,2% traten Zyklusunregelmäßigkeiten auf. Entsprechend den geführten Basaltemperaturkurven kam es bei 32,9% der Frauen zu einer Verbesserung des Zyklusablaufes. Nur bei 3,2% trat eine Verschlechterung auf. Die 17-Ketosteroidausscheidung war nach Therapie bei 37,3% geringer als vor der Therapie und bei 64,7% der Frauen blieb sie unverändert. Dosis und Anwendungsdauer erwiesen sich als günstig und eine gute Zykluskontrolle wurde erreicht.SummaryThe effectiveness of therapy with cyproterone acetate and ethinyl estradiol was studied in 103 women. Acne and seborrhea responded best with 91.7 and 93.3% respectively, including complete and partial therapeutic success. For hirsutism complete remission and partial improvement were found in 75.3% of the treated women. Under therapy, body weight did not change in 51.9%, while 24.7% of the patients gained weight and 23.4% lost weight. The cycle length remained normal after therapy in 35.8%. Normalization or improvement was found in 54.7%. In 6.3% no improvement was noted after therapy and in 3.2% cycle irregularity developed in women with previous undisturbed pattern. According to BBT, improvement of the functional capacity of the reproductive system was found in 32.9% of the patients. Only 3% of the women studied demonstrated a deterioration. The 17-ketosteroid excretion was diminished in 35.3% after therapy and remained unchanged in 64.7%. The therapeutic regimen used for the study was well tolerated and good cycle control was obtained.

Psychosocial consequences of sterilization: A review of the literature and preliminary findings

Tubal ligation continues as a frequently used method of birth control. Nonetheless, psychosocial consequences, sexual satisfaction, and later regret regarding the procedure and the loss of childbearing potential remain as concerns. This is particularly true for the population of childless women requesting the procedure. The authors review all available recent literature on regret, psychosocial correlates, and sexual satisfaction related to tubal sterilization, with particular attention to the literature on childless women. They also present preliminary findings from a prospective controlled 5-year follow-up study of sterilization in childless women.

Estrogen-progestin pharmacodynamics of the postmenopausal endometrium studied by thymidine labeling

Five postmenopausal women were treated with conjugated equine estrogens, 1.25 mg tablets for 25 days, and medroxyprogesterone acetate, 10 mg tablets, in combination with the last 10 estrogen doses. Twenty-five endometrial biopsy specimens were incubated in vitro with tritiated thymidine and radioautographic slides were prepared. Within five days of estrogen treatment the thymidine labeling index (TLI) in both glands and stromal cells increased from a very low resting state to relatively high levels of DNA synthesis and cell proliferation. Within five days after addition of progestin, epithelial TLIs decreased to low levels and returned to minimal baseline levels four days after the last steroid dose. Analysis of variances indicated significant changes in epithelial cells (P less than 0.0001) confirming that the proliferative effect of estrogens was suppressed during the progestin phase. Stromal TLI changes were not significant (P = 0.46).

Herpes simplex: Clinical aspects and electron microscopic findings

Abstract An unusual case of an infection with the herpesvirus hominis (HVH) has been presented. Vesicular and ulcerative lesions involved the vulva, the perineum, and the anus, including hemorrhoids. Gangrenous bullous lesions occurred on the skin of seven fingers. The typical clinical appearance and the absence of bacterial pathogens justify the diagnosis of herpetic whitlow. The clinical course was complicated by incapacitating constitutional symptoms and fever. The diagnoses of a HVH infection was confirmed by positive virus cultures, the electron microscopic demonstration of the HVH in biopsy specimens of an ulcerative lesion, and by a fourfold increase of the neutralizing antibody titer in the patients serum. Three morphologically different stages of the HVH and phagocytosis of the virus by leukocytes has been observed and illustrated by electron micrographs. It has been discussed how the electron microscope can be used as a diagnostic method, how it can aid in clinicopathologic research concerning the mechanisms involved in virus infections, and how it could aid in the development of new modes of therapy.

[Postcoital contraception using a high-dose depot estrogen (Org 369-2) (proceedings)].

A combination of 12.5 mg estradiol benzoate and 10 mg estradiol phenylpropionate was used for postcoital contraception in 60 women. Treatment occurred within 48 hours of unprotected coitus in almost all cases and generally between the 10th and 18th days of the cycle. Plasma luteinizing hormone follicle-stimulating hormone prolactin estradiol and progesterone were determined before and 8 days after treatment and after the following menstruation. Few side effects were observed. Cycle length and duration of menstruation were not greatly changed. In 7 women plasma progesterone levels were above 5 ng/ml before treatment while in 35 others they were below 1 ng. In about one-third of the women plasma progesterone was below 1 ng/ml in both determinations indicating anovulatory cycles. It is impossible to determine whether the estrogen medication was responsible for these. Since 3 pregnancies were observed in the group the effectiveness of this treatment is questionable.