The Effect of Medroxyprogesterone Acetate on Androgen Metabolism in the Polycystic Ovary Syndrome

Gg, Gordon; Al, Southren; Calanog, Anthony; Olivo, Jaime; Rafii, Fereidoon

doi:10.1210/jcem-35-3-444

Cited by 28 publications

(9 citation statements)

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“…Whichever of these hypotheses is correct, conflicting reports on the basal levels of serum LH have been recorded in PCO patients. Mainly normal concentrations were found by some workers (Gambrel1 er Zarate et al, 1973) whilst significantly elevated levels were noted by others (Yen et al, 1970;Gordon et al, 1972;Friedman, 1973).…”

Section: Introductionmentioning

confidence: 88%

Sex Hormone Levels and Gonadotrophin Release in the Polycystic Ovary Syndrome

Duignan

Shaw

Rudd

et al. 1975

Clinical Endocrinology

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The response to synthetic luteinizing hormone-releasing hormone was studied in eighteen patients with the polycystic ovary syndrome. The release of follicle-stimulating hormone was similar to that found in normal women. The mean response of luteinizing hormone was similar to that found in the luteal phase, but significantly greater (P less than 0-02) than that found in the early follicular phase of the normal menstrual cycle. Basal serum levels of FSH and LH, estimated in twenty-five patients, were similar to those found in normal subjects. The sex hormone binding globulin capacity was reduced in twenty-four of them. Basal serum testosterone levels were elevated in twelve of twenty-two patients and the mean level was significantly greater (P less than 0-01) than the mean level of normal women. Basal serum androstenecione levels were elevated in nine of twenty-two patients and the mean level was also significantly greater (P leess than 0-001) between basal testosterone and LH levels. These data suggest the pituitary gland of patients with the polycystic ovary syndrome contains adequate amounts of LH but that the ovulatory surge of LH which occurs in normal women is inhibited by testosterone acting on either the pituitary or, more probably, on the hypothalamus.

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Section: Introductionmentioning

confidence: 88%

Sex Hormone Levels and Gonadotrophin Release in the Polycystic Ovary Syndrome

Duignan

Shaw

Rudd

et al. 1975

Clinical Endocrinology

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“…Before wedge resection, patients with the Stein-Leventhal syndrome had significantly higher plasma testosterone levels than control patients (P<O.OOl), but after wedge resection there was no significant difference between control patients and those with the Stein-Leventhal syndrome. After wedge COMMENTS There are those who have found normal basal LH levels in patients with the Stein-Leventhal syndrome (Gambrell et al, 1971 ;ZBrate et al, 1973), while some have found the raised basal LH levels that we observed in such patients (Yen et al, 1970;Gordon et al, 1972;de Vane et al, 1975;Duignan et al, 1975). Several workers Patton et al, 1975;Berger et al, 1975) reported an exaggerated response to LHRH for LH but not for FSH.…”

Section: Preoperative Basal and Post-lhrh Valuesmentioning

confidence: 63%

“…WEDGE resection of the ovaries in a patient with the Stein-Leventhal syndrome probably cures infertility, caused by anovulation, by somehow restoring normal hypothalamicpituitary-ovarian relationships (Stoppelli et al, 1974;Greenblatt and Mahesh, 1974;Goldzieher, 1975). The results of the few available studies of basal and post-LHRH gonadotrophin levels are contradictory (Yen et al, 1970;Gambrel1 et al, 1971;Gordon et al, 1972;Zarate et al, 1973;de Vane et al, 1970;Berger et al, 1975;Patton et al, 1975;Duignan et al, 1975) and there is no information about the effect of wedge resection on both these measures of pituitary function.…”

mentioning

confidence: 99%

Effect of Ovarian Wedge Resection for the Stein‐leventhal Syndrome on Plasma Fsh, Lh, Oestradiol and Testosterone Levels and on the Responses of the Pituitary to Intraven Us LHRH

Valkov¹,

Dokumov²

1977

BJOG

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Summary We studied basal plasma FSH, LH, testosterone and oestradiol levels and post‐LHRH plasma FSH and LH levels in ten patients both before and after a wedge resection of the ovaries for Stein‐Leventhal syndrome. We compared the results with those obtained in 15 healthy patients between the third and seventh day of a normal menstrual cycle. Before operation, patients with the Stein‐Leventhal syndrome had raised basal and post‐LHRH LH levels and raised plasma testosterone levels. All these abnormalities disappeared after wedge resection of the ovaries. Both before and after operation patients with the Stein‐Leventhal syndrome had low plasma oestradiol levels. These results are used to formulate a hypothesis about the aetiology of the Stein‐Leventhal syndrome.

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“…Previous studies in the polycystic ovary syndrome have shown that blood testosterone levels can be effectively reduced by a dosage of 40 mg MPA orally per day for 4-6 weeks (Gordon et al, 1972). 30 mg MPA per day produced the same effects after 3 months (Ettinger & Golditch, 1977).…”

Section: Discussionmentioning

confidence: 88%

“…High dose MPA is also used in the treatment of breast cancer (Gorins et al, 1983). Inhibition of LH secretion (Gordon, Southren & Tochimoto, 1970), with subsequent reduced T production and increased metabolic clearance rate of testosterone (Altmann et al, 1972;Gordon et al, 1972), results in a decrease of androgen serum levels. Previous studies have shown that systemic MPA treatment also has beneficial effects in hirsutism (Ettinger & Golditch, 1977;Schweikert & Wilson, 1974).…”

mentioning

confidence: 99%

Medroxyprogesterone acetate therapy in hirsutism

1985

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In a pilot study, 26 hirsute females were treated with medroxyprogesterone acetate (MPA). We used an ointment containing 0.2% MPA in 13 patients, subcutaneous injection of MPA into the hairy areas of the face in five patients and intramuscular injection of low doses of MPA in 13 patients, each for an average duration of 16 weeks. The best clinical result was achieved by subcutaneous injection, the next most successful was the intramuscular injection, and the least successful was the topical application. Hair diameter measurements, carried out in 12 patients, were found to be reduced by 33% on average. Serum androgen levels, measured monthly, remained unaffected by topical treatment, but were decreased by intralesional and intramuscular injection. The clinical improvement with topical therapy despite the lack of effect on serum androgen levels supports the idea that MPA works partly at the cellular level. The intralesional and systemic injection of MPA may exert an effect both by systemic androgen suppression and a local action.

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The Effect of Medroxyprogesterone Acetate on Androgen Metabolism in the Polycystic Ovary Syndrome

Cited by 28 publications

References 0 publications

Sex Hormone Levels and Gonadotrophin Release in the Polycystic Ovary Syndrome

Sex Hormone Levels and Gonadotrophin Release in the Polycystic Ovary Syndrome

Effect of Ovarian Wedge Resection for the Stein‐leventhal Syndrome on Plasma Fsh, Lh, Oestradiol and Testosterone Levels and on the Responses of the Pituitary to Intraven Us LHRH

Medroxyprogesterone acetate therapy in hirsutism

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