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Valutazione della somministrazione di isoflavoni di soia per via vaginale nel trattamento dei disturbi vulvovaginali in postmenopausa
No full textAim. Hormonal replacement therapy (HRT) is safe and effective in the relief of postmenopausal symptoms. For the genital tract (vaginal dryness and thinning of genital tissue) a local estrogen therapy can be used. If the patient prefers to avoid hormones, there are some preparations with soy isoflavones extracts that locally applied induce relief of urogenital symptomatology caused by estrogen loss. Methods. Thirty healthy menopausal women (>1 year) with urogenital diseases were examined, randomly divided into 2 groups and treated for 3 months: group A, 18 women treated with soy isoflavones cream (1 vaginal application daily); group B, 12 women treated with a moisture gel. Local symptomatology was evaluated: dryness, dyspareunia e itch-burning. Results. Both groups showed improvement in symptomatology. In group A there was a significant reduction (p<0.005) compared to group B at the 1st and 3rd month of therapy for dyspareunia and itch-burning. Dryness showed the same reduction in both groups. Conclusion. The possibility to use a preparation like that used in the present study with an adequate dose of soy isoflavones makes it possible not only to treat, with a continued use, vulvo-vaginal symptomatology but to prevent its appearance
Metformin treatment is effective in obese teenage girls with PCOS
No full textBACKGROUND: Polycystic ovary syndrome (PCOS) is the most frequent cause of menstrual disorders in teenage
girls. Little information is available about the effects of metformin in adolescent girls with PCOS and its dose and its
efficacy in regulating menstrual cyclicity and hyperandrogenic symptoms. We evaluated the effects of metformin
treatment on ovulatory function, hirsutism, acne, hormonal patterns and body weight in adolescent girls with PCOS.
METHODS: Eighteen girls, ranging in age from 15 to 18 years, were enrolled in the study. Clinical diagnosis of
PCOS was based on the consensus criteria for PCOS accepted in May 2003 at Rotterdam. All subjects received 1700
mg/day metformin as tablets continuously for 6 months. They were then followed up for 6 months. RESULTS: Two
patients complained of side effects for >2 weeks and interrupted treatment; they were not evaluated. All the others
showed an improvement in menstrual cyclicity. Menstrual periods were ovulatory, with progesterone levels up to
6 ng/ml in luteal phase and a significant reduction in testosterone, androstenedione and free testosterone. BMI was
restored within normal limits in all girls between 21 and 24 kg/m2. Six months after the end of metformin treatment,
menstrual cycles continued to be regular and ovulatory with normal BMI. Side effects were slight. CONCLUSIONS:
The present results confirm the positive effects of metformin on menstrual periods and show that the drug can be
administered to young women to improve ovulation and hyperandrogenic symptoms such as hirsutism, acne and
weight gain
A Combined Treatment with Myo-Inositol and Monacolin K Improve the Androgen and Lipid Profiles of Insulin-Resistant PCOS Patients
No full textCombined oral contraceptives in women with menstrual migraine without aura
No full textOBJECTIVE:
To compare the efficacy of two regimens (21 active pills + 7 placebo pills vs. 24 active pills + 4 placebo pills) of combined oral contraception (COC), both containing 20 μg of ethinyl E(2) and 3 mg of drospirenone, in improving the severity of pure menstrual migraine without aura.
DESIGN:
Prospective randomized study.
SETTING:
Patients attending the gynecology department of the University of Siena for consultation regarding an appropriate contraception.
PATIENT(S):
Women ages 20 to 35 years (n = 60) suffering from pure menstrual migraine without aura.
INTERVENTION(S):
Three months of contraceptive use (ethinyl E(2) 20 μg/drospirenone 3 mg) in two different regimens: group A received 21 active + 7 placebo pills whereas group B received 24 active + 4 placebo pills.
MAIN OUTCOME MEASURE(S):
Monthly evaluation of the duration and severity of patients' daily headache attacks.
RESULT(S):
Although both study groups demonstrated significant reduction in the intensity and duration of menstrual migraine, patients in group B (24/4 COC) reported a significant reduction in the intensity and a shorter duration of their menstrual migraine, compared with group A (21/7 COC).
CONCLUSION(S):
The 24/4 COC regimen is recommended as the preferred treatment for patients suffering from pure menstrual migraine without aura
Evaluation of effects of an oral contraceptive containing ethinylestradiol combined with drospirenone on adrenal steroidogenesis in hyperandrogenic women with polycystic ovary syndrome
No full textObjective: To investigate whether the administration of an oral contraceptive containing the new antiandrogenic
drospirenone is associated with reduced adrenal androgen synthesis in hyperandrogenic women with diagnosis of
polycystic ovary syndrome. Drospirenone, an analogue of spironolactone and aldosterone antagonist, is a novel
progestin under clinical development that is similar to the natural hormone progesterone, combining potent
progestogenic with antimineralocorticoid and antiandrogenic activities.
Design: Prospective study.
Setting: Healthy volunteers in University Department of Obstetrics and Gynecology.
Patient(s): Fifteen women ages 18 to 28 years with the diagnosis of polycystic ovary syndrome.
Intervention(s): Three months of contraceptive use (30 mcg ethinylestradiol, 3 mg drospirenone).
Main Outcome Measure(s): An adrenocorticotropic hormone test was performed before and after the study.
Result(s): Adrenal production of cortisol was unchanged after therapy with oral contraceptives. An interesting
observation was reduced basal concentrations of androgens such as androstenedione, dehydroepiandrosterone
sulfate, testosterone, and free testosterone during therapy. The ratios of the areas of substrates to products before
and after oral contraceptive administration were compared for differences in 17-hydroxylase (17-hydroxyprogesterone/
progesterone) and 17,20-lyase (androstenedione/17-hydroxyprogesterone); activities were significantly
reduced, indicating a reduction in the activities of these enzymes.
Conclusion(s): The present results show for the first time that oral contraceptives containing drospirenone affect
adrenal steroidogenesis by reducing synthesis and release of androgens in response to adrenocorticotropic
hormone, leaving adrenal production of cortisol unchanged
Effects of raloxifene therapy on plasma renin and aldosterone levels and blood pressure in postmenopausal women
No full textObjective. Blood pressure, which generally increases after menopause, is one of the best tools to characterize cardiovascular disease. The renin–aldosterone system plays a role in determining cardiovascular risk and the role of estrogen in the regulation of angiotensinogen gene expression and serum levels is well known. Raloxifene can induce endothelium-dependent vasodilation without affecting endothelium-independent vasorelaxation. The aim of the study was to investigate the effects of raloxifene on the renin–aldosterone system and blood pressure in postmenopausal women.
Designs. Forty women, 54–59 years of age, in physiological menopause for 6 months to 4 years, were enrolled in the study and treated with raloxifene 60 mg/day for 6 months. All had blood pressure less than 130/85 mm Hg at the start of the study. The women were divided into two groups: the first (group A; 20 women) with normal blood pressure and the second (group B; 20 women) with previous high blood pressure treated with antihypertensive drugs, not angiotensin-converting enzyme inhibitors or angiotensin receptor blockers.
Results. No significant changes in plasma renin activity (PRA) or plasma concentrations of aldosterone were observed between the two groups after 6 months of raloxifene use. There was a slight reduction in PRA (11±4% for group A and 13±5% for group B) and in plasma levels of aldosterone (3.6±0.5% and 4.6±0.5%, respectively) with respect to basal values, but neither change was statistically significant.
Conclusions. The results of the present study show that raloxifene at 60 mg/day dose is well tolerated and has no clinical impact on blood pressure, PRA or aldosterone in postmenopausal women
Effectiveness of oral administration of Lactobacillus paracasei subsp. paracasei F19 in association with vaginal suppositories of Lactobacillus acidofilus in the treatment of vaginosis and in the prevention of recurrent vaginitis [Efficacia dell'utilizzo del Lactobacillus paracasei subsp. paracasei F19 nella vaginosi e nella prevenzione delle recidive di vaginite somministrato per via orale contemporaneamente ad un Lactobacillus acidofilus per via vaginale
No full textAim. The aim of this paper was to estimate the effectiveness of the contemporary oral administration of Lactobacillus paracasei subsp paracasei F19 in association with vaginal suppositories containing Lactobacillus acidofilus in the treatment of bacterial vaginosis and in the prevention of recurrent vaginitis. Methods. We have recruited 60 women in good health, aged between 18 and 40 years with suspect or confirmed diagnosis of bacterial vaginosis. The women were randomized in 2 groups: Group A treated with vaginal suppositories containing Lactobacillus acidofilus (Calagin, SIFFRA, Florence); Group B treated with the same vaginal suppositories + probiotic containing Lactobacillus paracasei subsp paracasei F19 for oral administration (Gene-filus F19, SIFFRA, Florence). The patients were examined at the end of therapy (3 months) and then after 3 months from the end of treatment. Results. In both groups at end of therapy there was a significant reduction of vaginal pH, an improvement of sniff test and of the subjective symptomatology after 3 months of treatment which still decreased during follow-up (3 months). In Group B there was a meaningful reduction of vaginal pH and of sniff test at the end of therapy and a maintenance of positive effect also after 3 months. Conclusion. The results obtained in this study show that the therapy with vaginal Lactobacillus in the treatment of bacterial vaginosis is successful. The association of oral administration is useful to balance the vaginal environment with the intestinal microflora with improvement of long-term results. The use of probiotics was determinant in the treatment of a pathology like bacterial vaginosis and as an alternative to the conventional local antibiotic therapies
Natural molecules for the therapy of hyperandrogenism and metabolic disorders in PCOS
No full textOBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of women of reproductive age and a complex endocrine condition, due to its heterogeneity and uncertainty about its etiology. However, PCOS is also associated with other metabolic abnormalities such as insulin resistance, impaired glucose tolerance, and diabetes. There are few medications that are approved for the most common symptoms of PCOS, leading to the off-label use of medications that were approved for other indications. One of the most common medications being used off label for PCOS is metformin. Research of other effective therapeutic options has included the utility of inositol.PATIENTS AND METHODS: A systematic literature search of PubMed was performed using the following combination of terms: 'PCOS', 'hyperandrogenism' 'inositol', 'natural molecules'. Only papers published between 2000 and 2016 were included in our analysis. The present review analyzes all aspects of the choice of natural molecules in the treatment of hyperandrogenism and metabolic disorders in PCOS women.RESULTS: The rationale underlying the use of inositols as a therapeutic application in PCOS derives from their activities as insulin mimetic agents and their salutary effects on metabolism and hyperandrogenism without side effects.CONCLUSIONS: In this review will discuss the role of a number of natural associations between inositol and different substances in the treatment of hyperandrogenic symptoms in PCOS women
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