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Liver function, renal function, PT and PPT did not change significantly during the 12-month trial. The E + D group had a more pronounced increase in high density lipoprotein cholesterol (HDL-C) than the E + P group (10.6% vs. 2.7%) after 12 months of treatment (p < 0.05). Both groups showed reduced concentrations of total cholesterol (T-CHO), low density lipoprotein cholesterol (LDL-C) and ATIII, whereas triglyceride (TG) was increased at the end of the trial (without intergroup difference).
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Between September 1999 and March 2001, a total of 91 couples with infertility were recruited at Al-Hammadi Hospital, Riyadh, Kingdom of Saudi Arabia and Badeea Hospital, Jordan. In this prospective trial 46 couples were allocated to luteal phase support with hCG injections, while 45 couples were allocated to Duphaston (oral progestogens) as luteal support.
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Six synthetic steroids were tested subcutaneously in a new bio-assay for short- and long-lasting progestational activity, using traumatic deciduoma production in immature female rats. As reference standard, a daily subcutaneous dose of 0.25 mg progesterone regularly induced a distinct deciduomagenic effect. A single dose of 12.5 mg of progesterone showed a prolonged activity. Medroxyprogesterone acetate showed a distinct deciduomagenic effect at the 0.05 mg daily s.c. dose level; a distinct prolonged effect was induced with a single s.c. injection of 0.5 mg. 16alpha-Aethylprogesterone induced regularly decidual reaction at the 0.1 mg s.c. dose level, it showed prolonged activity at the 0.25 mg dose level. The daily threshold dose for chlormadinone acetate was 0.25 mg; prolonged activity was shown with 2.5 mg. The daily threshold dose for duphaston is between 0.5 mg and 1.0 mg. A single s.c. dose of as much as 20.0 mg of 17alpha- hydroxyprogesterone caproate did not have a deciduomagenic effect.
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It is established that hormone therapy (HT) is related with significant increased prothrombotic risk factor. The aim of our study was to assess the effects of oral hormone therapy (o-HT) and transdermal hormone therapy (t-HT) on hemostasis parameters: fibrinogen (Fg) concentration, the maximum velocity of polymerization of clot formation, fibrin half-time lysis, plasma level of thrombin inhibitor of fibrinolysis (TAFI) and activity of generated thrombin and plasmin amidolytic activity. We observed that values of initial velocity of polymerization in o-HT group were increased (94.64 mOD/min vs. 131.50 mOD/min, p < 0.001) compared to control group. Fibrin lysis half-time increased in both groups with HT (controls - 18.26 min vs. 32.43 min (o-HT); 23.34 min transdermal hormone therapy (t-HT) p < 0.001) compared to controls. The activity of thrombin was statistically higher in plasma of women after o-HT (72.6 ± 8.5 mOD/min) than in patients with t-HT (53.7 ± 10.1 mOD/min) and controls (51.2 ± 10 mOD/min. Plasmin activity was the highest in controls (84.5 ± 10.2 mOD/min). The highest level of TAFI we observed in patients after oral hormones (80.38 ± 8.23%); women on transdermal HT had 61.58 ± 9.81% and the lowest concentration of TAFI we noted in controls 44.70 ± 10.16). The results of our study show that HT may partly explain the increase in venous thrombosis (VTE) and cardiovascular events reported after the use of it, especially the oral form of treatment.
Prospective controlled study.
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To investigate the difference in histopathology and cell cycle kinetics in the menopausal endometrium treated with sequential-combined hormone replacement therapy (HRT) using different types and doses of progestins.
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Administration of six 28-day treatment cycles of a continuous daily dose of 2 mg of micronised 17beta oestradiol with a randomly allocated dose of 5-20 mg of dydrogesterone added for the last 14 days of each.
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The incidence of GH in the study group was significantly lower than the control group (1.7% versus 12.9%, p = 0.001). The incidence of fetal distress was also significantly lower in the study group compared to the control group (4.3% versus 18.1%, p = 0.001).
Cross-reaction of oral contraceptives (OCs) in competitive binding assays of progesterone and estradiol was investigated. The compounds tested were chlormadinone acetate, diethylstilbestrol, dimethisterone, dydrogesterone, ethinyl estradiol, ethynodiol diacetate, megestrol acetate, mestranol, norethynodrel, norethindrone, d-norgestrel, medroxyprogesterone acetate, quinestrol, and quingestanol acetate. Only ethinyl estradiol had a cross-reaction of more than 1% (2%) in the estradiol radioimmunoassay and dydrogesterone (1.4%) and d-norgestrel (4%) were the only compounds that showed a cross-reaction more than 1% in the progesterone competitive protein-binding assay. These results indicate that the steroids tested, in doses currently being used in OCs, will not markedly interfere with the assay of endogenous estradiol and progesterone.
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Two review authors independently assessed all the studies for inclusion in the review, assessed risk of bias and extracted the data. Data were checked for accuracy.
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Continuous and sequential transdermal estrogen/progestogen treatments with estradiol/NETA appear to be effective and safe alternatives to continuous transdermal estrogen and oral sequential progestogen for the treatment of menopausal symptoms. Continuous transdermal therapy with estradiol/NETA may be more acceptable for a majority of patients, i.e., those who wish to avoid monthly bleeds, whereas the sequential regimen may be preferable when the clinician and/or patient believes monthly bleeding to be appropriate.
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No statistically significant difference in endometrial thickness between phase E (6.5+/-1.6 mm) and phase E/P (6.0+/-1.7 mm) was observed. In phase 0, compared with phases E and E/P, a statistically significant decrease in endometrial thickness was found (4.1+/-1.2 mm). Doppler flow impedance parameters of uterine arteries during the different phases of the HRT cycle showed no differences between the phases considered.
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To determine the efficacy of luteal phase support with human chorionic gonadotropin (hCG) or oral progesterone during human menopausal gonadotropin (hMG) ovulation induction.
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The metabolic postmenopausal syndrome (MPS) is characterized by a complex of metabolic disorders: lipid (76%), purin (56%), calcium-phosphorus (61%). There is also a rise in amplitude of spontaneous platelet aggregation (61%) and fibrinogen levels (78%). Clinically, these phenomena manifest in arterial hypertension and defective cerebral circulation. An estrogen-histogen drug femoston was tried for clinical effectiveness and tolerance in 40 females with MPS. Femoston was used in long-term regimen for 12 months. The response was observed in all the patients, all the above parameters underwent positive changes. The drug was well tolerated, side effects were moderate. No withdrawals occurred.
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One hundred and fifty-four women completed the questionnaire at baseline and 141 (including 131 completers) responded at the end. At baseline, 82% indicated to be pleased that menstruation had ceased, but nevertheless 94% stated that return of periods would be acceptable. At the end, 91% still found the occurrence of cyclic bleeds acceptable; this mostly depended on the perceived benefits outweighing the discomfort. Of the women who actually experienced bleeds (101) 60% regarded discomfort and blood loss less than during their previous menstrual cycles. A regular cycle pattern was considered more important than modest flow and short duration.
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Uteroplacental blood flow.
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The findings from the present study provide evidence for the efficacy of Femoston hormone replacement therapy in terms of control of hemostasis and inducement of a potentially beneficial lipoprotein profile, which is important for reducing the risk of vascular pathology in peri- and postmenopausal women.
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To investigate the mechanism by which exogenous oestrogen influences the homocysteine metabolism in postmenopausal women.
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The study was completed by 131 women (87%). The percentage of women with bleeding (mean +/- SD) was 57.2 +/- 3.6% in the 1/5-mg group and 65.8 +/- 4.2% in the 1/10-mg group (p < 0.001); cross-sectional analysis showed that, in every cycle, there were more women with bleeding in the 1/10-than in the 1/5-mg group (p < 0.001). With regard to the day of onset of bleeding, the mean difference between groups was 1.4 +/- 1.1 days (p < 0.001). There was no difference in duration of bleed (5 days), or intensity or incidence of intermittent bleeding (3-14% per cycle). Both regimens resulted in high rates of amenorrhea in each cycle (26-49%), but only 14/151 (9%) women were amenorrheic throughout. Three patients (2%) discontinued owing to bleeding problems. Endometrial protection was adequate in 98.3% (1/5-mg group) and 98.5% (1/10-mg group) with only one case of proliferation (1/10-mg group) and one of simple hyperplasia (1/5-mg group).
In contrast with the revised AFS score, the study of the type of peritoneal lesions shows a changing pattern of activity. The significance in pathophysiological and clinical studies should be investigated further.