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Environmental Health Perspectives Apr 1983Since 1973 a number of investigators have reported an association between liver neoplasia and steroid usage. Through referral material we have examined the histology of...
Since 1973 a number of investigators have reported an association between liver neoplasia and steroid usage. Through referral material we have examined the histology of over 250 cases of hepatic neoplasia, most in patients receiving steroid medications. The majority have been benign, predominantly focal nodular hyperplasia (55%) and hepatocellular adenoma (39%). The average age was 31.4 years; 83% had significant steroid exposure with an average duration of 71 months for focal nodular hyperplasia and 79.6 months for hepatocellular adenoma. The type of estrogenic agent was predominantly mestranol; however, during the period mestranol was the most frequently used synthetic steroid. A distinct clinical entity of life threatening hemorrhage from the lesion occurred in 31% of patients with hepatocellular adenoma and 9% of patients with focal nodular hyperplasia. Recurrence of benign tumors has occurred in some patients who continued using steroids and regression has been observed in patients who had incomplete tumor removal but discontinued steroid medication. Medial and intimal vascular changes have been present in a large number of the benign tumors. The relationship of these vascular changes to oncogenesis is unclear, but similar lesions have been described in the peripheral vasculature associated with steroid administration. A number of hepatocellular carcinomas have also been seen. Of significance is the young age of these patients and lack of abnormal histology in adjacent nonneoplastic liver. A striking number of the malignant hepatocellular tumors have been of the uncommon type described as "eosinophilic hepatocellular carcinoma with lamellar fibrosis." The epidemiology of liver lesions within this series is difficult to assess, since the material has been referred from very diverse locations.
Topics: Adenoma; Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Steroids
PubMed: 6307679
DOI: 10.1289/ehp.8350201 -
British Medical Journal Apr 1968
Topics: Adult; Contraceptives, Oral; Female; Humans; Mestranol; Pigmentation Disorders
PubMed: 5646086
DOI: 10.1136/bmj.2.5597.120 -
British Medical Journal Mar 1966
Topics: Adult; Chemical and Drug Induced Liver Injury; Ethinyl Estradiol; Female; Humans; Mestranol; Norethindrone; Pruritus
PubMed: 5909490
DOI: 10.1136/bmj.1.5489.739-e -
British Medical Journal Jul 1965
Topics: Contraceptive Agents; Contraceptives, Oral; Female; Humans; Mestranol; Thrombophlebitis; Thrombosis; Toxicology
PubMed: 14310212
DOI: 10.1136/bmj.2.5456.301-d -
British Medical Journal Feb 1969A controlled cross-over trial in 20 epileptic women, receiving regular anticonvulsant therapy showed that an oral contraceptive with a low oestrogen/ progestogen content... (Clinical Trial)
Clinical Trial
A controlled cross-over trial in 20 epileptic women, receiving regular anticonvulsant therapy showed that an oral contraceptive with a low oestrogen/ progestogen content had no significant effect on the average frequency of fits compared with identical dummy tablets.
Topics: Adolescent; Adult; Clinical Trials as Topic; Contraceptives, Oral; Electroencephalography; Epilepsy; Female; Humans; Mestranol; Middle Aged; Norethindrone; Placebos
PubMed: 4883651
DOI: 10.1136/bmj.1.5639.294 -
Fertility and Sterility Sep 1988The main conclusion of this study is that a profound suppression of the pituitary and ovary can be associated with an inadequate response which may require a longer or... (Comparative Study)
Comparative Study
The main conclusion of this study is that a profound suppression of the pituitary and ovary can be associated with an inadequate response which may require a longer or different regimen of stimulation to achieve the desired outcome for IVF. We suggest that a pretreatment determination of E2 and gonadotropins can be of value to predict the nature of ovarian response in women with suppressed pituitary-ovarian function.
Topics: Contraceptives, Oral; Contraceptives, Oral, Combined; Drug Combinations; Estradiol; Female; Fertilization in Vitro; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Menotropins; Mestranol; Norethindrone; Ovarian Follicle; Ovary; Pituitary Gland; Progesterone
PubMed: 3137106
DOI: No ID Found -
Fertility and Sterility Aug 1978A pituitary stimulation test with gonadotropin-releasing hormone (GnRH) and thyrotropin-releasing hormone (TRH) was undertaken to determine (1) whether pituitary... (Comparative Study)
Comparative Study
A pituitary stimulation test with gonadotropin-releasing hormone (GnRH) and thyrotropin-releasing hormone (TRH) was undertaken to determine (1) whether pituitary responses to GnRH vary in individual women taking oral contraceptive steroids over time, (2) whether a less suppressive pituitary gonadotropin effect is produced by formulations containing less than 50 microgram of estrogen, and (3) to obtain more information concerning prolactin secretion in users of oral contraceptive steroids. The same subjects who had had a suppressed luteinizing hormone (LH) and follicle-stimulating hormone (FSH) response 6 to 9 months previously also had a suppressed response, indicating that this effect persists over time. Contraceptive formulations containing less than 50 microgram of estrogen have a lesser suppressive effect on LH release than do formulations containing 50 microgram of estrogen or more. The basal prolactin (PRL) response as well as the maximal PRL response to TRH were found to be significantly greater in subjects using oral contraceptives than in the control subjects. However, no difference in PRL response was found between the subjects using low or high doses of estrogen fomulations.
Topics: Adult; Contraceptives, Oral; Estradiol; Female; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Pituitary Gland; Pituitary Hormone-Releasing Hormones; Prolactin; Thyrotropin-Releasing Hormone
PubMed: 98356
DOI: 10.1016/s0015-0282(16)43451-5 -
Fertility and Sterility Nov 1979A radioimmunoassay to quantitate ethinylestradiol (EE-2) in both plasma and endometrium is described. In 29 women under sequential oral contraceptive therapy...
A radioimmunoassay to quantitate ethinylestradiol (EE-2) in both plasma and endometrium is described. In 29 women under sequential oral contraceptive therapy (chlormadinone acetate, 2 mg, plus mestranol, 80 microgram) for 6 to 84 months, a single blood sample and a single endometrial sample were simultaneously obtained on different days of the pseudomenstrual cycle. In 24 women under 40 years of age the mean plasma EE-2 concentrations were similar during the first (989 +/- 94 pg/ml) and the second half of the cycle (1053 +/- 186 pg/ml) (P greater than 0.05). A similar finding was observed with regard to mean endometrial EE-2 concentrations (3.55 +/- 2.1 and 5.89 +/- 1.7 microgram/gm of wet tissue, respectively). On the other hand, five women over 40 years of age had plasma EE-2 concentrations similar to those of the previous group, but the mean endometrial EE-2 concentrations was 0.9 +/- 0.6 microgram/gm of wet tissue (P less than 0.05). Although plasma follicle-stimulating hormone and luteinizing hormone did not show midcycle peak values, complete suppression of both gonadotropins was not observed. These results show that endometrium has a great ability to concentrate EE-2, and this ability seems to be greater in women below age 40 than above. Whether or not this observation might be related to the known higher incidence of endometrial cancer in women less than 40 years old who have been under chronic sequential oral contraceptive therapy cannot be disclosed from this limited number of determinations.
Topics: Adolescent; Adult; Age Factors; Contraceptives, Oral; Contraceptives, Oral, Sequential; Endometrium; Ethinyl Estradiol; Female; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Middle Aged
PubMed: 499582
DOI: 10.1016/s0015-0282(16)44352-9 -
British Medical Journal Jan 1974The urinary gonadotrophin and ovarian steroid excretion pattern was studied in five women taking an oral contraceptive formulation consisting of mestranol 50 mug and...
The urinary gonadotrophin and ovarian steroid excretion pattern was studied in five women taking an oral contraceptive formulation consisting of mestranol 50 mug and norethisterone 1 mg. Both the pretreatment and post-treatment cycles were normal. The ovulatory peak of luteinizing hormone (LH) during the treatment cycles was uniformly suppressed, but LH continued to be excreted within the normal range. In one fifth of the treatment cycles there was a pronounced and sustained rise of oestrogen output in the absence of ovulation, and in many of the other treatment cycles oestrogen levels suggested that active ovarian steroidogenesis was taking place.
Topics: Adult; Body Temperature; Contraceptives, Oral; Estrogens; Female; Humans; Luteinizing Hormone; Mestranol; Norethindrone; Pregnanediol; Pregnanetriol
PubMed: 4808812
DOI: 10.1136/bmj.1.5896.11 -
Endocrinologia Japonica Jun 1976This paper describes the LH and FSH responses to synthetic LH-RH in 81 anovulatory women and 37 ovulatory women at various estradiol (Ed) levels. Besides, effects of...
This paper describes the LH and FSH responses to synthetic LH-RH in 81 anovulatory women and 37 ovulatory women at various estradiol (Ed) levels. Besides, effects of mestranol of releases of LH and FSH in response to LHrh were examined in 4 anovalatory women. Subjects were divided into 3 groups: low Ed group, moderate Ed group and high Ed group. No significant correlation was found in ovulatory women, but in anovllatory women a positive significant correlation was found between the LH/FSH ratio after LHrh injection and the circulating Ed level. In ovulatory women, a mean LH/FSH after administration of LHrh was not significantly different from LH/FSH at the LH peak in the normal menstrual cycle. But in anovulatory women, a mean LH/FSH after the adminitration in the low Ed group was significantly lower than LH/FSH and mean LH/FSH after the administration in two other Ed groups were significantly higher than that at the LH peak in the normal menstrual cycle. Among the low Ed group, four patients with primary ovarian failure and elevated gonadotropin levels in serum were treated with mestranol. With increased doses of mestranol, the LH/FSH after administration of LH-RH was increased and reached to the same level as the normal ovulatory peak in these 4 patients. Our results demonstrated that responses of pituitary gonadotropins to LH-RH in anovulatory women were significantly different in the LH/FSH from those in ovulatory women. Abnormality of these responses in anovulatory women seems to be unfavorable to ovulation.
Topics: Adult; Anovulation; Estradiol; Female; Follicle Stimulating Hormone; Follicular Phase; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Mestranol; Ovulation; Pituitary Gland
PubMed: 791640
DOI: 10.1507/endocrj1954.23.237