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57 EFFECT OF VAGINAL OESTRIOL (E3) APPLICATIONS ON RECEPTOR KINETICS IN

OESTAOGEN TARGET TISSUES OF POST-MENOPAUSAL WOMEN

M. van Haaften, J. Poortman, G.H. Donker, M.A. Wiegerinck, A.A. Haspels

and J.H. Thijssen - Utrecht, The Netherlands

Biochemical, histological and cytological effects of vaginal E3 (0.5 mg p.d.,

3 weeks) on vagina, endometrium and myometrium of post-menopausal women were

investigated (group A, n=7) and compared with a control group (group B, n=5).

Oestrogen receptors (ER) and progesterone receptors (PgR) were measured in

cytosol (c) and nuclear fractions (n) of these tissues [ll.

Vaginal cytology showed oestrogenic stimulation in all cases in group A.

Endometrial histology showed oestrogenic stimulation in 4 patients of group A.

The mean PgR in the cytosol of uterine as well as vaginal tissues showed an

approximately six-fold increase after treatment. Between groups A and B no

differences in mean ERc and ERn concentrations have been found in any of the

tissues. ERc and PgRc concentrations in vaginal cytosol were lower than those in

the cytosol of the other tissues, ERn concentrations however did not differ.

Concluding we found signs of oestrogenic effects of vaginal E3 medication on

vaginal as well as myometrial and endometrial tissues of post-menopausal women

with PgRc induction as biochemical indicator. It was not possible to observe E2

receptors shifts from cytosol to nucleus in any of the tissues.

[II Haaften, M van, Poortman J et al, J Steroid Biochem Vol 20, 4, part B,

1984, in press.

58 MANAGEMENT OF PERSISTENT MENOPAUSAL SYMPTOMS WITH OESTRADIOL-TESTOSTERONE

IMPLANTS: CLINICAL, BIOCHEMICAL AND HORMONAL RESULTS

Jean Hailes and Henry Burger - Melbourne, Australia

Menopausal symptoms normally respond to oestrogen therapy. However, loss of

libido, which can lead to marital difficulties and loss of self-esteem, often

does not. We undertook an open trial based on 17 patients to assess the

usefulness of oestradiol (Ep)-testosterone (T) subcutaneous implants in the

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treatment of continuing loss of libido despite adequate doses of oral

oestrogens. Patients were assessed monthly for 5 months and an overall

improvement in menopausal symptoms was seen for 4-6 months after implantation.

Libido increased on an analogue scale of O-100 from 13.5 to a maximum of 86.1

at three months. Maximal changes in the serum hormones were observed after one

month, the results expressed as a percentage of pretreatment values being follicle-stimulating hormone (FSH: 53, luteinizing hormone (LH): 54, E2: 186,

total T: 291, and free-T: 342. At 5 months, the T values had returned to

baseline. There were no significant changes in serum cholesterol subfractions or

triglycerides. We conclude that E2-T implants raise E2 levels to the

mid-follicular range and T levels to about three times the normal at the time of

the maximal changes. The changes persist for 5-6 months and correlate with a

dramatic improvement in libido. One patient complained of the development of

hirsutism and another of voice alteration.

59 IN VITRO OBSERVATION OF IMPAIRED TESTICULAR ENDOCRINE FUNCTION IN ELDERLY

MEN

Mats Hammar, Christer Ahlstrand and Anders f:son Berg - Linkdping, Sweden

Measurements of testosterone concentrations in peripheral and spermatic venous

blood have yielded conflicting results regarding testosterone production in

elderly men.

To elucidate further the testicular endocrine capacity during aging,

peripheral serum hormone levels and the in vitro conversion of progesterone and

pregnenolone in histopathologically normal testicular tissue were investigated

in 22 elderly men and 28 younger adult males.

Nineteen elderly men (aged 65-83 years) underwent orchidectomy due to early

prostatic carcinoma, while three others underwent testicular biopsy because of a

suspected tumour. Twenty-eight younger men (aged 18-49 years) with no clinical,

histopathological or laboratory signs of testicular endocrine disorder

volunteered to undergo testicular biopsy.

The in vitro conversion of pregnenolone mediated by 3fl-hydroxyste-

roid-dehydrogenase and of progesterone mediated by l7&-hydroxylase was studied

by means of an incubation technique [l] using radiolabelled precursors.