Sarkola T, Mäkisalo H, Fukunaga T, Eriksson C J
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Alcohol Clin Exp Res. 1999 Jun;23(6):976-82.
Heavy alcohol consumption is associated with menstrual irregularities, including anovulation, luteal-phase dysfunction, recurrent amenorrhea, and early menopause. In addition, moderate to heavy alcohol intake has been found to increase the risk of spontaneous abortions and breast cancer. These adverse effects could at least in part originate from alcohol-mediated changes in hormone levels.
The acute effect of alcohol on the hormone balance in women using oral contraceptives (OC+) and also in nonusers (OC-), was evaluated in 30 OC- and 31 OC+ subjects, representing the whole period of the menstrual cycle. It was also evaluated in 40 OC- and 47 OC+ subjects during the midcycle phase and in 10 OC+ subjects with unknown cycle phase.
We found that among subjects who used oral contraceptives, estradiol levels increased and progesterone levels decreased after intake of alcohol (0.5 g/kg). No dose effect (0.34-1.02 g/kg) on progesterone was observed in a substudy on 10 OC+ subjects. With regard to estrone levels, no effect was observed, although a significant increase was found in the estradiol-to-estrone ratio. Among subjects not using oral contraceptives, progesterone levels decreased after intake of alcohol (0.5 g/kg). No effect was found in estradiol, estrone, or the estradiol-to-estrone ratio during midcycle in this study group. A transient elevating effect of alcohol (0.5 g/kg) on prolactin levels was observed in both study groups. We found that alcohol (0.5 g/kg) had no significant effect on luteinizing hormone (LH) levels among subjects not using oral contraceptives, and observed a decline among subjects using oral contraceptives at midcycle.
We suggest that the estradiol and progesterone effects are related to decreased steroid catabolism, resulting from the alcohol-mediated increase in the hepatic NADH-to-NAD ratio. The transient effect on prolactin levels may reflect acute changes in opioid and dopamine levels in the hypothalamus. The present findings regarding female sex steroids may be of relevance in the association between moderate to heavy alcohol consumption and the development of breast cancer.
大量饮酒与月经不调有关，包括无排卵、黄体期功能障碍、复发性闭经和早绝经。此外，已发现中度至重度饮酒会增加自然流产和乳腺癌的风险。这些不良反应至少部分可能源于酒精介导的激素水平变化。
在30名未使用口服避孕药（OC-）和31名使用口服避孕药（OC+）的受试者中评估了酒精对女性激素平衡的急性影响，涵盖月经周期的整个阶段。还在40名OC-和47名OC+受试者的月经周期中期以及10名月经周期阶段不明的OC+受试者中进行了评估。
我们发现，在使用口服避孕药的受试者中，摄入酒精（0.5 g/kg）后雌二醇水平升高，孕酮水平降低。在对10名OC+受试者的子研究中，未观察到孕酮的剂量效应（0.34 - 1.02 g/kg）。关于雌酮水平，未观察到影响，尽管雌二醇与雌酮的比值显著增加。在未使用口服避孕药的受试者中，摄入酒精（0.5 g/kg）后孕酮水平降低。在该研究组的月经周期中期，未发现对雌二醇、雌酮或雌二醇与雌酮比值有影响。在两个研究组中均观察到酒精（0.5 g/kg）对催乳素水平有短暂的升高作用。我们发现，酒精（0.5 g/kg）对未使用口服避孕药的受试者的黄体生成素（LH）水平无显著影响，而在月经周期中期使用口服避孕药的受试者中观察到LH水平下降。
我们认为，雌二醇和孕酮效应与类固醇分解代谢减少有关，这是由酒精介导的肝脏中NADH与NAD比值增加所致。对催乳素水平的短暂影响可能反映了下丘脑阿片类物质和多巴胺水平的急性变化。目前关于女性性激素的研究结果可能与中度至重度饮酒与乳腺癌发生之间存在的关联有关。
