Ramos A M G, Camargos A F, Pereira F E L
Department of Gynecology and Obstetrics, Health Sciences School of the Santa Casa of Vitória, ES, Brazil.
Clin Exp Obstet Gynecol. 2007;34(1):52-4.
Testosterone (T) associated with estrogen (E) has been used in hormonal replacement therapy in postmenopause women and the effects of this hormonal association on the uterus are not known.
To study the effect of long-term simultaneous exposure to testosterone and estrogen on the uterus of non-castrated adult female rats.
Groups of ten adult noncastrated female Wistar rats were treated with non-esterified testosterone and beta estradiol (subcutaneous implants with 50 mg of each hormone) or with testosterone cipionate and estradiol valerate (weekly intramuscularly or by subcutaneous injection of respectively, 2.85 mg/kg and 0.166 mg/kg). Control groups received no treatment (10 rats) or injections of diluents (6 rats). All animals were killed six months after hormonal exposure.
All rats treated with T+E developed hyperplasia and hyperkeratosis of the vaginal and cervical epithelium and focal metaplasia with keratinization of the endocervical and endometrial epithelium. Ascending pelvic inflammatory disease with pyometra and tuboovarian abscesses were frequent (25% mortality until the end of the experiment).
Testosterone associated with estrogen induced metaplasia of the genital epithelium but did not induce neoplastic lesions. The metaplasic lesions reduced the mucosal defense mechanisms enhancing ascending genital inflammatory disease. Although metaplasia of the cervical and endometrial epithelium has been observed after estrogen exposure in rats, testosterone does not appear to inhibit these estrogen effects.
睾酮(T)与雌激素(E)联合已用于绝经后女性的激素替代疗法,而这种激素联合对子宫的影响尚不清楚。
研究长期同时暴露于睾酮和雌激素对未阉割成年雌性大鼠子宫的影响。
将十只成年未阉割雌性Wistar大鼠分为几组,分别用非酯化睾酮和β-雌二醇(皮下植入,每种激素50mg)或环戊丙酸睾酮和戊酸雌二醇(每周肌肉注射或皮下注射,分别为2.85mg/kg和0.166mg/kg)进行治疗。对照组未接受治疗(10只大鼠)或注射稀释剂(6只大鼠)。所有动物在激素暴露六个月后处死。
所有接受T+E治疗的大鼠均出现阴道和宫颈上皮增生、角化过度以及宫颈内膜和子宫内膜上皮局灶性化生伴角化。伴有子宫积脓和输卵管卵巢脓肿的上行性盆腔炎很常见(直到实验结束死亡率为25%)。
睾酮与雌激素联合可诱导生殖上皮化生,但不诱导肿瘤性病变。化生病变降低了黏膜防御机制,增强了上行性生殖系统炎症。尽管在大鼠雌激素暴露后观察到宫颈和子宫内膜上皮化生,但睾酮似乎并未抑制这些雌激素作用。