Pluchino Nicola, Ninni Filippo, Stomati Massimo, Freschi Letizia, Casarosa Elena, Valentino Valeria, Luisi Stefano, Genazzani Alessandro D, Potì Elena, Genazzani Andrea R
Department of Reproductive Medicine and Child Development, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy.
Maturitas. 2008 Apr 20;59(4):293-303. doi: 10.1016/j.maturitas.2008.02.004. Epub 2008 Apr 3.
The purpose of this study was to evaluate the effects on hormonal milieu of 1-year therapy with 10 mg/day oral dehydroepiandrosterone (DHEA) or 50 microg transdermal estradiol plus 100 mg/day oral micronized progesterone in a group of 20 healthy postmenopausal women (age=50-58 and years since menopause (ysm)=1-6) and also the effects observed by combining these two therapies in a group of 12 postmenopausal women (age=54-61 and ysm=6-10) characterized by lower baseline DHEA and DHEAS levels (<2.40 and <0.55 microg/ml, respectively). DHEA produced a significant rise in androgens levels, whereas HRT did not. Moreover, DHEA alone induced a significantly lower increase in estrogens and beta-endorphin levels and a higher decrease in cortisol levels than HRT. DHEA and HRT also produced a significant similar increase in allopregnanolone levels. DHEA plus HRT induced a significantly higher increase in testosterone and estradiol and a lower increase in allopregnanolone and beta-endorphin levels and a significantly lower decrease in cortisol levels than HRT alone treated group. A similar increase was observed in progesterone and SHBG levels in all groups. These results suggest that 10-mg DHEA seems to be the proper dose to replace androgen deficiency in subjects with reduced Delta-5 androgens plasma levels. However, the aging process and the number of years since menopause may further modulate the effects of hormone therapy on hormonal milieu.
本研究的目的是评估10毫克/天口服脱氢表雄酮(DHEA)或50微克经皮雌二醇加100毫克/天口服微粉化孕酮对一组20名健康绝经后妇女(年龄50 - 58岁,绝经年限(ysm)=1 - 6年)激素环境的影响,以及在一组12名绝经后妇女(年龄54 - 61岁,ysm = 6 - 10年)中联合使用这两种疗法的效果,这些妇女的基线DHEA和硫酸脱氢表雄酮(DHEAS)水平较低(分别<2.40微克/毫升和<0.55微克/毫升)。DHEA使雄激素水平显著升高,而激素替代疗法(HRT)则没有。此外,与HRT相比,单独使用DHEA导致雌激素和β - 内啡肽水平升高显著较低,皮质醇水平下降较高。DHEA和HRT还使别孕烷醇酮水平显著升高。与单独使用HRT治疗组相比,DHEA加HRT使睾酮和雌二醇升高显著更高,别孕烷醇酮和β - 内啡肽水平升高较低,皮质醇水平下降显著更低。所有组孕酮和性激素结合球蛋白(SHBG)水平均有类似升高。这些结果表明,对于血浆Δ5雄激素水平降低的受试者,10毫克DHEA似乎是替代雄激素缺乏的合适剂量。然而,衰老过程和绝经年限可能会进一步调节激素疗法对激素环境的影响。