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孕激素及相关孕激素:新的潜在健康益处。

Progesterone and related progestins: potential new health benefits.

机构信息

Population Council and Rockefeller University, New York, NY 10065, USA.

出版信息

Climacteric. 2013 Aug;16 Suppl 1:69-78. doi: 10.3109/13697137.2013.802556. Epub 2013 May 29.

Abstract

Progesterone is a steroid hormone that is essential for the regulation of reproductive function. The main physiological roles of this hormone have been widely described. Progesterone and progestins have been approved for a number of indications including the treatment of irregular and anovulatory menstrual cycles and, when combined with estrogen, for contraception, and the prevention of endometrial hyperplasia in postmenopausal hormonal replacement therapy (HRT) regimens. Lack of understanding between the differences in categories of the progestins as well as with the physiological hormone has resulted in considerable controversy surrounding the use of progestins for HRT regimens. Newer evidence suggests that there are distinct differences between the molecules and there is no progestin class effect, with regard to benefits or side-effects. In addition to its role in reproduction, progesterone regulates a number of biologically distinct processes in other tissues, particularly in the nervous system and the vessels. Recently, it has been shown in animal experiments that progesterone and the progestin Nestorone(®) have positive effects on neuroregeneration and repair of brain damage, as well as myelin repair. The potential benefits of natural progesterone and its related derivatives warrant further investigation. It is hoped that a better understanding of the mechanism of action of progesterone and selected progestins will help in defining better therapies for men and women.

摘要

孕激素是一种甾体激素,对于生殖功能的调节至关重要。这种激素的主要生理作用已经得到了广泛的描述。孕激素和孕激素类药物已经被批准用于多种适应症,包括治疗不规则和无排卵性月经周期,以及与雌激素联合用于避孕和预防绝经后激素替代疗法(HRT)方案中的子宫内膜增生。由于对孕激素类药物的分类以及与生理激素之间的差异缺乏了解,导致了围绕 HRT 方案使用孕激素的大量争议。新的证据表明,这些分子之间存在明显的差异,而且在益处或副作用方面,没有孕激素类药物的类别效应。除了在生殖中的作用外,孕激素还调节其他组织中许多生物学上不同的过程,特别是在神经系统和血管中。最近的动物实验表明,孕激素和孕激素类药物 Nestorone(®)对神经再生和脑损伤修复以及髓鞘修复有积极作用。天然孕激素及其相关衍生物的潜在益处值得进一步研究。希望对孕激素和选定孕激素类药物作用机制的更好理解将有助于为男性和女性定义更好的治疗方法。

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