Lumsden M A, West C P, Hillier H, Baird D T
Department of Obstetrics and Gynaecology, University of Edinburgh, Scotland.
Fertil Steril. 1989 Dec;52(6):924-9. doi: 10.1016/s0015-0282(16)53153-7.
Six premenopausal women with uterine fibroids were treated with a combination of tamoxifen, 20 mg/d, and goserelin, 3.6 mg every 28 days, for a total of 24 weeks. Results were compared with those from six women, matched for pretreatment uterine volume, who had been treated with goserelin alone. During combined therapy, plasma and urinary estrogen concentrations were significantly lower than during goserelin alone, whereas sex hormone binding globulin concentrations were significantly higher. Plasma luteinizing hormone and follicle stimulating hormone (FSH) concentrations were both suppressed, in contrast with results during goserelin alone when FSH levels remained within the pretreatment range. None of the women on combined therapy bled in response to the endocrine changes of the initial treatment cycle. Despite this profound pituitary-ovarian suppression, there was no significant change in uterine volume during combined therapy. These results suggest that tamoxifen is acting as an estrogen agonist in women rendered hypoestrogenic with luteinizing hormone-releasing hormone agonists.
6名患有子宫肌瘤的绝经前女性接受了他莫昔芬（20mg/d）和戈舍瑞林（每28天3.6mg）联合治疗，共24周。将结果与6名年龄匹配、治疗前子宫体积相同、仅接受戈舍瑞林治疗的女性的结果进行比较。联合治疗期间，血浆和尿雌激素浓度显著低于单独使用戈舍瑞林时，而性激素结合球蛋白浓度显著更高。血浆促黄体生成素和促卵泡生成素（FSH）浓度均受到抑制，这与单独使用戈舍瑞林时FSH水平保持在治疗前范围内的结果形成对比。联合治疗的女性中，无人因初始治疗周期的内分泌变化而出血。尽管垂体-卵巢受到显著抑制，但联合治疗期间子宫体积无显著变化。这些结果表明，在因促黄体生成素释放激素激动剂而导致雌激素缺乏的女性中，他莫昔芬起到了雌激素激动剂的作用。
