The effect of steroids on the in vitro migration of washed human spermatozoa in modified Tyrode's solution or in fasting human blood serum

In modified Tyrode's solution, 17 beta-estradiol at concentrations between 0.1 microgram/ml and 320 nmoles/ml was effective in increasing human spermatozoal forward migration. 17 alpha-Estradiol, although structurally similar to 17 beta-estradiol, had no effect on human spermatozoal motility. DL-Norgestrel at concentrations between 0.1 migrogram/ml and 320 nmoles/ml inhibited spermatozoal motility. These stimulatory and inhibitory effects were not observed when fasting human blood serum was used as a penetration medium in place of the modified Tyrode's solution. Also, the motility of spermatozoa suspended in fasting human blood serum was better than that of spermatozoa suspended in modified Tyrode's solution or in seminal plasma. These observations indicated that there is a component(s) of fasting human blood serum which increases spermatozoal motility and can counteract the activation or inhibition of spermatozoal motility by 17 beta-estradiol or DL-norgestrel at the concentrations used here.

Metabolic effects of oral contraceptives containing 30 micrograms and 50 micrograms of oestrogen

In Study A, biochemical data from 17 women who were not taking oral contraceptives were compared with those from women taking preparations which contained either 30 microgram of ethinyl oestradiol and 150 microgram of D-norgestrel (18 women) or 50 microgram of ethinyl oestradiol and 250 microgram of D-norgestrel (nine women). In Study B, biochemical data were collected from eight women before and during the first three or four months therapy with preparations containing 30 microgram of ethinyl oestradiol and 150 microgram of D-norgestrel. The two oral contraceptive dosage forms studied produced qualitatively and quantitatively similar metabolic changes. Both caused an increase in serum concentration of triglycerides (30% to 33%), beta-lipoproteins (27% to 29%) and ceruloplasmin (75% to 90%), and a decrease in serum levels of antithrombin III (22% to 29%) and ascorbic acid (30% to 42%). Serum cholesterol and phospholipid concentrations were unchanged. However, the proportion of serum cholesterol carried by alpha-lipoproteins (high density lipoproteins) decreased, while that carried by beta-lipoproteins (low density and very low density lipoproteins) increased. The former change is in the same direction, but much smaller than that observed in coronary heart disease.

Steroid absorption and enterohepatic recycling

A short review on steroid absorption and enterohepatic recycling in man with special emphasis on contraceptive and related steroids is presented. Some new experimental data on the intestinal metabolism of steroids is described and includes further observations on the effect of antimicrobial agents on steroid hormone metabolism. Evidence is presented that plasma levels of steroids may be influenced if the intestinal microflora is altered. Some formation of biologically active steroids, like estradiol, may occur in the intestinal tract and this may have both biological and pathological consequences and may be influenced by such factors as diet and sex. It is concluded that our knowledge of the intestinal and especially, the mucosal metabolism of steroids is scanty and further studies are needed to clarify the role of the intestine and enterohepatic circulation in determining the bioavailability of natural and synthetic steroids.

[Comparative biochemical investigations with contraceptives at different dose levels (author's transl)]

In adolescent girls the administration of hormonal contraception raises special problems because of the still unstable menstrual cycle of this group. The influence of four oral contraceptives with different high doses on the levels of the two gonadotropins, estradiol and progesterone has been studied with the aid of the GnRH-test before, during and after treatment. According to the results obtained low-dose combination preparations should be administered to adolescents with stable cycles as in this group normal physiological conditions reappeared without delay after discontinuation of a one-year treatment. If the cycle pattern is still irregular a low-dose gestagen ("minipill") preparation may be chosen. This type of treatment showed the least central inhibition, probably advantageous with regard to the still immature cycle.

Bone loss during oestriol therapy in postmenopausal women

In contrast to all other oestrogens examined thus far oestriol hemisuccinate (12 mg/day) did not prevent bone loss in 28 postmenopausal women. The average bone loss, however, was somewhat less than expected from placebo studies, while the bone loss achieved by a group taking 4-6 mg/day was equal to that achieved by previous placebo groups. To be an effective agent for prevention of post-menopausal osteoporosis oestriol would have to be prescribed in daily doses considerably in excess of 12 mg.

Disposition of chlordiazepoxide: sex differences and effects of oral contraceptives

There is considerable interspecies and interdrug variability in the effect of sex differences and oral contraceptive (OC) steroids on hepatic drug elimination. Their influence on the disposition of chlordiazepoxide has been studied in 11 healthy young men (29 +/- 5 yr), 11 healthy young women (28 +/- 5 yr), and 7 healthy women receiving OC steroids (27 +/- 2 yr) for more than 6 months. The elimination half-life (t1/2(beta)) was longer (from 14.8 +/- 5.9 hr to 8.9 +/- 2.5 hr) and protein binding less (95.5 +/- 1.4% and 97.0 +/- 1.2%) in women than in men. Weight-normalized plasma clearances of total drug did not differ, but the clearance of unbound drug was significantly less in women (8.7 +/- 5.0 ml/min/kg) than in men (15.6 +/- 5.3 ml/min/kg). Women on OC steroids had a lower plasma binding (from 93.6 +/- 1.5% to 95.5 +/- 1.4%) and a higher volume of distribution (from 0.62 +-/ 0.23 l/kg to 0.40 +/- 0.14 l/kg) than women not on OC steroids. The elimination t1/2 was longer (from 24.3 +/- 12 hr to 14.8 +/- 5.9 hr) and the clearance of unbound drug lower (from 5.7 +/- 3.0 ml/min/kg to 8.7 +/- 5.0 ml/min/kg) in women on OC steroids than in those not using them, but these differences were not statistically significant.

Alterations of peripheral testosterone matabolism after induced hypoprolactinemia in patients with prostatic carcinoma

In 12 patients with advanced prostatic carcinoma the effect of bromocriptine-induced hypoprolactinemia on the peripheral androgen metabolism was investigated after 3H-testosterone injection under conditions that each individual served as his own control. After a 5-day significant prolactin suppression, the elimination of 3H-label 1 h after testosterone injection was about 45% and equal to pre-bromocriptine values. The recovery of dihydrotestosterone separated by silica gel T.L.C., however, was significantly augmented, resulting in a marked decrease of the testosterone/dihydrotestosterone ratio from 12.2 to 6.3. This induced 5alpha-reductase activity after prolactin suppression is in accordance with our earlier findings on prostatic carcinoma tissue, matches well with observations of Magrini et al. on induced hyperprolactinemia and may be a new approach to the understanding of androgen dependent disorders.

The effect of oral contraceptive treatment on the serum concentration of dehydroisoandrosterone sulfate

Dehydroisoandrosterone sulfate (DS), the major C19-steroid in the human circulation, was measured in serum obtained from blood samples collected daily (8 to 10 A.M.) throughout the menstrual cycles of eight normal, presumably ovulatory women and daily throughout the treatment cycles in four women taking an oral contraceptive (norethindrone, 1 mg., plus mestranol, 80 mcg.). The serum concentrations of DS in the ovulatory women ranged from 1,025 to 4,200 ng. per milliliter; mean, 2,062 +/- 137 ng. per milliliter (mean and standard error; n = 213). Serum DS concentrations during the follicular and luteal phases of the menstrual cycles of these women were similar. In women taking the oral contraceptive, the plasma DS concentrations ranged from 475 to 1,400 ng. per milliliter (mean, 895 +/- 83; n = 119). The 24 hour secretory pattern of DS was evaluated in one subject during a nontreatment cycle and again after 20 days of oral contraceptive treatment. In this subject, the mean serum DS level was 34 per cent lower during oral contraceptive treatment than the level before treatment. The decrease in the serum concentration of DS during oral contraceptive treatment likely results from a reduction in adrenal DS secretion since DS secretion by the normal human ovary is negligible and ovarian dehydroisoandrosterone secretion is small. Therefore, it is likely that the reduced serum DS levels in women taking oral contraceptives are the consequence of reduced adrenal secretion of DS resulting from reduced release of adrenocorticotropic hormone.

Effect of oral contraceptives on plasma androgenic steroids and their precursors

Plasma dehydroepiandrosterone (DHEA), its sulfate ester (DHEAS), and androstenedione (A2), delta5-pregnenolone (delta5-P), and 17 alpha-hydroxypregnenolone were measured in women using estrogen-containing oral contraceptives and in female controls of similar age. All three androgenic steroids and their two C21 precursors were reduced in the oral contraceptive users compared with the controls. It is concluded that oral contraceptives cause a decrease in plasma DHEA, DHEAS, and A2, one possible mechanism for which is the inhibition of delta5-P synthesis from cholesterol.