Lack of tumor reduction in hyperprolactinemic women with extrasellar macroadenomas treated with bromocriptine.

Three patients with hyperprolactinemia and large extrasellar pituitary macroadenomas were treated with bromocriptine, 10 mg daily, for 8 weeks. In spite of correction of their amenorrhea, galactorrhea, and hyperprolactinemia, radiologic evaluation by CT scan failed to show evidence of tumor shrinkage. After surgical resection, histologic examination revealed that PRL-secreting cells comprised only a small portion of the tumor cell population in two patients and in the third patient were completely absent.

Estrogen replacement therapy and hypertension.

The common assumption that estrogen replacement therapy (ERT) will frequently induce or aggravate hypertension cannot be supported by current evidence. While hypertension may occur as a rare idiosyncratic reaction to ERT, studies strongly suggest that blood pressure, systolic and diastolic, is consistently lowered by estrogen administration, although the decrement is small. There are suggestive data that on a weight basis, natural human estrogens have less of an effect on the renin-angiotensin system than do conjugated and synthetic estrogens, but the clinical significance of these findings has not been demonstrated.

Comparison of hepatic impact of oral and vaginal administration of ethinyl estradiol.

The pronounced hepatic impact of oral ethinyl estradiol has been attributed by some to its so-called first-pass effect through the liver as only some 40% of ingested ethinyl estradiol reaches the systemic circulation. Others believe that ethinyl estradiol exerts its hepatic effects because of its chemical composition, specifically its 17 alpha-ethinyl group. In an attempt to resolve this controversy, a study was undertaken to determine whether vaginal administration of ethinyl estradiol can selectively reduce the hepatic effects of oral ethinyl estradiol.

The relation of physiological changes to subjective symptoms in postmenopausal women with and without hot flushes.

This study was designed to fully correlate the temporal relationship between augmented digital perfusion, (vasodilatation) and hot flushes, peripheral temperature, plasma luteinizing hormone, (LH) epinephrine and norepinephrine. Plasma samples were measured every 3 min for 2-4 h, in 5 symptomatic women before and after estrogen replacement and in 3 asymptomatic post-menopausal women. In all 5 symptomatic women the augmented digital perfusion occurred at a mean (+/- SEM) of 1.