Overview of elagolix for the treatment of endometriosis.

Introduction: Suppression of sex-steroid secretion is required in a variety of gynecological conditions. This can be achieved using gonadotropin releasing hormone (GnRH) agonists that bind pituitary gonadotropin receptors and antagonize the link-receptor of endogenous GnRH, inhibiting the mechanism of GnRH pulsatility. On the other hand, GnRH antagonists immediately reduce gonadal steroid levels, avoiding the initial stimulatory phase of the agonists.

[Bacterial vaginosis: efficacy of a local treatment with a gel containing a fraction derived from propinibacterium acnes].

Background: Bacterial vaginosis (BV) is favored by a decreased activity of vaginal immune system. The fraction derived from Propionibacterium acnes is known to activate the immune system and is used parenterally to treat respiratory and urinary infections. The employ of a fraction derived from Propionibacterium acnes locally, in the context of the vaginal immune system, is made possible by a vaginal gel in which this fraction is associated with hyaluronic acid, well-known for its moisturizing activity, and polycarbophil, capable of miming the function of cervical mucus.

Effect of Estradiol valerate plus dienogest on body composition of healthy women in the menopausal transition: a prospective one-year evaluation.

In the menopausal transition (MT), combined oral contraceptive (COC) should be chosen accordingly to its neutrality on liver metabolism and to its ability to counter the increase of fat mass (FM) that occurs in this reproductive period of life. This prospective multi-centric observational study was conducted on 36 women in their MT at the Universities of Cagliari, Modena and Naples. The body weight (BW), the Body Mass Index (BMI), the waist to hip ratio (WHR), the measurement of body composition (BC) with the Multi-frequency Bioelectrical Impedance (MF-BIA) were performed before, at the 6th and at the 12th month of the study in which a group of women (control group; N.

Clinical effect of hormonal replacement therapy with estradiol associated with noretisterone or drospirenone. A prospective randomized placebo controlled study.

The study was performed to compare the clinical effect of a hormone replacement therapy (HRT) with two different progestins. Postmenopausal women (PMW) with climacteric symptoms (CS) randomly received for 12 months orally, either placebo (n = 20), 1 mg estradiol (E) plus 0.5 mg noretisterone acetate (NETA; n = 40), or 2 mg drospirenone (DRSP; n = 40), a testosterone- and spironolactone-derived molecule, respectively.

Observational study on the efficacy of the supplementation with a preparation with several minerals and vitamins in improving mood and behaviour of healthy puerperal women.

We investigated whether a formulation containing vitamins and minerals (vit&min) could improve the worsening of mood changes occurring after delivery ("a.d.").

Pharmacokinetic evaluation of ulipristal acetate for uterine leiomyoma treatment.

Introduction: Progesterone (P), and its receptors (PRs), play a key role in uterine leiomyoma growth. Selective progesterone receptor modulators exert mixed antagonist and agonist effects on the PRs. Mifepristone, a PR-antagonist, reduces leiomyoma volume and related symptoms.

Endocrinological, metabolic and clinical features of treatment with oral contraceptive formulation containing ethinylestradiol plus chlormadinone acetate in nonobese women with polycystic ovary syndrome.

Background: Chlormadinone acetate (CMA) is a progestin compound similar to progesterone, with antiandrogenic properties. In healthy eumenorrheic women, it was demonstrated that the monophasic estroprogestin formulation containing CMA (2 mg) plus ethinyl estradiol (EE) (30 mcg) (EE30+CMA) is efficacious both in reducing hyperandrogenic symptoms, fat mass and in improving lipoprotein panel, without changes in insulin-glucose metabolism. These metabolic properties are important for women affected by polycystic ovary syndrome (PCOS) in whom there is a predisposition to insulin resistance.

Evidence that in healthy young women, a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol plus 2 mg of chlormadinone acetate reduces fat mass.

Background: We aimed to evaluate whether a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol (EE2) plus 2 mg of chlormadinone acetate (CMA) (EE2+CMA) alters body weight (BW) and body composition of healthy young women with normal menstrual cycles. The results in treated subjects were compared to those obtained in nontreated women as control.

Study Design: Multifrequency bioelectrical impedance analysis (MF-BIA) was performed in 48 healthy young women during the follicular phase of their menstrual cycle.

Autoimmunity in gestational diabetes mellitus in Sardinia: a preliminary case-control report.

Background: We previously reported a high prevalence (22.3%) of gestational diabetes mellitus (GDM) in a large group of Sardinian women, in contrast with the prevalence of Type 2 diabetes. Sardinia has an unusual distribution of haplotypes and genotypes, with the highest population frequency of HLA DR3 in the world, and after Finland, the highest prevalence of Type 1 diabetes and Autoimmune-related Diseases.

Reduced serum level of THDOC, an anticonvulsant steroid, in women with perimenstrual catamenial epilepsy.

Purpose: Seizure exacerbation in catamenial epilepsy (CE) is associated with the decrease in progesterone secretion and increase in estradiol secretion during the premenstrual period. Moreover, experimental evidence suggests that tetrahydrodeoxycorticosterone (THDOC), a positive modulator of the type A receptor for gamma-aminobutyric acid (GABA), and dehydroepiandrosterone sulfate (DHEAS), a negative modulator of this receptor, might play a crucial role in modulating seizure frequency during the menstrual cycle. Following these studies it seems of interest to investigate possible variations, among other hormonal parameters, of THDOC and DHEAS in CE patients.

The oral contraceptive containing 30 microg of ethinylestradiol plus 3 mg of drospirenone is able to antagonize the increase of extracellular water occurring in healthy young women during the luteal phase of the menstrual cycle: an observational study.

Purpose: This nonrandomized study aimed to evaluate body weight and composition during the menstrual cycle and during oral contraception with 30 microg of ethinylestradiol plus 3 mg of drospirenone (EE+DRSP).

Design: Multifrequency bioelectrical impedance analysis was carried out in 38 normally cycling women (mean age, 25.5 years) at baseline during the follicular phase (FP) and the luteal phase (LP) of the menstrual cycle and after three and six cycles of EE+DRSP to evaluate total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass and fat-free mass.

Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy.

Objective: To assess whether IV tramadol before outpatient hysteroscopy could reduce procedure-related pain.

Design: A randomized double-blind placebo controlled trial.

Setting: Outpatient Hysteroscopy Centre in the Department of Obstetrics and Gynaecology of Cagliari University.

Observational study on the stability of the psychological status during normal pregnancy and increased blood levels of neuroactive steroids with GABA-A receptor agonist activity.

We investigated whether pregnancy could modify psychological symptoms and whether neuroactive steroids which exert an anti-anxiety effect by acting on the gamma-aminobutyric acid (GABA)-A receptors, are modified during pregnancy in young healthy women. Healthy volunteer women in the Department of Obstetrics and Gynecology at Cagliari University participated in the study. They were divided into women with low (group 1, seven subjects) and high (group 2, seven subjects) psychological score by SCL-90 psychometric scale.

Short-term variations in bone remodeling markers of an oral contraception formulation containing 3 mg of drospirenone plus 30 microg of ethinyl estradiol: observational study in young postadolescent women.

The clinical study of treated subjects and nontreated controls was made in healthy eumenorrheic young postadolescent women volunteers in the Department of Obstetrics and Gynaecology at Cagliari University, to investigate whether an oral contraceptive (OC) containing drospirenone (3 mg) plus ethinyl estradiol (30 microg) (DRSP+EE) can affect bone metabolism. Control group (n = 26) and OC group (n = 28) women did not differ in age, body mass index, waist-to-hip ratio and main outcome measures [urinary levels of deoxypyridinoline and pyridinoline, serum levels of osteocalcin, bone specific alkaline phosphatase (bSAP), total testosterone (total-T), sex hormone-binding globulin (SHBG), progesterone and bone mineral density (BMD) at the heel]. The control group was studied at the luteal phase (LP) during both the first and the sixth menstrual cycle; the OC group was studied during the first cycle at the LP, and on days 16-18 of the sixth cycle of DRSP+EE treatment.

Psychological effect of the oral contraceptive formulation containing 3 mg of drospirenone plus 30 microg of ethinyl estradiol.

Objective: To investigate in healthy eumenorrheic young women whether an oral contraceptive (OC) containing drospirenone (DRSP) (3 mg) + ethinyl estradiol (EE) (30 microg) (DRSP + EE) could modify psychological symptoms and whether it could modify steroids interfering with the gamma-aminobutyric acid (GABA)-A receptors.

Design: Clinical study of treated subjects and nontreated controls.

Setting: Healthy volunteers in the Department of Obstetrics and Gynecology at Cagliari University.

Observational study on the efficacy of tibolone in counteracting early carotid atherosclerotic lesions in postmenopausal women.

Objective: To study whether tibolone affects lipid profile and diffused intima media thickness (IMT) of the common carotid arteries (CCA) in postmenopausal women (PMW).

Methods: Twenty-two PMW and 20 premenopausal women participated in the study. The PMW were randomly divided into 11 women who did not receive any treatment and 11 women who received tibolone (2.

The diagnosis of functional ovarian cysts using transvaginal ultrasound combined with clinical parameters, CA125 determinations, and color Doppler.

Objectives: To investigate the role of transvaginal ultrasound combined with clinical parameters, CA125 determinations, and color Doppler in the differentiation between functional cysts and other adnexal masses.

Study Design: Two hundred and eighty-seven consecutive persistent adnexal masses were submitted to B-mode transvaginal ultrasonography associated with color and power Doppler imaging. Plasma CA125 concentrations were measured before surgery.

Pattern of bone markers during pregnancy and their changes after delivery.

Objective: To investigate whether bone resorption markers change during pregnancy and lactation, and how they are correlated with human placental lactogen (hPL) and PRL.

Subjects: Young women before pregnancy, during pregnancy and during a 12-month post-delivery period (study group; n = 22); and age- and weight-matched normal cycling women (control group; n = 22) for a 20-month-period participated in the study.

Results: In the study group, women both during pregnancy (from the 8th up to the 38th week) and during a 6-month period of lactation, pyridinoline and deoxypyridinoline urinary levels were significantly higher than those of pre-pregnancy and control women.

Raloxifene does not modify insulin sensitivity and glucose metabolism in postmenopausal women.

Insulin sensitivity (Si), glucose tolerance, and lipid metabolism were investigated in osteopenic postmenopausal women before and after 6 months of treatment with raloxifene (60 mg/d) or placebo. In a group of women (n = 34), glucose metabolism was evaluated by means of an oral glucose tolerance test (75 g). In another group of women (n = 24), Si and peripheral glucose utilization not dependent on insulin were evaluated by means of a frequently sampled iv glucose tolerance test associated with the minimal model method.

Efficacy and safety of oral and transdermal hormonal replacement treatment containing levonorgestrel.

Objectives: The oral combined formulation of levonorgestrel with estradiol valerate (LNG+EV) has demonstrated to be effective on some postmenopausal symptoms. The availability of a transdermal HRT in sequential formulation with 17-beta-estradiol plus levonorgestrel (TSE2+TSLNG) induced us to do this control-study with the aim to evaluate the efficacy and safety of both oral and transdermal treatments.

Methods: At baseline, the psychological symptoms with the psychometric scale SCL-90, the bone resorption with the measurement of the urinary levels of pyridinoline and dexoxypirydinoline, and the insulin and lipid metabolism were assessed in 30 postmenopausal women (PMW) and in 18 premenopausal women.

The antiandrogenic effect of flutamide improves uterine perfusion in women with polycystic ovary syndrome.

Objective: To evaluate whether, by blocking androgen action, flutamide can decrease and normalize vascular resistance in the uterine artery in patients with polycystic ovary syndrome (PCOS).

Design: Prospective and controlled study.

Setting: Endocrinological Centre of the Department of Obstetrics and Gynecology of the University of Cagliari, Italy.