A variety of treatments that enhance the
quality of life for women may soon be available, according to new research
being presented today in San Diego at ENDO 2005, the 87th Annual Meeting of
The Endocrine Society.
The four new studies, which will be featured at a press conference at the
San Diego Convention Center on Sunday, June 5 at 10:00 a.m., discuss potential
therapies to enhance the quality of life in middle-aged and post-menopausal
women, enhancing the chances for young women to remain fertile after
aggressive therapy for various types of leukemia and reducing the aggressive
growth of breast cancer.
New Methods May Preserve Fertility for Girls Receiving Cytotoxic Therapy
Girls who had received their first period and were receiving toxic
therapies for certain diseases, including leukemia and Hodgkins disease, were
treated successfully for protection of the ovaries during treatments.
The purpose of the pilot study, as conducted by Dr. Marta Snajderova at
the University Hospital-Motol, Prague, Czech Republic was to review clinical
results in ovary protection by combining the gonadotropin-releasing hormone
GnRH agonist and GnRH antagonist before and during high dose toxic therapy.
Using the protocol in the study, a rapid cell desensitization could be
achieved in all patients within 96 hours, allowing start of cancer treatment
without any delay. More than two-thirds of girls resumed their periods after
the end of cancer treatment. All menstruating girls in the study now have
regular menstrual cycles 28-30 days long.
"The combination of GnRH-agonist and GnRH-antagonist makes it possible to
achieve a rapid, reliable and cost-effective suppression of pituitary-gonadal
axis, protecting the ovaries during the treatment," said Snajderova. "If
these preliminary data are consistent in a larger group of patients, the GnRH-
agonist and GnRH-antagonist co-treatment should be considered in every young
fertile woman receiving cytotoxic treatment for further fertility
preservation."
Effects of Hormones on Breast Cancer
Evidence suggests that estrogen and inflammatory mediators play important
roles in the growth and progression of breast cancer. Activity of aromatase,
an enzyme that converts androgens to estrogens, can therefore result in high
local levels of estrogen production that stimulates tumor growth.
Immunoreactivity for aromatase in human breast tumors is highly correlated
with that of COX-2, the rate-determining enzyme in prostanoid biosynthesis,
according to this research conducted by Dr. Daniel Hardy, UT Southwestern
Medical Center in Dallas.
"Non-antibody proteins that act as intercellular mediators contributes to
the increase in expression in breast cancer," said Dr. Hardy. "And,
progesterone receptors play a dominant protective role in breast cancer cells
by antagonizing activation of COX-2, resulting in decreased expression."
Soy Treatments May Improve Quality of Life in Post-Menopausal Women
A study by Dr. Kendall Dupree of Johns Hopkins University looked into the
effects of soy on quality of life in post-menopausal women. Complementary and
alternative therapies are being used frequently in the United States. Studies
of post-menopausal women indicate that estrogen replacement improves physical,
psychosocial and vascular symptoms. Because of the reduction in use of
hormone replacement therapy, many women are choosing soy as an alternative.
Soy is a phytoestrogen, which is a naturally occurring estrogen found in
plants. It contains isoflavanoids called genistein and daidzein. These
isoflavanoids are similar to estrogen chemically and are capable of binding to
estrogen receptors and exerting an excitatory or inhibitory effect.
The study looked to demonstrate that when administered in adequate doses
to post-menopausal women, isoflavones will result in improved menopausal
symptoms and related quality of life.
The study looked at data on 35 post-menopausal women not on hormone
replacement therapy for at least six months prior to beginning the study.
Participants completed a three-month clinical trial and were randomized to the
active product, commercially available as Revival, with 160mg of total
isoflavones vs. a placebo. Each participant completed the MENQOL (Menopause-
Specific Quality of Life Questionnaire) at baseline, six weeks and three
months.
Researchers found that women taking the active compound experienced
significant improvement in their vasomotor symptoms, psychosocial symptoms and
physical function by 36%, 40% and 30 % respectively, compared to the placebo.
"We conclude that post-menopausal women taking isoflavones with high
concentrations of genistein experience improvement in their menopausal
symptoms and therefore have an improved quality-of-life, as reflected by the
self-administered MENQOL questionnaire," said Dupree.
The Effects of Androgens During Menopause
Dr. Jiangang Chen, University of California at Davis, and colleagues
announced that they have made headway in understanding the importance of
endogenous androgens and the benefits and risks of exogenous androgen
replacement therapy in women during menopausal transition through a newly
developed cell-based androgen bioassay in serum sampled from 100 mid-aged
women (42-58 years old) from SWAN (Study of Women's Health Across the Nation).
Circulating androgens are known to improve quality of life in regard to a
meaningful, intimate sexual relationship. To date, our understanding of the
importance of naturally occurring androgens and the benefits and risks of
androgen replacement therapy in women during menopause is incomplete.
This study investigated the relationship of circulating testosterone
measured by immunoassay to the bioactivity of androgens measured by the newly
developed cell based androgen bioassay. The resulting data support the
concept that free or bioavailable androgens are increased above what is
predicted by free testosterone in women with lower levels of sex hormone
binding globulin (SHBG). Therefore, a direct measure of bioactive androgens
may provide a different and possibly superior explanation for some decreases
in SHBG.
The findings also suggest the importance of adrenal steroid secretion
during menopause that may explain some differences in menopausal symptoms and
health outcomes among middle-aged women.
Growth Hormones Assist Post-Menopausal Women
A study led by Drs. Arthur Weltman and colleagues at the University of
Virginia and Dr. Johannes Veldhuis, Mayo School of Graduate Medical Education
found that the administration of the growth hormone recombinant human GHRH-
1,44-amide taken for three months can enhance the quality of life in post-
menopausal women.
Earlier studies have indicated that twice-daily sc administration of a
high dose of recombinant human GHRH-1,44-amide (GHRH) taken for 90 days can
alter body composition in healthy older men. Drs. Weltman and Veldhuis set
out to establish whether this is also true in post-menopausal women. To this
end, 10 post-menopausal volunteers underwent a baseline study and then
received 1 mg of GHRH twice daily for three months.
"At the conclusion of the study, there were no systemic adverse events,
although most subjects experienced local skin reactivity at the dose of 1 mg
injected subcutaneously twice per day. We concluded that a three-month regimen
of GHRH supplementation in post-menopausal women can stimulate GH and IGF-I
production, reduce abdominal visceral fat and improve selected measures of
physical performance," said Dr. Weltman.
Founded in 1916, The Endocrine Society is the world's oldest, largest, and
most active organization devoted to research on hormones, and the clinical
practice of endocrinology. Today, The Endocrine Society's membership consists
of over 12,000 scientists, physicians, educators, nurses and students in more
than 80 countries. Together, these members represent all basic, applied, and
clinical interests in endocrinology. The Endocrine Society is based in Chevy
Chase, Maryland. To learn more about the Society, and the field of
endocrinology, visit our web site at endo-society.
The Endocrine Society
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