Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0600142 (hot flushes)
 1,242 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a randomized, prospective trial, 199 previously untreated patients with Stage D2 prostatic cancer were treated with 3 mg/day diethylstilbestrol (DES) or 1 mg/day leuprolide acetate, a luteinizing hormone releasing hormone analog. Both DES and leuprolide suppressed testosterone to the desired castrate levels. Objective measures of disease, such as acid phosphatase levels, and subjective measures, such as bone pain, performance status, and mobility, showed similar decreases in both groups. No progression of disease was seen in 86 per cent of the leuprolide-treated group, compared with 85 per cent of the DES-treated group. The time to disease progression, development of adverse reaction requiring discontinuation of treatment, or death was identical for the two groups. Hot flashes were more common with leuprolide than with DES. Gynecomastia and breast tenderness, nausea and vomiting, and peripheral edema occurred more often in the DES group. Of those taking DES, 13 per cent discontinued treatment because of side effects, compared with 3 per cent of those taking leuprolide.
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PMID:Leuprolide versus diethylstilbestrol for previously untreated stage D2 prostate cancer. Results of a prospectively randomized trial. 307 35

Twenty-six peri- and postmenopausal women were treated with daily dose of 2 mg 17-beta-estradiol, 1 mg estriol and 1 mg norethisterone-acetate in a continuous regimen for 12 months. Clinical parameters such as vasomotor symptoms, bleeding patterns and histopathology were recorded. Blood samples were collected before, after 3 months and after 12 months of treatment and were analysed for estradiol-17-beta, estrone, androstenedione in serum and lipoprotein lipids. A marked reduction of hot flushes and sweatings was noted and the number of days with bleeding gradually decreased during treatment, especially in the postmenopausal group of women. No signs of hyperplasia of the endometrium were recorded. A decrease in the serum concentration of testosterone and androstenedione was found during treatment. The reduction in triglycerides in very low density lipoproteins after 3 months, concomitant with a decrease in the cholesterol content of high density lipoproteins, was interpreted as an effect mainly of the progestogen component in the preparation. The present formulation of estrogen-progestogen, continuously administered, may be an appropriate alternative treatment regimen for many women. One proposition of how to treat women with climacteric complaints around the menopause is presented.
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PMID:Estrogen-progestogen replacement in climacteric women, particularly as regards a new type of continuous regimen. 385 76

12 patients with troublesome hot flushes after orchidectomy (as a primary treatment for prostatic carcinoma) were treated with cyproterone acetate or placebo in a double-blind cross-over trial. The frequency of hot flushes was significantly reduced during the three weeks that cyproterone acetate (100 mg three times a day) was given. 5 patients complained of lassitude while on cyproterone acetate, but in none was it necessary to discontinue treatment.
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PMID:Cyproterone acetate in treatment of post-orchidectomy hot flushes. Double-blind cross-over trial. 613 71

A double-blind cross-over study was performed on 21 patients treated for endometrial carcinomas who had severe menopausal symptoms. The patients were randomized into two groups and received medroxyprogesterone acetate (MPA) 100 mg twice daily per os for 12 weeks and a placebo for 12 weeks. A significantly better effect on hot flushes and sweating was obtained with MPA than with the placebo. On average the maximum effect was achieved by MPA after 4-6 weeks. Six patients had a weight gain of more than 3 kg during the MPA administration, compared with none during the placebo administration. No significant difference was found in the blood pressure increase above 160/90 mmHg between MPA and placebo groups. Patients with endometrial carcinoma may risk exacerbation of their disease by undergoing therapy with exogenous estrogen. In contrast, MPA has been found of value in the treatment of disseminated endometrial carcinomas. In this study oral MPA was effective in the treatment of vasomotor menopausal symptoms and may be an alternative in women for whom estrogens might be hazardous.
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PMID:Effect of oral medroxyprogesterone acetate on menopausal symptoms in patients with endometrial carcinoma. 676 Jun 53

It has been suggested that women over age 40 use methods other than oral contraceptives (OCs) but there is evidence that the benefits of OCs should be weighed against the risks; some researchers have concluded that the existence of other predisposing risk factors is more important than age. Other hormonal methods available to middle aged women are: 1) continuous mini-progestogen OC which obviates the role of estrogens and are suggested for premenopausal women who do not show signs of hypoestrogenism, but pregnancy rate is still relatively high (3.0) for women aged 35 and over; 2) injectable contraceptives are believed to be highly effective but may depress some women; 3) estradiol pellet implants of 6-month intervals; in a group of 144 women aged 35-50 the pregnancy rate was 0.169; and 4) estradiol pellet implants with a 7-10 day course of an oral progestogen such as medroxyprogesterone acetate administered at monthly intervals to induce orderly withdrawal uterine bleeding; most common side effects are hypermenorrhea and mastodynia. The latter method is best suited to premenopausal women who wish to continue the low-dosage estrogen in advancing years, preventing the onset of hot flushes and sweats, minimizing the tendency to osteoporosis and decreasing the severity of menopausal migranoid headaches and mood changes.
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PMID:Contraception for middle aged women. 676 1

To avoid the risks of oestrogen therapy in post-menopausal women, we have examined the effects of a progestin, megestrol acetate (MA), on hot flushes and bone metabolism. Ten normal post-menopausal women were studied before and after the oral administration of 20, 40 and 80 mg of MA daily for 4 wk at each dose level. Finger temperature and skin resistance were recorded for 8 h as objective indices of flushing and perspiration, respectively. The fasting ratios of urinary calcium: creatinine (Ca/Cr) and hydroxyproline: creatinine (OHPr/Cr) were used as indices of bone resorption. A reduction (P less than 0.01) of flushing episodes was noted on all dose levels of MA, with 56, 11, 6 and 1 flushes occurring on 0, 20, 40 and 80 mg of medication. A decrease (P less than 0.05) of Ca/Cr was noted only with 80 mg of MA, whereas OHPr/Cr remained unchanged. We conclude that progestin therapy may provide an alternative mode of treatment for post-menopausal hot flushes. Definitive demonstration of an effect on post-menopausal bone resorption will require a long-term study of bone density.
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PMID:Effect of megestrol acetate on flushing and bone metabolism in post-menopausal women. 728 87

Six patients with symptomatic leiomyomata uteri and in whom surgical treatment was indicated received, during 3 months, intramuscular leuprolide acetate, 3,75 mg monthly, in order to 1) achieve a reduction of myomata size and 2) recover an anemic patient before surgery. In every patient, amenorrhea was induced since the second month of treatment. A significant decrease of myomas sizes was achieved. The reduction of the volume of the largest myoma in each case, varied between 51% and 77% (x = 60% +/- ES 4,3) LH and estradiol plasma levels diminished significantly and FSH did not changed in response to treatment. Side effects were well tolerated. Hot flashes were present in all patients, headaches in 2 and loss of strength in 2. Surgery was accomplished after 3 months of treatment. Myomectomy was performed in 5 cases and total hysterectomy in 1. Uterine shrinkage and the period of amenorrhea induced by Lupron-depot facilitated hysterectomy and myomectomy techniques and the recovery of one patient with a severe anemia.
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PMID:[Size reduction of uterine myomas with monthly administered leuprolide acetate]. 756 60

In an open, non-randomized prospective phase-III-study the clinical and endocrine efficacy as well as the safety of leuprorelin acetate depot (Enantone-Gyn Monats-Depot) were investigated. The therapeutic results of 198 patients, gathered from 5 university institutions and two city hospitals, are reported. Endometriosis was classified by the revised American Fertility Society score (r-AFS) before and at the end of treatment. Serum levels of LH, FSH, prolactin, estradiol, progesterone, androstenedione, testosterone and leuprorelin acetate were determined by radioimmunoassay. The mean total r-AFS score changed as follows: before surgical intervention during first-look laparoscopy 21 +/- 24 at the end of first-look laparoscopy 15 +/- 19 at the end of the GnRH-treatment 8 +/- 14 During leuprorelin acetate treatment the r-AFS stages changed as follows: [table; see text] Using the scoring system 85.2% of the patients improved. Relief of dysmenorrhoea could be achieved in 95.4%, relief of dyspareunia in 64% and of pelvic pain in 69.4% of patients. Baseline hormone levels dropped sharply during treatment. [table; see text] Androstenedione, testosterone, blood pressure, body weight, haematological parameters, liver enzymes, creatinine, electrolytes and HDL-/LDL-cholesterin remained more or less unchanged. Side effects being hot flushes, sweating, sleeplessness, headache, nausea, depression and vaginal dryness were due to estradiol deprivation. In 135 patients resumption of menstruation occurred in 95.6% within the first three months post-treatment. 23 patients of whom 21 were judged as infertile, became pregnant immediately after treatment was finished. The study results confirm the efficacy of leuprorelin acetate depot in the treatment of even advanced stages of endometriosis.
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PMID:[Treatment of endometriosis with the GnRH agonist leuprorelin acetate depot (Enatone-Gyn monthly depot): a multicenter study]. 784 80

Cyproterone (cyproterone acetate) is a steroidal antiandrogenic agent that inhibits the action of adrenal and testicular androgens on prostatic cells. Additionally, its progestogenic activity causes a centrally mediated reduction in testicular secretion of androgens. Studies have demonstrated the effectiveness of cyproterone monotherapy in patients with prostate cancer, and for those in whom orchiectomy is not an acceptable option cyproterone may be a useful alternative. In addition, the drug may be administered in combination with surgical or gonadotrophin-releasing hormone (GnRH) agonist-mediated castration to ensure ablation of adrenal androgens. However, the effectiveness of cyproterone in combination with these forms of testicular androgen deprivation remains to be fully established. Trials to date have not demonstrated prolonged survival in patients receiving the combination therapy. Importantly, however, cyproterone does prevent acute exacerbation of disease during initial treatment with a GnRH agonist. Furthermore, combination therapy tends to be associated with a lower incidence of hot flushes than GnRH agonist-mediated or surgical castration alone. Thus, cyproterone 200 mg/day has proven efficacy in preventing acute flare of disease and reducing the incidence of hot flushes associated with GnRH agonist therapy or orchiectomy. It may also facilitate maximal androgen deprivation in patients receiving GnRH agonist therapy. If this drug is used as monotherapy, dosages of 250 mg/day or greater will probably be required.
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PMID:Cyproterone. A review of its pharmacology and therapeutic efficacy in prostate cancer. 791 40

The introduction of steroid 'add-back' regimens draws on the recognition that several clinical entities targeted for treatment with gonadotrophin-releasing hormone agonist (GnRHa) are not '6-month diseases'. Included under this heading are individuals suffering from symptomatic endometriosis (not desires of pregnancy), uterine fibroids (ineligible or disinterested in definitive surgical therapy), ovarian hyperandrogenism, premenstrual syndrome, menopausal transition, or dysfunctional uterine bleeding. A 6-month course of therapy with a GnRHa does not adversely affect lipoprotein economy and therefore presumably the corresponding cardiovascular risk. A 6-month course of GnRHa therapy appears to be associated with a substantial decrease (of up to 8.2%) in lumbar bone density, a phenomenon which may not be entirely reversible 6 months after discontinuation of therapy. In principle, steroid 'add-back' therapy should diminish some or all of the side-effects associated with GnRHa therapy, may provide a medical treatment option for patients representing a high surgical risk, and may delay surgical intervention if desired. On the other hand, a steroid 'add-back' therapy may delay tissue diagnosis, be associated with a substantial cost as well as with the need for parenteral route of administration. Norethindrone-only (but not medroxyprogesterone acetate-only) 'add-back' regimens have proved promising in the context of endometriosis. Non-concurrent oestrogen/progestin 'add-back' regimens proved promising in the context of uterine fibroids. Substantial additional studies would have to be carried out to validate the utility of steroid 'add-back' regimens. Special emphasis will have to be placed on the evaluation of long-term utility with an eye towards assessing clinical efficacy, impact on lipoprotein economy, impact on bone density, impact on urogenital tissues, and impact on the hot flush. The concurrent or non-concurrent use of non-steroid 'add-back' regimens will also most likely constitute a major component of future studies.
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PMID:Long-term gonadotrophin-releasing hormone agonist therapy: the evolving issue of steroidal 'add-back' paradigms. 796 53


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