Estrogen production

In premenopausal women the ovary is the richest source of aromatase and hence estrogen. Aromatase is confined to the granulosa cells and is produced under the influence of gonadotropins (FSH and LH). Despite being a rich source of aromatase, three separate studies have shown that aromatase inhibitors are unable to sufficiently suppress ovarian estrogen production to postmenopausal levels. One explanation for this phenomenon may be a compensatory rise in gonadotrophins which maintains adequate estrogen production, despite the presence of the inhibitor. As such aromatase inhibitors cannot be used in premenopausal breast cancer patients. After menopause, ovarian... 

Amiodarone, ampicillin, amoxicillin, captopril, chlorpro-mazine, ceftriaxone, erythromycin estolate, estrogen products, methimazole, nafcillin, rifampin, sulfonamide antimicrobials, and sulfonylureas... 

Oral or transdermal estrogen products should be prescribed at the lowest effective dose for the relief of vasomotor symptoms. Topical products in the form of creams, tablets, or rings should be prescribed for women exclusively experiencing vulvovaginal atrophy. 

Many systemically administered estrogen products are available in the United States, but conjugated equine estrogens (CEEs), prepared from the urine of pregnant mares, is the most widely prescribed. Transdermal estrogen preparations are also available and usually are prescribed for patients who experience adverse effects, elevated triglycerides, or liver function abnormalities while taking an oral product. Transdermal preparations also have a lower incidence of venous thromboembolism than oral preparations.9... 

Drugs aiming to control the same problem may target different sites. For instance, in the treatment of breast cancer, tamoxifen acts to control cell growth by blocking estrogen receptors on the cancer cell, while Arimidex acts to reduce the body s estrogen production. 

Aminoglutethimide (Cytadren) is a competitive inhibitor of desmolase, the enzyme that catalyzes the conversion of cholesterol to pregnenolone it also inhibits 11-hydroxylase activity. This drug also reduces estrogen production by inhibiting the aromatase enzyme complex in peripheral (skin, muscle, fat) and steroid target tissues. 

Endogenous estrogen production IM 125 to 250 mg beginning on the tenth day of cycle and repeated every 7 days until suppression is no longer desired. 

Mechanism of Action Decreases the level of circulating estrogen by inhibiting aro-matase, an enzyme that catalyzes the final step in estrogen production. Therapeutic Effect Inhibits the growth of breast cancers that are stimulated by estrogens. 

Gyno that fails to react to these drugs normally must be removed by surgery. DHT derivatives can cause increases endogenous estrogen production also in some individuals. Cytadren was a commonly co-administered drug with Nolvadex. 

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