Sex hormone-related diseases

First we shall describe the effects of tamoxifen, a first-generation SERM used as adjuvant treatment in women with breast cancer, on uterine leiomyomas and endometriosis. Considerable space will be devoted to raloxifene, a second-generation SERM administered for the prevention and treatment of postmenopausal women recently tested for the treatment of these two sex-hormone-related diseases. Unfortunately, at present no or very little data are available on the new third-generation SERMs such as lasofoxifene, idroxifene, droloxifene, ospemifene, azomifene, fulvestrant, and MDL 103.323. 

The most common benign gynecological diseases, for prevalence and related economic costs, are probably uterine leiomyomas and endometriosis (Stewart 2001 Missmer et al. 2003). Notwithstanding the fact that both conditions are characterized by a sex-hormone-related development and by the possibility of a medical treatment consisting of hormonal manipulation, at present the main approach to these conditions is surgical excision (Palomba et al. 2006a Olive etal. 2001). 

Furthermore, the distribution of serotonin is different in the brain and in the cerebral endothelial cells of males and females (Fischette et al., 1983), and serotonin is an important modulator of BBB permeability (Sharma and Dey, 1986). The sex hormone-related differences in the serotonin and other neurotransmitter levels in endothelial cells may cause different responses under pathological conditions. Ozta (1998) hypothesized that if BBB permeability can increase more easily in females, then this increased breakdown may result in higher incidences of neurodegenerative diseases, such as AD and multiple sclerosis (MS) in women. 

Interaction of vitamin D and its metaboUtes with sex hormones has been demonstrated, particularly ia birds ia which the egg-laying functions combine calcium needs and reproductive activity. The metaboUtes of vitamin D behave as hormones. As such, they play an active role ia the endocrine system, along with other hormones, to maintain the various body functions. Several biological influences of metaboUtes of vitamin D have been studied, including effects related to cancer (193—197), skin diseases (198—201), immunomodulatory effects (202,203), and Alzheimer s disease (204—206) (Fig. 9). 

Danazol is a sex hormone that suppresses the pituitary-ovarian axis by inhibiting output of pituitary gonadotropins has weak, dose-related androgenic activity with no estrogenic or progestational activity. Danazol is indicated in treatment of endometriosis symptomatic treatment of fibrocystic breast disease and in prevention of attacks of hereditary angioedema. 

There are a number of disease states that are associated with the endocrine system. For example, hormones may be released in amounts that are too great or too small for the body to work normally. This situation is often referred to as hormone imbalance however, other problems are associated with the endocrine system. Typical diseases associated with the endocrine system include hyperthyroidism and hypothyroidism, diabetes and osteoporosis. Additionally, in this chapter we will consider drags that ad on the endocrine system or drags that are associated with problems related to this system. Details of drags that are employed in the conuol of various aspects relating to the endocrine S5 tem will also be detailed. For instance, the utilisation of synthetic sex hormones for birth control will be dealt with. 

Since the finding that cortisone ameliorates the symptoms of rheumatoid arthritis (1949) the adrenal corticosteroid hormones and especially the synthetically prepared steroid analogues which have no natural counterpart in the body, have been successfully employed in the treatment of diseases not related to sex or sex function. 

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