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Zeitschrift für Orthomolekulare Medizin 2009; 7(3): 9-13
DOI: 10.1055/s-0029-1185983
Wissen

© Hippokrates Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Progesteron: Genitale und extragenitale Wirkungen

Alexander Römmler, Josefine Römmler
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Publikationsverlauf

Publikationsdatum:
14. September 2009 (online)

    Lizenzen und Reprints

Zusammenfassung

Die Progesteronsubstitution im Alter stellt im Genitalbereich einen gewissen Karzinomschutz dar. Auch extragenital werden immer mehr gesundheitsfördernde Wirkungen erkannt, die vor allem das Nervensystem, kardiovaskuläre Endothelprotektion und den Knochen betreffen. Damit rückt Progesteron als mögliche hormonelle und nebenwirkungsarme Präventionsmaßnahme im Alter zunehmend in den Blickpunkt der Medizin.

Schlüsselwörter

Gestagene - Progesteron - Hormonersatz - Brustkrebs - systemische Wirkungen

Literatur

  • 1 Barrat J, de Lignières B, Marpeau L et al. The in vivo effect of the local administration of progesterone on the mitotic activity of human ductal breast tissue. Results of a pilot study.  J Gynecol Obstet Biol Reprod (Paris). 1990;  19 269-274
    Google Scholar
  • 2 Benster B, Carey A, Wadsworth F et al. A double-blind placebo-controlled study to evaluate the effect of progestelle progesterone cream on postmenopausal women.  Menopause Int. 2009;  15 63-69
    CrossrefGoogle Scholar
  • 3 Beral V. Million Women Study Collaborators . Breast cancer and hormone-replacement therapy in the Million Women Study.  Lancet. 2003;  362 419-427
    CrossrefGoogle Scholar
  • 4 Beral V, Bull D, Reeves G. Million Women Study Collaborators . Endometrial cancer and hormone-replacement therapy in the Million Women Study.  Lancet. 2005;  365 1543-1551
    CrossrefGoogle Scholar
  • 5 Beral V. Ovarian cancer and hormone replacement therapy in the Million Women Study.  Lancet. 2007;  369 1703-1710
    CrossrefGoogle Scholar
  • 6 Bulletti C, De Ziegler D, Giacomucci E et al. Vaginal drug delivery: the first uterine pass effect.  Ann N Y Acad Sci. 1997;  828 285-290
    CrossrefGoogle Scholar
  • 7 Campagnoli C, Clavel-Chapelon F, Kaaks R et al. Progestins and progesterone in hormone replacement therapy and the risk of breast cancer.  J Steroid Biochem Mol Biol. 2005;  96 95-108
    CrossrefGoogle Scholar
  • 8 Clarke C L, Southerland R L. Progestin regulation of cellular proliferation.  Endocrine Reviews. 1990;  11 266-301
    CrossrefGoogle Scholar
  • 9 De Lignieres B, Dennerstein L, Backstrom T. Influence of route of progesterone metabolism.  Maturitas. 1995;  21 251-257
    CrossrefGoogle Scholar
  • 10 De Lignieres B. Endometrial hyperplasia. Risks, recognition and the search for a safe hormone replacement regimen.  J Reprod Med. 1999;  44 (Suppl. 2) 191-196
    Google Scholar
  • 11 De Lignieres B, de Vathaire F, Fournier S et al. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women.  Climacteric. 2002;  5 332-340
    Google Scholar
  • 12 Fabre A, Fournier A, Mesrine S et al. Oral progestagens before menopause and breast cancer risk.  Br J Cancer. 2007;  96 841-844
    CrossrefGoogle Scholar
  • 13 Flesch-Janys D, Slanger T, Mutschelknauss E et al. Risk of different histological types of postmenopausal breast cancer by type and regimen of menopausal hormone therapy.  Int J Cancer. 2008;  123 933-941
    CrossrefGoogle Scholar
  • 14 Foidart J M, Colin C, Denoo X et al. Estradiol and progesterone regulate the proliferation of human breast epithelial cells.  Fertil Steril. 1998;  69 963-969
    CrossrefGoogle Scholar
  • 15 Fournier A, Berrino F, Riboli E et al. Breast cancer risk in relation to different types of hormone replacement therapy in the E3 N-EPIC cohort.  Int J Cancer. 2005;  114 448-454
    CrossrefGoogle Scholar
  • 16 Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3 N cohort study.  Breast Cancer Res Treat. 2008;  107 103-111
    CrossrefPubMedGoogle Scholar
  • 17 Graham J D, Yager M L, Hill H D et al. Altered progesterone receptor isoform expression remodels progestin responsiveness of breast cancer cells.  Mol Endocrinol. 2005;  19 2713-2735
    CrossrefPubMedGoogle Scholar
  • 18 Graham J D, Mote P A, Salagame U et al. DNA replication licensing and progenitor numbers are increased by progesterone in normal human breast.  Endocrinology. , [Epub ahead of print: 2009 Apr 2]
    Google Scholar
  • 19 Gregg C, Shikar V, Larsen P et al. White matter plasticity and enhanced remyelination in the maternal CNS.  J Neurosci. 2007;  27 1812-1823
    CrossrefPubMedGoogle Scholar
  • 20 Groshong S D, Owen G I, Grimison B et al. Biphasic regulation of breast cancer cell growth by progesterone: role of the cyclin-dependent kinase inhibitors, p 21 and p 27(Kip1).  Mol Endocrinol. 1997;  11 1593-1607
    CrossrefGoogle Scholar
  • 21 Hart A R, Luben R, Welch A et al. Hormone replacement therapy and symptomatic gallstones – a prospective population study in the EPIC-Norfolk cohort.  Digestion. 2008;  77 4-9
    CrossrefGoogle Scholar
  • 22 Hermsmeyer R K, Mishra R G, Pavcnik D et al. Prevention of coronary hyperreactivity in preatherogenic menopausal rhesus monkeys by transdermal progesterone.  Arterioscler Thromb Vasc Biol. 2004;  24 955-961
    CrossrefGoogle Scholar
  • 23 Hermsmeyer R K, Thompson T L, Pohost G M et al. Cardiovascular effects of medroxyprogesterone acetate and progesterone: a case of mistaken identity?.  Nat Clin Pract Cardiovasc Med. 2008;  5 387-395
    CrossrefPubMedGoogle Scholar
  • 24 Ho S M. Estrogen, progesterone and epithelial ovarian cancer.  Reprod Biol Endocrinol. 2003;  1 73-81
    CrossrefGoogle Scholar
  • 25 Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?.  Postgrad Med. 2009;  121 73-85
    Google Scholar
  • 26 Ibanez C, Shields S A, El-Etr M et al. Systemic progesterone administration results in a partial reversal of the age-associated decline in CNS remyelination following toxin-induced demyelination in male rats.  Neuropathol Appl Neurobiol. 2004;  30 80-89
    CrossrefGoogle Scholar
  • 27 Jacobsen B M, Schittone S A, Richer J K et al. Progesterone-independent effects of human progesterone receptors (PRs) in estrogen receptor-positive breast cancer: PR isoform-specific gene regulation and tumor biology.  Mol Endocrinol. 2005;  19 574-587
    Google Scholar
  • 28 Kaaks R, Berrino F, Timothy Key T et al. Serum sex steroids in premenopausal women and breast cancer risk within the European prospective investigation into cancer and nutrition (EPIC).  J Natl Cancer Inst. 2005;  97 755-765
    Google Scholar
  • 29 Koenig H L, Gong W H, Pelissier P. Role of progesterone in peripheral nerve repair.  Rev Reprod. 2000;  5 189-199
    CrossrefGoogle Scholar
  • 30 Kovari E, Gold G, Herrmann F R et al. Cortical microinfarcts and demyelination significantly affect cognition in brain aging.  Stroke. 2004;  35 410-414
    CrossrefGoogle Scholar
  • 31 Leo J C, Wang S M, Guo C H et al. Gene regulation profile reveals consistent anticancer properties of progesterone in hormone-independent breast cancer cells transfected with progesterone receptor.  Int J Cancer. 2005;  117 561-568
    CrossrefGoogle Scholar
  • 32 Leonelli E, Bianchi R, Cavaletti G et al. Progesterone and its derivatives are neuroprotective agents in experimental diabetic neuropathy: a multimodal analysis.  Neuroscience. 2007;  144 1293-1304
    CrossrefGoogle Scholar
  • 33 L'hermite M, Simoncini T, Fuller S et al. Could transdermal estradiol + progesterone be a safer postmenopausal HRT? A review.  Maturitas. 2008;  60 185-201
    CrossrefGoogle Scholar
  • 34 Liang M, Liao E Y, Xu X et al. Effects of progesterone and 18-methyl levonorgestrel on osteoblastic cells.  Endocr Res. 2003;  29 483-501
    CrossrefGoogle Scholar
  • 35 Liu B, Beral V, Balkwill A and for the Million Wornen Study Collaborators et al. Gallbladder disease and use of transdermal versus oral hormone replacement therapy in postmenopausal women: prospective cohort study.  BMJ. 2008;  337 386-395
    CrossrefGoogle Scholar
  • 36 Micheli A, Muti P, Secreto G et al. Endogenous sex hormones and subsequent breast cancer in premenopausal women.  Int J Cancer. 2004;  112 312-318
    CrossrefGoogle Scholar
  • 37 Mote P A, Graham J D, Clarke C L. Progesterone receptor isoforms in normal and malignant breast.  Ernst Schering Found Symp Proc. 2007;  1 77-107
    Google Scholar
  • 38 Minshall R D, Stanczyk F Z, Miyagawa K et al. Ovarian steroid protection against coronary artery hyperreactivity in rhesus monkeys.  J Clin Endocrinol Metab. 1998;  83 649-659
    CrossrefGoogle Scholar
  • 39 Musgrove E A, Lee C S, Sutherland R L. Progestins both stimulate and inhibit breast cancer cell cycle progression while increasing expression of transforming growth factor alpha, epidermal growth factor receptor, c-fos, and c-myc genes.  Mol Cell Biol. 1991;  11 5032-5043
    Google Scholar
  • 40 Nilsen J, Brinton R D. Impact of progestins on estrogen-induced neuroprotection: synergy by progesterone and 19-norprogesterone and antagonism by medroxyprogesterone acetate.  Endocrinology. 2002;  143 205-212
    CrossrefGoogle Scholar
  • 41 Oelkers W K. Effects of estrogens and progestogens on the renin-aldosterone system and blood pressure.  Steroids. 1996;  61 166-171
    CrossrefGoogle Scholar
  • 42 Opatrny L, Dell'Aniello S, Assouline S et al. Hormone replacement therapy and variations in the risk of breast cancer.  Br J Obstet Gynecol. 2008;  115 169-175
    Google Scholar
  • 43 Otsuki M, Saito H, Xu X et al. Progesterone, but not medroxyprogesterone, inhibits vascular cell adhesion molecule-1 expression in human vascular endothelial cells.  Arterioscler Thromb Vasc Biol. 2001;  21 243-248
    Google Scholar
  • 44 Pei W, Bellows C G, Jia Y et al. Effect of age on progesterone receptor expression, and osteoprogenitor proliferation and differentiation in female rat vertebral cell populations.  J Endocrinol. 2006;  190 261-270
    CrossrefGoogle Scholar
  • 45 PEPI-Trial . Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The postmenopausal estrogen/progestin interventions (PEPI) trial. The writing group for the PEPI trial.  JAMA. 1996;  275 370-375
    CrossrefGoogle Scholar
  • 46 Prentice R L, Chlebowski R T, Stefanick M L et al. Estrogen plus progestin therapy and breast cancer in recently postmenopausal women.  Am J Epidemiol. 2008;  167 1207-1216
    CrossrefGoogle Scholar
  • 47 Prentice R L, Chlebowski R T, Stefanick M L et al. Conjugated equine estrogens and breast cancer risk in the Women's Health Initiative clinical trial and observational study.  Am J Epidemiol. 2008;  167 1407-1415
    CrossrefGoogle Scholar
  • 48 Prentice R L, Manson J E, Langer R D et al. Benefits and risks of postmenopausal hormone therapy when it is initiated soon after menopause.  Am J Epidemiol. , [Epub ahead of print: 2009 May 25]
    Google Scholar
  • 49 Quinkler M, Diederich S, Bähr V et al. The role of progesterone metabolism and androgen synthesis in renal blood pressure regulation.  Horm Metab Res. 2004;  36 381-386
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 50 Rabe T, Geisthövel F, Hadji P et al. Hormonersatztherapie – Nutzen und Risiken.  J Reproduktionsmed Endokrinol. 2006;  3 155-165
    Google Scholar
  • 51 Römmler A. Paradigmenwechsel bei der Substitution mit Östrogenen.  ZS Orthomol Med. 2003;  3 13-17
    Google Scholar
  • 52 Römmler A. Endokrinologische Aspekte der Anti-Aging-Medizin. CME Praktische Fortbildung Gynäkologie, Geburtsmedizin, Gynäkologische Endokrinologie.  akademos. 2006;  3 18-34
    Google Scholar
  • 53 Römmler A. Update Hormonersatz: Bioidentische Hormongaben sind risikoarm.  Zs f Orthomol Med. 2007;  2 16-21
    Google Scholar
  • 54 Rossouw J E, Anderson G L, Prentice R L Writing Group for the Women's Health Initiative Investigators et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial.  JAMA. 2002;  288 321-333
    CrossrefGoogle Scholar
  • 55 Schumacher M, Guennoun R, Robert F et al. Local synthesis and dual actions of progesterone in the nervous system: neuroprotection and myelination.  Growth Horm IGF Res. 2004;  14 (Suppl. A) S18-S33
    CrossrefGoogle Scholar
  • 56 Schumacher M, Guennoun R, Ghoumari A et al. Novel perspectives for progesterone in hormone replacement therapy, with special reference to the nervous system.  Endocr Rev. 2007;  28 387-439
    CrossrefGoogle Scholar
  • 57 Stefanick M L, Anderson G L, Margolis K L et al. WHI Investigators. Effects of conjugated equine estrogens on breast cancer and mammography screening in postmenopausal women with hysterectomy.  JAMA. 2006;  295 1647-1657
    CrossrefGoogle Scholar
  • 58 Simoncini T, Mannella P, Fornari L et al. Differential signal transduction of progesterone and medroxyprogesterone acetate in human endothelial cells.  Endocrinology. 2004;  145 5745-5756
    CrossrefGoogle Scholar
  • 59 Vashisht A, Wadsworth F, Carey A et al. Bleeding profiles and effects on the endometrium for women using a novel combination of transdermal oestradiol and natural progesterone cream as part of a continuous combined hormone replacement regime.  BJOG. 2005;  112 1402-1406
    Google Scholar
  • 60 Vassilev V, Pretto C M, Cornet P B et al. Response of matrix metalloproteinases and tissue inhibitors of metalloproteinases messenger ribonucleic acids to ovarian steroids in human endometrial explants mimics their gene- and phase-specific differential control in vivo.  J Clin Endocrinol Metab. 2005;  90 5848-5857
    CrossrefGoogle Scholar
  • 61 Weiderpass E, Adami H O, Baron J A et al. Risk of endometrial cancer following estrogen replacement with and without progestins.  J Natl Cancer Inst. 1999;  91 1131-1137
    CrossrefGoogle Scholar
  • 62 Wood C E, Register T C, Lees C J et al. Effects of estradiol with micronized progesterone or medroxyprogesterone acetate on risk markers for breast cancer in postmenopausal monkeys.  Breast Cancer Res Treat. 2007;  101 125-134
    CrossrefGoogle Scholar
  • 63 Wood C E, Register T C, Cline J M. Transcriptional profiles of progestogen effects in the postmenopausal breast.  Breast Cancer Res Treat. 2009;  114 233-242
    CrossrefGoogle Scholar
  • 64 Zhao C, Fancy S P, Magy L et al. Stem cells, progenitors and myelin repair.  J Anat. 2005;  207 251-258
    CrossrefGoogle Scholar
  • 65 Zhou B, Sun Q, Cong R et al. Hormone replacement therapy and ovarian cancer risk: a meta-analysis.  Gynecol Oncol. 2008;  108 641-651
    CrossrefGoogle Scholar

Privatdozent Dr. med. Alexander Römmler

Deutsche Gesellschaft für Prävention und Anti-Aging Medizin e. V. München (GSAAM)

Siebenbürgener Str. 13

81377 München

eMail: ADRROE@aol.com

Dr. med. Josefine Römmler

Innere Medizin (Endokrinologie)
Ludwig-Maximilian-Universität München (LMU)

Ziemssenstraße 1

80336 München

eMail: josefine.roemmler@med.uni-muenchen.de

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