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  • Title: The role of sex steroid receptors in obstetrics and gynecology.
    Author: Roberts DK, Van Sickle M, Kelly RW.
    Journal: Obstet Gynecol Annu; 1983; 12():61-78. PubMed ID: 6866353.
    Abstract:
    Estrogen receptors (ER) and progesterone receptors (PR) play an important role in the growth and development of the reproductive tract. Estrogen and progesterone influence tissues sensitivity by regulating levels of their own receptors and receptors for other hormones, with estrogen increasing levels of ER and PR and progesterone decreasing levels of ER and PR. Serum levels of estrogen and progesterone and their effect on receptor levels within the endometrium, fallopian tube, and ovary correlate with proliferative and secretory changes observed in uterine tissue throughout the menstrual cycle. Estrogens cause rapid growth of endometrium, while estrogen and progesterone in combination moderate endometrial growth and promote glandular differentiation and secretion. Serum levels also affect receptor levels in the uterus, with estrogen enhancing uterine growth by increasing tissue levels of ER and PR and progesterone antagonizing estrogen action by decreasing receptor levels. In the postmenopausal uterus, ER content and synthesis are continually stimulated by estrogen and unopposed by progesterone. The ability of the uterus to respond to estrogen is related to the quantity of cytoplasmic ER per cell. Although the ontogenic relationship between ER, PR, cellular growth, and differentiation remains unclear, alpha-fetoprotein may play a protective role in the fetus and neonate and may be related to the onset of puberty. The role of receptors during pregnancy also needs further study, but it has been suggested that increased PR in the amnion near term removes progesterone from its protective role in the myometrium, thereby triggering labor. Insufficient production of androgen receptors in certain genotypic males results in the development of phenotypic females and may be the basis for the testicular feminization syndrome. The application of receptor technology has not yet been established in gynecologic oncology; however, in breast cancer, the success of hormonal treatments is related to the presence of ER in tumor tissue and antiestrogens are assumed to suppress tumor growth through an effect on ER. A patient's endocrine status is thought to determine the antagonist's biologic activity.
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