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  • Title: Progesterone receptor in Norplant endometrium.
    Author: Lau TM, Witjaksono J, Rogers PA.
    Journal: Hum Reprod; 1996 Oct; 11 Suppl 2():90-4. PubMed ID: 8982750.
    Abstract:
    Endometrial progesterone receptor plays an important role in determining the biological activity of progestogens in fertility regulation. Studies during the normal menstrual cycle have shown that the concentrations of endometrial progesterone receptor and its mRNA vary in glandular epithelia but remain steady in stromal cells. There is general agreement between progesterone receptor mRNA and protein levels during the normal menstrual cycle. Norplant endometrium had an increase in immunoreactive progesterone receptor concentration but a reduction in progesterone receptor mRNA levels compared with controls. An immunohistochemical study, using the expression of the lysosomal protease cathepsin D as a marker for the functional status of progesterone receptors, failed to confirm the functionality of the receptors in Norplant endometrium. Together, these results suggest that (i) there is a differential sensitivity of glandular and stromal progesterone receptors to steroid regulation during the normal menstrual cycle; (ii) there appears to be a dissociation between the concentrations of progesterone receptor and its mRNA in Norplant endometrium; and (iii) there was significantly more progesterone receptor mRNA and lower plasma oestrogen concentrations in Norplant subjects with amenorrhoea than with endometrial bleeding. The clinical significance of the differences in progesterone receptor mRNA levels and plasma oestrogen concentrations between the amenorrhoea group and the bleeding group requires further investigation. Research on the effects of levonorgestrel on endometrial progesterone receptors in Norplant users is critical to reducing the menstrual disturbances associated with this contraceptive method. Studies conducted during the normal menstrual cycle have indicated that the concentrations of endometrial progesterone receptor and its mRNA vary in glandular epithelia but remain steady in stromal cells. The endometrium in Norplant users shows an increase in immunoreactive progesterone receptor concentration but a reduction, compared to controls, in progesterone receptor mRNA levels. Overall, the clinical research suggests: 1) there is a differential sensitivity of glandular and stromal progesterone receptors to steroid regulation during the normal menstrual cycle; 2) there appears to be a dissociation between the concentrations of progesterone receptor and its mRNA in Norplant endometrium; and 3) there are significantly more progesterone receptor mRNA and lower plasma estrogen concentrations in Norplant users with amenorrhea than in those with normal menstrual bleeding.
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