Update on the Male and Female Climacteric, R.B. Greenblatt, MD, C. Nezhat, MD, R. A. Roesel, PhD, and P.K. Natrajan, MD; J American Geriatrics Society, Vol XXVII 11/79 Number 11

The gonadal steroids - estrogens and androgens - appear to have a mood-elevating, psychotonic effect. The improved sense of well-being and increased vigor probably is engendered by restoration of somatic efficiency and psychic equilibrium. 1. The male climacteric, as observed in a limited number of men, is associated with a low level of serum testosterone. The levels of follicle-stimulating hormone and luteinizing hormone are not elevated because estrogen concentration continues unaltered well into old age. Androgen replacement therapy often lessens fatigue, depression and headaches, and improves libidinous drives. 2. In the aging female, many climacteric symptoms other than those due to vasomotor instability were heretofore considered merely coincidental. Recent studies suggest that the metabolism of cerebral hormones is markedly influenced by endogenous and exogenous gonadal steroids. Thus, postmenopausal depression, headaches, and nervousness may be hormone-dependent symptoms. 3. The incidence of endometrial cancer is no greater and is probably less in estrogen-treated women than in women not treated with estrogen, if regular cyclic courses of an oral progestogen are added to the regimen.

Is Hormonal Treatment Efficacious in the Management of Ovarian Cysts in Women with Histories of Endometriosis? Ceana H. Nezhat, Farr Nezhat, Soheila Borhan, Daniel S. Seidman, & Camran R. Nezhat; Human Reproduction, Vol. 11, No. 4, p.874-77, 1996

In a controlled, randomized study, we evaluated the effectiveness of various hormonal regimens in treating 70 women (mean age 34.7 + 5.7 years) who had unilateral or bilateral ovarian cysts presumed to be physiological (functional) and a history of endometriosis. The patients were assigned randomly to one of the following groups: group I (control), no treatment; group II, oral contraceptives (35 ug ethinyl oestradiol and 1 mg norethindrone); group III, oral contraceptives (50 ug ethinyl oestradiol and 1 mg norethindrone); group IV, danazol 800 mg/day. Serum CA-125 concentrations were measured in 32 women. All medications were taken continuously for 6 weeks. Subjects were re-evaluated by pelvic examination and transvaginal ultrasound. Those with persistent cysts were offered diagnostic and possible operative laparoscopy. As 11 patients did not complete the study and five did not follow-up, the final study population comprised 54 women. At 6 weeks follow-up, complete resolution of cysts was found in: group I, 12 out of 18 (66.7%); group II, five out of nine (55.6%); group III, eight out of 14 (57l1%); and group IV, seven out of 13 (53.9%), Two of the 22 women with persistent cysts opted for 6 weeks further medical therapy and achieved complete resolution; 19 underwent laparoscopy, and one was lost to follow-up. All laparoscopic findings revealed benign masses. We found no statistically significant effect when hormonal treatment was compared with expectant management. There was no correlation between serum CA-125 concentrations and the persistence or resolution of cysts.

Aphrodisiacs; Robert B. Greenblatt, Jaswant S. Chaddha, Ana Zully Teran, and Ceana H. Nezhat; Psychopharmocology: Recent Advances and Future Prospects.

In recent years, pharmacologic agents and hormones have been employed as aphrodisiacs to provoke libidinous drive, enhance or maintain penile erection, and stimulate vaginal lubrication and hyperaemia.

Estrogens: Whence, When, Why, How; Robert B. Greenblatt, MD, Jaswant S. Chaddha, MD, Ana Zully Teran, MD, Ceana Nezhat, MD; Part 1 of 2 parts, p50-61Today's Therapeutic Trends