Dydrogesterone and other progestins in benign breast disease: an overview

Anti-hyperplasia Effects of Total Saponins From Phytolaccae Radix in Rats With Mammary Gland Hyperplasia via Inhibition of Proliferation and Induction of Apoptosis

Mammary gland hyperplasia (MGH) is a pathological condition that affects the majority of women at the child-bearing stage. The hormone and endocrinal therapy are typically used to treat MGH. Nevertheless, there are still some certain side effects accompanied with the benefits, which negatively affect the life quality of patients. Therefore, plant-derived agents that are effective against MGH development and with fewer side effects should be developed. The aim of this study was to investigate the protective effects and underlying mechanism of total saponins of Phytolaccae (TSP) against MGH in vivo. The results showed that treatment with TSP could significantly correct the disorder of serum sex hormones levels in rats with MGH, and eliminate the formation of MGH. Moreover, TSP significantly protected estrogen and progesterone-induced MGH histological changes, inhibited the swelling of the nipple, and improved the organ coefficient of uterus in rats with MGH. Mechanistically, TSP treatment not only effectively suppressed the mRNA and protein expression of ERα and PR in mammary gland, but also simultaneously up-regulated ERβ expression, and thus blocked sex hormones from interacting with their receptors. TSP treatment markedly suppressed mammary phosphorylation levels of ERK1/2, as well as reduced the mRNA and protein overexpression of VEGF and bFGF in mammary of rats. In addition, TSP treatment substantially down-regulated the expression of Bcl-2 and Ki-67, as well as elevated the expression of Bax. These findings indicated that TSP could potentially be used for effective treatment of MGH.

Successful use of dydrogesterone as maintenance therapy in recurrent endometrial stromal sarcoma: a case report

Endometrial stromal sarcoma is known to be a hormone-dependent tumor. Efficacy of hormonal therapy including high-dose progestins, aromatase inhibitors or gonadotropin-releasing hormone analogs has been reported. We report a case of recurrent endometrial stromal sarcoma, the tumor cells of which were strongly positive for CD10, estrogen and progesterone receptors. Although almost all of the pelvic tumors infiltrating the rectum or pelvic side wall remained, the patient is alive with slight disease 9 years and 6 months after the initial failure. During the treatment period of 4 years and 3 months, the patient was treated exclusively with dydrogesterone at a daily dose of 10 mg and the tumor clinically disappeared. Dydrogesterone at a daily dose of 10 mg may be effective in treating low-grade endometrial stromal sarcoma.