title: Vaginally administered estroprogestinic decreases serum inhibin A and inhibin B levels and reduces endometrial thickness.
abstract: OBJECTIVE
  Serum levels of inhibin A, inhibin B, FSH, and LH were measured in healthy volunteers before and during oral or vaginal estroprogestinic administration. In addition, the effect on endometrial thickness and on follicular growth pattern were also assessed by vaginal ultrasound.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University of Siena.
  
  
  METHODS
  Seventeen healthy fertile women.
  
  
  METHODS
  This open-label study was performed in 10 healthy volunteers, who were assigned to vaginal ethinylestradiol (15 microg) and etonogestrel (120 microg), one ring to be used for one cycle, after stratification for the ovulation day in a pretreatment cycle. A similar study on seven women assigned to oral ethinylestradiol (20 microg) and levonorgestrel (100 microg) was considered, to compare the effects of the two different routes of administration. Blood samples were collected the cycle before (days 8-10) and during (days 8-10) vaginal ring insertion and serum inhibin B, inhibin A, FSH, and LH levels were measured by ELISA. Concomitantly, transvaginal ultrasound was performed in all subjects for endometrial and follicular growth assessment.
  
  
  METHODS
  Inhibin A, inhibin B, FSH, and LH levels.
  
  
  RESULTS
  Vaginal administration induced a significant decrease of serum inhibin A, inhibin B, FSH, and LH. No significant changes in inhibin B and FSH secretion were observed during oral contraceptive (OC) administration, whereas LH and inhibin A levels significantly decreased. Endometrial thickness and ovarian volume decreased significantly during vaginal ring insertion, but not after OC administration.
  
  
  CONCLUSIONS
  The present findings showed that treatment with vaginal estroprogestinic decreases serum inhibin A and inhibin B levels, the follicular diameter, and endometrial thickness, showing a rapid and significant effect with the vaginal route.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Luisi
authors.forename: Lavinia Estrela
authors.initials: LE
authors.lastname: Borges
authors.forename: Lucia
authors.initials: L
authors.lastname: Lazzeri
authors.forename: Ariana
authors.initials: A
authors.lastname: Dell'Anna
authors.forename: Filiberto Maria
authors.initials: FM
authors.lastname: Severi
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D003276:Contraceptives, Oral / Q000008:administration & dosage; D004338:Drug Combinations; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000187:drug effects*; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood*; D009652:Norpregnenes / Q000008:administration & dosage*; D014463:Ultrasonography
chemical_list: D003276:Contraceptives, Oral; D004338:Drug Combinations; D009652:Norpregnenes; C494367:estroprogestin; C422362:inhibin A; C422364:inhibin B; D004997:Ethinyl Estradiol; D007265:Inhibins