Concurrent estrogen action was essential for maximal progestin effect in oral contraceptives

Bono Y, Yukiko Bono, Satoru Kyo, Kyo S, Kiyono T, Tohru Kiyono, Yasunari Mizumoto, Mizumoto Y, Nakamura M, Mitsuhiro Nakamura, Maida Y, Yoshiko Maida, Takakura M, Masahiro Takakura, Hiroshi Fujiwara
Fertility and sterility · 2014 · vol. 101(5) , pp. 1337–1343 · doi:10.1016/j.fertnstert.2014.02.005 · PMID:24656887 · W2086147144
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study investigated the interplay between estrogen and progestin in oral contraceptives, finding that estrogen action is necessary for the full progestin effect.

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Abstract

ObjectiveTo investigate the impact of estrogen contained in oral contraceptives (OCs) on the action of progestin on ovarian endometrioma epithelial cells.DesignExperimental in vitro study and immunohistochemical analysis.SettingUniversity hospital.Patient(s)Patients who underwent surgery due to ovarian endometrioma.Intervention(s)Not applicable.Main outcome measure(s)Telomerase-immortalized epithelial cells derived from ovarian endometrioma were treated with norethindorone (NET; 80 nmol/L) or levonorgestrel (LNG; 20 nmol/L) with or without 17β-ethynylestradiol (EE; 0.6 nmol/L) for 96 hours, and the cell growth was monitored. Estrogen receptor (ER) α, progesterone receptor (PR) A, and PRB expressions in clinical samples of ovarian endometrioma epithelial cells were analyzed with the use of immunohistochemistry.Result(s)NET or LNG effectively suppressed cell growth, and addition of EE significantly enhanced the growth suppression. This EE-mediated enhancement of cell growth suppression was observed only in cells that expressed ERα and therefore was ERα dependent. Western blot analysis revealed that expression of PRB was significantly induced by the addition of EE. Immunohistochemical analysis confirmed that ERα expression and PRB expression are significantly correlated, indicating that progestin-sensitive cells with PRB expression are predisposed to react with estrogen stimulation.Conclusion(s)These findings suggest that EE contained in OCs plays a supportive role in progestin-induced growth inhibition of ovarian endometrioma epithelial cells. In the absence of estrogen priming, concurrent estrogen action was essential for rapid induction of PR to achieve maximal progestin effect.

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Condition tags

endometriosis

MeSH descriptors

Contraceptives, Oral Endometriosis Endometriosis Endometriosis Estrogens Progestins Cell Line, Transformed Contraceptives, Oral Drug Combinations Estrogens Female Humans Progestins Treatment Outcome

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References (27)

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