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Epidemiological studies indicate sex-specific differences in prevalence rates and the natural course of mental disorders. Affective, anxiety, somatoform and eating disorders are more prevalent in women than men, whereas substance use disorders occur more commonly in men, and some disorders are equally distributed in both sexes (e. g. psychotic disorders). The aim of this review is to depict the natural course of mental disorders during the reproductive stages (premenstrual phases, peripartum period, perimenopause) in women, including also neuroendocrine features associated with the menstrual cycle, pregnancy, puerperium and perimenopause. Recommendations for sex-specific diagnostic and therapeutic procedures are provided., (© Georg Thieme Verlag KG Stuttgart · New York.)

The ovarian remnant syndrome arises as a consequence of incomplete ovariectomy or ovariohysterectomy. Remnant ovarian tissue which has been left mostly unintentionally in the bitch may show endocrine activity a few weeks to several years after surgery, provoking a variety of clinical signs. The majority of affected bitches return to heat, in other cases signs of pseudopregnancy and endometritis may be observed. Occasionally, bitches with unclear clinical signs are presented with the suspicion of an inactive ovarian remnant. The following article intends to place the origin of the ovarian remnant syndrome into a factual context regarding the responsibility of the veterinarian and to demonstrate a reasonable diagnostic procedure according to the respective clinical signs. In this regard, the clinical-gynaecological examination, including vaginal cytology, must receive high priority, with the addition of progesterone analysis in peripheral blood plasma or serum if required. Using these combined diagnostic tools, ovarian remnants in stages of endocrine activity (follicular and luteal phases as well as cystic or tumourous ovarian tissue) can be easily unequivocally diagnosed. The application of a GnRH-stimulation test is only reasonable in bitches in which clinical signs are missing. In this context, the usefulness of semi-quantitative LH-assays is also discussed.

Cancer is the second most common cause of death in women of childbearing age. However, renal cell carcinoma (RCC) is a rare tumor in this collective with an incidence far below 5/100,000 cases per year. Therefore, medical experience with respect to diagnostics and therapeutic management of newly diagnosed RCC in pregnant women is scarce and the number of published cases low. However, recent studies indicated that higher estrogen levels and multigravidity could be associated with a higher risk of RCC. The aim of this article is to summarize the clinical experience in treating pregnant women with renal cancer against the background of those cases published in the literature.

Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

Background: For a long time, orthopaedic surgeons have suspected an influence of smoking on several musculoskeletal diseases. The aim of this review is to discuss the influence of smoking on low back pain (LBP) and the outcome of spinal surgery. LBP is a highly prevalent disease and plays an important economic role, as it is associated with high direct and indirect health-care costs. In order to be successful in prevention, risk factors for LBP must be identified., Methods: A review of the literature (using PubMed with the search terms: smoking, low back pain and pathophysiology) was performed. Of the search results, 196 publications from peer-reviewed journals were analysed (including three randomised clinical trials, 134 clinical, 28 experimental articles and 31 reviews [including one Cochrane Database review and five systematic reviews]). Additionally, 11 official publications of the US Department of Health and Human Services, the International Agency for Research on Cancer (France) and the "Deutsches Krebsforschungszentrum" were used., Results: While the evidence level for severe adverse effects of smoking on osteoporosis is good, many studies performed on LBP describe a statistical association, but are not useful to detect a causal link between smoking and lumbar disease. However, with plausible pathophysiological mechanisms and an overwhelming number of studies identifying a correlation it is suggested that smoking is likely to contribute to LBP and affects spinal surgery adversely. As for all diseases with multifactorial (including psychosocial) aetiology, it proves difficult to distract the confounding factors for analysis., Conclusion: A high number of studies performed to identify an association between smoking and LBP have not led to a final conclusion. But still, on the basis of the current knowledge, a negative contribution of smoking on LBP and spinal surgery seems probable., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Regular physical activity is an important component of a health pregnancy. Being physically active during pregnancy often creates uncertainty and leads to numerous questions: How much and which kind of sports is possible? In pregnant woman a lot of physiological changes are taking place in haemodynamics, in the respiratory system, in the muculoskeletal system, in the glucose metabolism, and in further endocrinological feedback systems besides the psyche and bring about changes in fitness and physical performance., Discussion: There is evidence that the most active women show the lowest prevalence for gestational diabetes (GDM) and, moreover a lower incidence for obesity and diabetes in both mother and child. Physically active women rarely develop not only GDM but also pre-eclampsia. The protective effect of physical activity can be explained by an enhanced placental growth and vascularity, by decreased oxidative stress, reduced inflammation and an adaption of the disease-related endothelial dysfunction. Maternal obesity increases the frequencies of infertility and miscarriage. Weight loss programmes with nutritional advice and activity counsellings represent a cost-effective infertility treatment. Moreover the possibility of health problems during pregnancy are limited thereby. A high degree of fitness before pregnancy and regular physical activity before conception can prevent the excessive weight gain during pregnancy and influence the weight at the very best., Conclusions: Considering common recommendations for training, as well as careful measures and contraindications, a moderate individual training to maintain physical and psychic fitness is desirable. Many kinds of sports like jogging, nordic walking, swimming and cycling, for example, can be carried out in a pregnancy without any risks and furthermore promote the health of the future mother and child., (Georg Thieme Verlag KG Stuttgart, New York.)

Osteoporosis and osteomalacia are systemic metabolic bone diseases characterized by an impaired composition, architecture, and quality of bone. In light of the demographic development and the recent use of sensitive tests, both diseases are increasingly diagnosed. Subjects at high risk include elderly, chronically hospitalized patients, and nursing home residents. Patients with gastrointestinal, rheumatologic and endocrine disorders are also at risk for the development of osteoporosis or osteomalacia. In this review, we will discuss practical aspects of the clinical presentation and the diagnosis of osteoporosis and osteomalacia.

Gynecomastia is a potential side effect of hormone therapy for prostate cancer. In large, randomized, placebo controlled studies approximately 50% or more of patients with prostate cancer experienced gynecomastia attributable to various mechanisms. Although it is mostly reported as mild to moderate, gynecomastia is one of the reasons most frequently cited for premature discontinuation of such treatment. Prophylactic radiotherapy and prophylactic tamoxifen have been shown to decrease the incidence of hormone-induced gynecomastia; nevertheless, there are still cases of refractory gynecomastia, and in these plastic surgery is needed for correction. Gynecomastia is a benign enlargement of the male breast, requiring no treatment unless it is a source of embarrassment and/or distress for the adolescent or man affected. The indications for surgical treatment of gynecomastia are founded on two main objectives: restoration of the male chest shape and diagnostic evaluation of suspected breast lesions. The authors believe that the complete circumareolar technique with no further scarring creates the best aesthetic results with fewer complications. When this is used in combination with liposuction very pleasing aesthetic results can be achieved.

Women suffer from migraine far more frequently than men. This sex difference during the reproductive years is considered to result from additional trigger factors, such as the fluctuating hormones of the menstrual cycle and with the reproductive milestones of women. The role of the female hormones on migraine is illustrated by the phenomenon of menstrual migraine, and the changes in the clinical course of migraine with menarche, pregnancy, menopause and the external application of hormones. In summary, epidemiological, clinical and experimental studies document a substantial influence of female sex hormones on the pathophysiology of migraine headache.

Based on an overview of the literature, this contribution critically discusses the importance of non-alimentary trigger factors of migraine and tension-type headache. Menstruation, environmental factors, psychological effects as well as sleep disorders and fatigue are mentioned most frequently. According to controlled studies, menstruation is indubitably associated with an increased risk of headache. Although a correlation between specific meteorological parameters and the appearance of headaches was established in some patients, the subjective observations of the patients did not however correlate with the objective weather data. Sensory stimuli function as triggers particularly for migraine with aura. Psychological factors, especially stress and everyday pressures, have been confirmed as trigger factors, but further prospective trials addressing this issue would be advantageous. Additional studies are also needed to elucidate the significance of sleep (disorders) and fatigue since their importance as triggers or symptoms of a headache attack has not been conclusively determined.

Childhood acne has different clinical expressions which may be present from birth or manifest within the first weeks of life or after the third to sixth month of life. The condition may occur as a physiological phenomenon or may be pathological and require endocrinologic evaluation and treatment. It may be induced by drugs or ointments or due to intoxication. Severe courses with a tendency to scarring in childhood may be observed. Childhood acne may persist and develop into juvenile acne. It is likely that childhood acne may represent a risk factor for the development of severe acne in puberty.

Large differences exist between women and men in the syndrome of heart failure (HF). In contrast to men, hypertension and diabetes represent the major risk factors for development of HF in women and hypertension is also the major cause of left ventricular hypertrophy and stroke. Left ventricular hypertrophy in women increases the risk for mortality to a higher degree than it does in men. The clinical course of HF is generally more benign and more frequently characterized by HF with preserved systolic function. Estrogen receptors are present in the human heart. Based on data from rodent models, they are believed to modulate hypertrophy and the progression of HF. Some of the signaling pathways have been described and involve phosphorylation of intracellular kinases and production of nitric oxide. Interestingly, estrogen receptors are upregulated in human hypertrophy and HF. The clinical course of HF in women is characterized by the more frequent occurrence of diastolic HF. Myocardial remodeling with age and, as a consequence, of mechanical load is different in both genders. Adherence to guidelines in the diagnosis and treatment of HF is less strict in women than in men, leading to undertreatment with inhibitors of the renin-angiotensin system. Women are generally underrepresented in clinical trials in HF and gender-specific analyses have been neglected in most older large survival trials. In some of the large survival studies angiotensin-converting enzyme inhibitors or beta-receptor blockers did not reach significant endpoints in women. However, meta-analyses show overall positive effects for these groups of substances. Angiotensin receptor blockers were effective in large studies including high percentages of women.

Bone metabolism and trabecular bone density were studied prospectively in 69 pre-, peri- and early postmenopausal women. Markers of bone resorption (OC = osteocalcin, BAP = bonespecific alkalic phosphatase) and bone formation (PYD = pyridinolin, DPD = desoxypyridnolin, NTX = N-terminal telopeptide crosslinked collagen type I, CTX = C-terminal telopeptide crosslinked collagen type I) in serum and urine were followed over a course of two years with five points of examination (0, 3, 6, 12 and 24 months). Bone density was measured at 0 and 24 months. The results of 40 hormonally untreated women who completed all examinations were compared regarding menopausal status and changes over the 2-year-period. While baseline tracecular bone density was lowest in early postmenoapusal women, perimenopausal women showed greatest bone loss (- 10,6 %) during the two year study period. Bone metabolism markers were highest in the postmenopausal group. Perimenopause was associated with a gradual rise in OC, PYD and CTX. Perimenopausal women showed the highest serum estradiol at 0 and 12 months with values exceeding those of premenopausal women. Whether the increased perimenopausal bone loss could be related to the increase in anovulatory cycles during the perimenopausal transition is subject to ongoing investigation.

The endocrine system of aging males reveals changes of more or less unknown significance for estrogens, dehydroepiandrosterone (DHEA), melatonin and growth hormone. The difference between physiological changes and clear hormone deficiency is not really understood and the clinical relevance of the observed changes needs to be investigated. Estrogens do not show any changes, but DHEA, melatonin or growth hormone show several changes in their concentrations concomitant with increasing age, without validated clinical significance. According to the guidelines of the ISSAM, the significance of changes in DHEA, DHEAS, melatonin, growth hormone and IGF-1 are not well enough understood to justify routine examination when investigating late-onset hypogonadism in aging men. There is no indication for treatment with these hormones (with the exception of, e.g., estrogens in prostate cancer or male-to-female-transsexualism), as the assumed positive effects as well as negative side effects are not clearly understood and need further investigation.

High oestrogen concentrations in blood or high intake of oestrogen-active compounds with forage can be associated with an enhanced occurrence of udder diseases. Mean somatic cell count (MSCC) can increase and milk yield can decrease. Subclinically infected udder quarters can develop clinical mastitis and the rate of new infections can be high. This review describes concentrations of oestrogens in peripheral blood plasma in cattle and occurrence of oestrogen-active compounds in forage. Relationships between oestrogens or oestrogen-active compounds and udder health are presented. The possible mechanisms of enhanced susceptibility of the udder to infection under the influence of oestrogens are discussed.

In the present study we investigated whether a correlation exists between menstrual cycle phase on the day of an acute psychiatric admission and diagnostic entities. Therefore we assessed the menstrual cycle phase in 155 women at the time of acute admission for any non-organic psychiatric disorder. A specific diagnosis according to ICD-10-criteria and to Leonhard's nosology was established without knowledge of the menstrual cycle phase. Independent of diagnosis and classification, the majority of patients (57%) was admitted during the pre-menstrual/menstrual period. Comparing the frequencies of admission before (increasing blood-estrogen-level) and after ovulation (decreasing blood-estrogen-level) we found using ICD-10 criteria there were no significant differences between affective psychoses (F3), acute polymorphous psychotic disorder (F23), schizophrenia/schizoaffective psychoses (F20 and F25) and patients suffering from neuroses or personality disorders (F4-F6). Applying Leonhard's criteria we found no significant differences between endogeneous psychoses and personality disorders and no significant differences between cycloid psychoses and affective psychoses or affective psychoses and schizophrenias as well. However, patients with cycloid psychoses were significantly more frequently admitted to hospital during the luteal-/menstrual phase than patients with schizophrenia (chi 2-Test, p = 0.02). These findings do not confirm a specificity of a pre-menstrual exacerbation of psychotic symptoms for schizophrenia. Rather we found cycloid psychoses to be significantly more frequently associated with premenstrual exacerbation of symptoms.

Over a 12-month period we evaluated 185 patients who consulted our outpatient department with symptoms of secondary amenorrhoea. Hormonal levels and body mass index were determined and an assessment made, on the basis of specific questioning. of the occurrence of possible mental alterations in the patients before they became amenorrhoic. Of our collective, 36 patients (19.5%) showed normal hormonal values, 50 patients (26%) were hypoestrogenemic, 46 women (25%) had elevated androgens, 15 patients (8%) had increased gonadotropins, 4 patients (2%) suffered from hyperprolactinemia, and 2 women (1%) had thyroid dysfunction. The remaining 32 amenorrhoic patients (17.2%) demonstrated different combinations of altered hormone values. The hypoestrogenemic patients showed a significant difference (p < 0.043) in body mass index in comparison with patients demonstrating normal hormone values. In contrast to reports in the literature hypoestrogenemia was the most frequent cause of secondary amenorrhoea in our study.

High impact training may influence the pubertal development of athletes. The effects of high intensity training on pubertal development of female and male elite gymnasts are presented. 22 female and 18 male elite gymnasts were enlisted in this study. Prepubertal and pubertal stages were determined and hormonal levels regarding the hypophyseal, gonadal and adrenal axes were measured. The LH/FSH ratio necessary for the advancement of full pubertal maturation was assessed at 13.9 amd 13.0 years in female and male gymnasts, respectively. Female gymnasts demonstrated, on average, a delayed bone age of 1.7 years compared to their chronological age, whereas both bone and chronological age were identical in male gymnasts. There were no significant pubertal increase of estrogen levels in female gymnasts during their peripubertal development indicating a low amount of fat mass in female elite gymnasts. Intensive physical training of elite female gymnasts combined with inadequate nutritional intake markedly affect pubertal development. These peripubertal effects are not observable in male gymnasts due to different training regimes in male and female elite gymnast. Regular monitoring of female gymnast during their vulnerable growth phase is necessary to minimize life-long physiological and psychological side effects of high impact training.

The occurrence of hormonal disorders in 1.4 to 9.7% of the patients of andrology units justify a corresponding hormone analysis. Besides helping to make the differential-diagnosis of a disease hormone results are important for the description of preservation of spermatogenesis in cases of aspermia or azoospermia. Indications of a rest-spermatogenesis or a spermatozoon-pool could be crucial for assisted reproduction. Spermatological and testis-histological data of 2 independent collectives (n1 = 138; n2 = 110) were correlated with basal levels of FSH, LH, PRL, T, free T, and E2. Serum FSH appears with a sensitivity of 88.8% and a specification of 94.1% as good, but not absolutely certain discriminator of preserved or disturbed spermatogenesis. The inclusion of testis volume improves the diagnostic reliability only negligibly--the critical size is 16 ml. Because of its low diagnostic sensitivity the serum LH alone gives not much information but it can indicate together with serum testosterone causally relevant disorders in androgen metabolism (i.e. androgen resistance syndrome. Klinefelter-syndrome). PRL, T, free T, and E2 gave no conclusion of occurrence of disturbed or preserved spermatogenesis. For indication of performing testis biopsy because of diagnosis and therapeutic considerations further factors of spermatogenesis are required.

Experiment 1: In a field experiment in 19 of 87 cows being in day 260-265 of pregnancy subclinical metabolic acidosis was found. The control group included 10 healthy cows in the same stage of pregnancy. Blood samples from cows of both groups were collected once daily until day 2 post partum for determination of oestrogens, progesterone and cortisol. Dystocia was found in four and retained placenta in three cows having acidosis. These cows had lower oestrogens and markedly higher cortisol and progesterone concentrations during parturition. Course of pregnancy and delivery in control cows an without any difficulties and hormonal profiles in these cows were typical. Experiment 2: On day 265 of pregnancy experimental acute acidosis was evoked in five cows and five other cows served as control. Sampling of blood was the same as in experiment 1. Acidosis caused on day 269 in two cows premature birth with retained placenta. Moreover concentrations of studied steroids were atypical. In three other cows with acidosis course of pregnancy and delivery was without any trouble. Only cortisol was increased while progesterone and oestrogen values were in agreement with concentrations of control cows. Data suggest that metabolic acidosis can cause dystocia, premature birth and retained placenta. Furthermore, acidosis clearly affects the profile of steroid hormones.

Polyostotic hyperostosis is a finding that is often seen on x-rays in companion birds. Hyperestrogenism might be a causative for polyostotic hyperostosis. The purpose of this study was to compare endocrinologic and pathologic findings in birds with polyostotic hyperostosis. Thirty-five affected and three control birds were examined. Blood samples were taken for endocrinologic statement (estrone, estradiol, testosterone and estrone sulfate) and the values were compared with the pathologic findings. In the present study the comparison of endocrinologic and pathologic findings did not reveal any significant results supporting the hypothesis that polyostotic hyperostosis was caused by hyperestrogenism.

The concentrations of hormones, metabolites and electrolytes in plasma of 45 ewes have been examined repeatedly during gestation (day 80 to 149) and at the third day of lactation. Healthy single pregnant (n = 8) and twin pregnant ewes (n = 12) have been compared with ewes sick with subclinical (3-hydroxybutyrate > 1,0 mmol/l, n = 6) and clinical (3-hydroxybutyrate > 1,6 mmol/l, n = 19) pregnancy ketosis. The concentration of 3-hydroxybutyrate, glucose, calcium, sodium and growth hormone in the plasma of the healthy animals were higher post partum than ante partum, while the concentrations of inorganic phosphorus, cortisol and total oestrogen were lower post partum than during pregnancy. In the pregnant ewes the concentrations of 3-hydroxybutyrate, bilirubin, total oestrogen and growth hormone in the plasma increased, while the concentration of insulin decreased with raising number of fetuses. In comparison with the healthy twin pregnant ewes the animals with subclinical and clinical pregnancy ketosis showed increased values of bilirubin, glutamate-dehydrogenase, growth hormone, total oestrogen, cortisol and cortisol/insulin ratios as well as decreased values of glucose, insulin and potassium. Individual differences of the animals within their groups were observed for the examined hormones as well as for glucose, calcium, sodium and potassium (analysis of variance). Beside multiple pregnancy low insulin values and high cortisol/insulin ratios, which are obviously due to individual disposition, influence enhanced ketogenesis and disorder of glucostasis.

The rectal temperature and any alterations in eight different external signs of parturition were investigated twice daily in 22 "Deutsche Schwarzbunte" cows during the last 10 days of gestation. There was great variation in the externally detectable signs of parturition during the preparatory stages and short before labour. During the same time period, plasma progesterone and total oestrogens were determined using radioimmunology. From 60 hours to 12 hours prior to calving the progesterone levels fell rapidly to 0.77 +/- 0.22 ng/ml. Additionally, the plasma progesterone was determined semi-quantitatively in 31 cows using a rapid progesterone assay in order to predict the commencement of parturition within 36 hours. This allowed a more objective and reliable assessment of calving time than the evaluation of external signs of labour.

This review describes the factors influencing the estrogen und progesterone levels in late pregnant cows. The various endogenous and exogenous factors (breed, calf birth weight, sex of calf, number of fetuses, season, nutrition and stressors) influence particularly significant estrogen and progesterone concentrations in peripheral blood and may lead to high variations of hormone values between cows. The possible mechanisms of influence on the estrogen und progesterone levels are discussed.

The aim of the present investigations was to characterize the endocrine changes in the peripheral plasma during the periparturient phase of mares with a known history of obstetrical disorders. Blood plasma samples from 9 mares (8 mares during parturition, 1 mare during abortion) were collected and the following steroid hormones were radioimmunologically determined: progesterone (P4), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), estrone (E1), estrone sulfate (E1-S), estradiol-17 beta (E2), estriol (E3), cortisol and transcortin. In general, with the exception of cortisol, DHEA and transcortin, all steroid hormone levels declined significantly after parturition. Mean plasma concentrations of DHEA-S, the direct fetal precursor of estrone, were 6 times higher than DHEA. However, DHEA-S levels varied considerably between all mares as well as between daily values of the same mare. Levels of E1-S were found to be about thousand times higher than those of E1, E2, and E3. The rather low concentrations of E3 suggest that this hormone is mainly produced by peripheral conversion and that in the horse fetus the 16 alpha-hydroxylation of DHEA-S is lacking. Despite the fact that most of the examined mares showed signs of severe disease none of the investigated steroid hormones indicated any disturbances of gestation. It is concluded that, from the clinical point of view, serial determinations of E1-S plasma levels are the best way to prove the fetal well-being. However, it should be stressed, that even the E1-S values are no indicators for the onset of parturition or abortion.

In order to test the hypothesis that oestrogens as well as androgens modify the body shape resp. the paedomorphous habitus of !Kung San circulating levels of sex hormones (testosterone, 5 alpha-dihydrotestosterone, and oestradiol in the serum as well as free testosterone in the saliva) of 114 healthy !Kung San men from the Northern Kalahari of Namibia were quantitatively determined by means of the radioimmunoassay method. The probands were described by 50 body measurements and morphological characters like gynaecomastia. The results show that sex hormone concentrations and body shape are significantly correlated in !Kung San men as it has been previously demonstrated for non-African samples. This does not only refer to the expression of sexual dimorphism but also to the special aspect of paedomorphism. The hypothesis of Marrett, Davies and Tobias, however, that the paedomorphous type of the San is due to "over-oestrogenization" could not be confirmed. Rather, the comparatively low testosterone level of the !Kung San men seems to be of significance.

No other species of domestic animal suffers so frequently from vaginal prolapse ante partum as the sheep. All the different therapeutic methods are symptomatic in nature with the main result of preventing recurrence. There is a high rate of complications at the time of labour because of dystocia and high lamb mortality rates. In the pregnant ewe suffering from vaginal prolapse, pathologically high levels of circulating oestrogens were found. The origin of these still remains unclear. Possible genetical defects on the maternal and/or fetal side, and the possible influence of phyto-oestrogens in this context are discussed.

A case of an unusual combination of a metastasing bronchus cancer, a non-metastasing cancer of prostata and an excessive high level of serum-estrogen is described. This casuistic gives rise to some more general discussion of the pathogenesis and differential diagnosis of paraneoplastic endocrinopathies.

In a prospective study estriol, estradiol, progesterone, human placental lactogen (HPL) prolactin and SP1 (a placental glycoprotein specific for pregnancy), were performed in the second half of uncomplicated pregnancies in order to answer the question if there exist a circadian rhythm of these hormones in serum. All serum concentrations were measured by radioimmunoassay at 8.00, 10.00, 16.00, 20.00, 24.00 and 4.00 o'clock. 58 pregnant women with uncomplicated pregnancies show no circadian rhythm of serum levels from estriol, progesterone, HPL and SP1, while serum levels of estradiol and prolactin have a significant circadian rhythm. The estradiol serum levels are significant higher at 8.00 and 12.00 o'clock, significant less at 24.00 and 4.00 o'clock. The prolactin serum levels are significant less at 16.00 and 20.00, at 4.00 and 8.00 significant higher. In 20 pregnancies complicated by preeclampsia and 12 pregnancies complicated by intrauterine growth retardation serum levels of all hormones were measured at 8.00, 10.00, 16.00, 20.00, 24.00 and 4.00 o'clock. The serum concentrations in complicated pregnancies show no difference to the serum levels in uncomplicated pregnancies.

Alcohol is a noxious substance with considerable effects on men's potency and fertility. In case of acute intoxication as well as in case of long-term effects of ethanol there is a significant decrease of testosterone and a consecutive increase of gonadotrophin LH resulting in primary hypogonadism. Moreover, chronic alcoholism leads to organic damages of the testes and the liver. Consequently the clinical symptoms and laboratory data show complex changes. Aside from the decrease of testosterone there is an increase of oestrogens (chiefly of estrone); thus increased oestrogenial effects are found in connection with changes regarding synthesis, metabolism, conversion, as well as intravascular and intracellular (receptors) binding proteins. These patients often show gynaecomastia.