THE INFLUENCE OF CYCLOSPORINE-A THERAPY ON SEX-HORMONE LEVELS IN PREMENOPAUSAL AND POSTMENOPAUSAL WOMEN WITH PRIMARY BILIARY-CIRRHOSIS

The mechanism underlying sex hormone disturbances in post-menopausal w omen with primary biliary cirrhosis is unclear, but these alterations may occur as a consequence of liver disease. As cyclosporine may have some therapeutic potential is this condition, we have evaluated short- term alterations in plasma sex hormone levels in 11 pre- and 19 post-m enopausal women with primary biliary cirrhosis following randomisation to cyclosporine A or placebo therapy. Baseline sex hormone binding gl obulin levels were markedly depressed in all pre-menopausal women but were elevated for the postmenopausal group when compared to standard r eference ranges. Testosterone and dihydrotestosterone levels were low or markedly depressed in both patient groups. Androstendione concentra tions tended to be higher than the normal range in the post-menopausal group. Oestradiol levels were within the normal range for the pre-men opausal group but were relatively higher in the post-menopausal group than in other normal post-menopausal women. Cyclosporine A therapy res ulted in significant decreases in sex hormone binding globulin levels (26.6+/-5.0 to 16.2+/-4.6 nmol/l; p<0.05) in the premenopausal group a nd reduction in total (336+/-163 to 140+/-132 pmol/l; p<0.01) and free (6+/-to 2+/-3 pmol/l; p<0.05) oestradiol levels in the post-menopausa l group at 6 months. There were no significant alterations in other ho rmonal parameters. No temporal changes occurred in the placebo group. Cyclosporine A therefore induces significant but variable sex hormone changes in both pre- and post-menopausal women with primary biliary ci rrhosis. (C) Journal of Hepatology.