THE remarkable female predominance of such diverse autoimmune diseases as systemic lupus erythematosus (SLE), Hashimoto's thyroiditis, rheumatoid arthritis, and primary biliary cirrhosis has suggested to many clinicians that hormonal differences between the sexes must confer some protective effect on males or enhance the susceptibility of females to these diseases. This review will examine the evidence in support of such an hypothesis. We will examine the effects of gonadal steroids on the function of the normal immune system as well as their impact on autoimmune processes. We will explore current knowledge of the cellular and molecular mechanisms by which gonadal steroids might modulate both normal and disordered function of the immune system.
Alendronate (Fosamax), risedronate (Actonel), zoledronic acid (Reclast), and raloxifene (Evista) have an indication from the Federal Drug Administration (FDA) for the prevention of osteoporosis (such as for those with osteopenia), as well as for the treatment of osteoporosis. For raloxifene (Evista) and risedronate (Actonel), the doses used for osteopenia are the same as those used for osteoporosis. Zoledronic acid (Reclast) is an intravenous medication given yearly for the treatment of osteoporosis but every other year for the prevention of osteoporosis. Alendronate (Fosamax) is given as 10 mg daily or 70 mg weekly for osteoporosis, and the dose is halved for the prevention of osteoporosis (5 mg daily or 35 mg weekly).
Progestins , the most important of which is progesterone , are the other type of female sex hormone and are named for their role in maintaining pregnancy (pro- gestation ). Estrogens and progestins are secreted cyclically during menstruation . During the menstrual cycle , the ruptured ovarian follicle (the corpus luteum ) of the ovary produces progesterone, which renders the uterine lining receptive to the implantation of a fertilized ovum . Should this occur, the placenta becomes the main source of progesterone, without which the pregnancy would terminate. As pregnancy progresses, placental production of progesterone increases, and these high doses suppress ovulation , preventing a second conception . The contraceptive quality of progesterone led to the development of structurally modified progestins and estrogens—the oral contraceptives known as birth-control pills, used by women to prevent unwanted pregnancy.