We have shown that traditional herbal medicine, Shakuyaku-Kanzo-To consisted of Shakuyaku and Kanzo decreased serum testosterone levels in woman and rat. Therefore, paeoniflorin and glycyrrhizin, a main component of Shakuyaku and Kanzo, respectively, and glycyrrhetic acid, a metabolite of glycyrrhizin in vivo, were investigated for the steroid production in the rat ovary on the morning of proestrus. The homogenized tissues of one ovary were incubated in the Dulbecco's modified Eagle medium (pH 7.5) with 100 micrograms/ml of paeoniflorin, glycyrrhetic acid and glycyrrhizin and the medium only (the control) at 37 degrees C for 270 min. After the centrifugation, the concentrations of delta 4-androstenedione, testosterone and estradiol in the supernatants were determined by RIA. The production of the hormones expressed by [concentration x supernatant volume/weight of the ovary] was compared to the control. Paeoniflorin, glycyrrhetic acid and glycyrrhizin decreased significantly the testosterone production but did not change that of delta 4-androstenedione and estradiol. Testosterone/delta 4-androstenedione production ratio was lowered significantly by paeoniflorin, glycyrrhetic acid and glycyrrhizin. Estradiol/testosterone production ratio was increased significantly by glycyrrhetic acid and not changed by paeoniflorin and glycyrrhizin. These results suggest that paeoniflorin, glycyrrhetic acid and glycyrrhizin affect the conversion between delta 4-androstenedione and testosterone to inhibit testosterone synthesis and stimulate the aromatase activity to promote estradiol synthesis by the direct action on the rat proestrous ovary.

Primary pulmonary hypertension (PPH) is an uncommon but serious disease. Most patients with PPH are young women and the disease is more serious and eventful in pregnant women. We have experienced a patient with PPH in pregnancy, who was delivered successfully but died suddenly on the 7th day after the delivery. We report the obstetric course and the clinical management for the delivery of the patient with PPH.

The effect of the traditional herbal medicine, Shakuyaku-Kanzo-To (SK), which contains Shakuyaku (S) and Kanzo (K) in equal amounts, on serum testosterone levels was investigated in androgen-sterilized rats. They were given orally SK [0, 22.5, 45, 90 and 180 mg/kg body weight (b.w.)] and S or K (0, 11.25, 22.5, 40 and 90 mg/kg b.w.) in 2 ml of water daily for 2 weeks. Dose-dependent decreases in free serum testosterone (T) levels were found in the administration of SK. Total serum T levels in the administration of SK and S decreased in a dose-dependent manner. K decreased total serum T levels slightly in 11.5 and 22.5 mg/kg doses but showed the dose-dependent increase in much higher doses, the extent of which was much less than that of the decrease in S. Serum estradiol/T (E2/T) ratios were significantly elevated in 45 to 180 mg/kg doses of SK, 90 mg/kg dose of S and 11.25 to 90 mg/kg doses of K. Serum LH and FSH levels were not changed by SK, S and K. Oophorectomized rats were similarly given SK (0, 90 and 180 mg/kg b.w.) and S or K (the half doses of SK). There were no changes in serum T, LH and FSH levels in all given doses. Thus, one of the mechanisms for SK to lower serum T levels is the direct action on the ovary to stimulate the aromatase activity, resulting in decreasing the T secretion and this is the additive effects of S and K.

The lower the % free T, the lower the rate of subsequent abortion. The value of % free T may be able to predict pregnancy outcome in early pregnancy.

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