Inhibition of Lactation by Synthetic Oestrogens

Abstract

The hormone control of lactation was reviewed by Nelson (1936). He concluided that the ovarian hormones, which are present in enormously increased amounts in pregnancy, are necessary for the development of the breasts, but inhibit the secretion of milk. The initiation and maintenance of lactation depend on the anterior lobe of the pituitary.After parturition the oestrogenic hormone ceases to be produced in large amounts, and with this release of control lactation begins. A further factor in the maintenance of lactation is the stimulus of suckling, the mechanism of which is obscure; nor is it known how the oestrogenic hormones inhibit lactation, though it is assumed that they do so by inhibiting the action of the anterior lobe. Folley (1936) showed that when the oestrogenic hormone was administered to the lactating cow, lactation was inhibited and the milk yield was reduced. This effect was temporary and depended on obtaining a high level of oestrogen in the blood. Folley and Kon (1936) studied the effect of sex hormones on lactation in the rat. They found that oestradiol caused a marked inhibition in intact rats, and a definite though less well marked effect in rats ovariectomized on the day after parturition. Testosterone propionate also caused pronounced inhibition, but progesterone and androsterone had no effect.On the basis of these and similar findings it was suggested that oestrogenic hormones might be used for the inhibition of lactation in puerperal women, and numerous reports of this use of the naturally occurring oestrogens have appeared. Foss and Phillips (1938) obtained satisfactory results in 62 cases with oestradiol (progynon B, Schering), giving a total dose of 10,000 I.U. They found that oestrogenic hormone was also useful for flushed and engorged breasts, relieving the symptoms without interfering with lactation. Lehmann (1938) used progynon B oleosum. He found that 100,000 units given by injection in the first 24 hours post partum inhibited lactation in 91% of cases. Inhibition of established lactation was pbtained in 89% of cases with 200,000 units, but in only 50% with 150,000 units. Jeffcoate (1939) gave oestrone by mouth in doses of 2 to 6 mg., gradually decreasing the dose over 3 to 6 days. He found that,it was usually necessary to supplement this by 1 to 2 mg. of oestradiol benzoate by injection. Literature of the OestrogensThe synthetic oestrogenic substance diethyl-stilboestrol, commonly known as stilboestrol, was first described by Dodds, Golberg, Lawson, and Robinson (1938a). It has since been shown by numerous workers that this substance, and others chemically allied to it, are capable of reproducing the biological and clinical effects of the naturally occurring oestrogens. They can be produced relatively cheaply and are equally ad potent when given by mouth as when injected, if not more so. Thus they stand in contrast to the naturally occurring oestrogens, which are generally very much less potent by mouth and are therefore best administered parenterally. Connally, Dann, Reese, and ...

Inhibition of Lactation by Hexoestrol Dipropionate

“…The one most widely employed has been stilboestrol. There are many published papers on the use of this compound in the inhibition of lactation (Abarbanel and Goodfriend, 1940;Abarbanel and Klein, 1941 ;Barnes, 1942;Bloom, 1941 ;Connally et al, 1940;Davis and Boynton, 1941;Mendel, Goldman, and Caire, 1941 ;Muckle, 1940;Palmer, Martin, and Fulton, 1942;Stewart and Pratt, 1941). The general opinion is that for this purpose stilboestrol is just as effective by mouth as by injection.…”

“…Hexoestrol has also been used for the inhibition of lactation (Bishop, et al, 1940;Barnes, 1942). It is given orally in a similar dosage to stilboestrol, and seems to produce much the same result.…”

“…It is given orally in a similar dosage to stilboestrol, and seems to produce much the same result. Barnes (1942) states that, weight for weight, hexoestrol is less potent than stilboestrol for the inhibition of lactation: she, however, administered both substances orally. Campbell et al (1939) claim that by injection hexoestrol is more potent than stilboestrol.…”

“…Other endocrines that have been used to inhibit lactation are dienoestrol (Barnes, 1942); trichlorethylene (Macpherson and Robertson, 1939;Haultain, 1942); testosterone propionate (Kurzrok and O'Connell, 1938;Siegler and Silverstein, 1940;Duffy and Corsaro, 1941); methyl testosterone (Kushner, 1942;Lass, 1942); and octofollin (Murphy, 1943).…”

Dienoestrol for Menopausal Symptoms

“…A clinical trial with dienoestrol was carried otut bv me (Barnes, 1942). The compound was used for the inhibition of lactation, and its effect for this purpose was compared with that of stilboestrol and hexoestrol.…”