Should lead to a reactivation PLK of endometriosis, but they are high enough to prevent hot flashes and bone loss, as demonstrated need during the treatment of endometriosis with DNG, unlike GnRH analogues. 4.1.3. There are few studies on the chest of the effects of DNG in the chest. The testers examined in a fine needle biopsies of mammary glands of women with E2 and E2V plus norethisterone acetate, or DNG was treated, the proliferation marker Ki67 was not significantly different between the groups and NETA DNG. In a small study, the effect of a high dose of DNG on the breast with ultrasound has been studied. For all women, a significant reduction in the size E of the mammary gland and regression mastopathic Ver Observed changes. In another study of postmenopausal women, had no effect on production DNG potentially genotoxic estrogen metabolites, which have been proposed to hormonabh for the development of breast cancer Ngigen important. Despite these encouraging data is to be noted that the proliferation of cells has greatly increased breast cancer is considered when certain components of the cell are overexpressed when progestins are added, which are found in patients with breast cancer a few. This k The increased Hte risk of breast cancer with combined estrogen / progestin therapy compared with treatment nnte estrogenonly seen in women Health Initiative study explained Ren. However, not all progestins have the same effects. Further research, ideally in a head to allow comparison with other progestins available DNG, under the same experimental models head is required to assess the effects of DNG in the chest. Only long-term, controlled study The randomized, as the WHI showed that different progestins have different effects on the risk of breast cancer. Can be done in the meantime, laboratory studies, biological plausibility Rate least t of the various actions progestins in the breast. 4.2. Activity t in terms of metabolic and vascular System no clinically significant effects on lipid metabolism, liver enzymes, h Mostatischen parameters or thyroid metabolism To have been observed with a maximum of 20 mg / day for 24 weeks DNG. In particular, showed a number of studies usingDNGin hormonal receiver Ngnisverhütung or hormonal therapy that does not diminish the DNG Ver Changes of estrogen production by the liver of hormone-sensitive proteins, including normal hours Hemostatic factors. For the evaluation of its vascular Compared Ren pharmacodynamics, a prospective randomized trial in postmenopausal women, the effects of therapy with E2V only those of a combined treatment on the secretion of vasoactive E2V/DNG mediators. Can E2V alone significantly increased Ht excretion of cyclic guanosine monophosphate, which reflect the production of nitric oxide. In addition, the ratio Ratio of prostacyclin / thromboxane, known to be crucial for the relationship between ht has vasorelaxation and vasoconstriction, also increased, Suggesting that the endothelium-dependent Independent Vasodilation protection. Endothelium-independent Independent vasoactive effects were also studied, for example, when progestins are capable of antagonizing the antagonism of the beneficial estrogen-induced calcium. These effects of progestins such as norethisterone, but found not to DNG, though, whether the.