Salivary and Plasma Progesterone in Normal Women and in Patients with Benign Breast

Data on possible involvement of ovarian function by means of decreased progesterone production and/or imbalance in progesterone/estrogen ratio iir the pathogenesis of benign breast disease have been reported in the literature (5). More recently, attention has been given to the possible role ofprolactin on altered breast physiology (7); the influences exerted by this peptide on ovarian stiroid hormone secretion (6) are generally acknowledged. Despite these observations, general agreement on the role of decreased levels of progesterone in the pathogenesis of cystic breast disease is lacking, owing to conflicting reports on hormonal profiles. Either normal (2) or low levels (5) of the gonadal steroid progesterone have been reported in women affected by fibrocystic mastopathy. A possible explanation of this discrepancy may be found in the involvement of different pathogenetical factors, but technical aspects also may be considered. Usually employed radioimmunoassay rnethods give an estimate of the total levels of circulating steroid hormones, whereas only the non-protein bound, free fraction is known to yield biological activity. Different methods have been described for the determination of plasma steroid,free fraction (1,8), but, at present, none is sufficiently accurate and easy to'perform on a routine basis. However, recent data from others (9,10) and our laboratory have given an insight on apparent free levels of steroid hormones, and particularly testosterone (3) and progesterone (4), by means of salivary evaluations. This work was based on the facts that saliva contains very low amounts of proteins and that a close correlation between (at least) salivary testosterone values and plasma free testosterone values (as measured by equilibrium dialysis) has been shown (9). In our study on t healthy, normally menstruating women (4), a marked rise in plasma progesterone Ievels (202Vo with respect to periovulatory values) was shown in the luteal phase, but such a rise was far less pronounced than that of salivary progesterone (2755Vo). These peak values were observed both in plasma and in saliva 8 days after the ovulatory peak.