Skip to main content
Home
Zeitschriften
Zeitungen
Podcast
Gesundheitspolitik
Praxis
Allerlei
Jobs
Fachgebiete
Allgemeinmedizin Anästhesiologie & Intensivmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kinder & Jugendheilkunde Neurologie & Psychiatrie Orthopädie & Unfallchirurgie Pflege Urologie Zahnmedizin Apotheke
Subfächer Innere Medizin
Diabetologie Gastroenterologie Infektiologie Kardiologie Onkologie und Hämatologie Pneumologie Rheumatologie
Fortbildungen
Überblick Fortbildungen DFP-Literaturstudium-Artikel DFP-Webcast Fortbildungen DFP-Podcasts
Erweiterte Suche
Anmelden
nach oben
Gynäkologie in der Praxis
Erschienen in: Journal für Gynäkologische Endokrinologie/Österreich 4/2018

12.06.2018 | Originalien

Der Effekt von Wachstumshormon auf die menschlichen Alterungsprozesse. Teil 2

verfasst von: Prof. Dr. med. Michael Klentze

Erschienen in: Gynäkologie in der Praxis | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Eine große Anzahl von Studien weist auf die signifikante Reduktion der Wachstumshormonsekretion und der damit zusammenhängenden IGF-1-Plasmaspiegel während des menschlichen Alterungsprozesses hin. Dies geht mit der Erniedrigung von Muskelmasse, Knochenmasse, Vitalität und dem Verlust von anderen wichtigen physiologischen Funktionen einher. Dazu gehören die Verschlechterung mentaler und kognitiver Funktionen, erhöhte Altersfragilität, ausgeprägte Adipositas, Insulinresistenz, Diabetes Typ 2 und kardiovaskuläre Komplikationen. In dieser Arbeit werden die Effekte von Wachstumshormon auf die Alterungsprozesse dargestellt.
Vorheriger Artikel Editorial
Nächster Artikel Endometriumdicke in der Sonographie – ein wichtiger Parameter der endometrialen Rezeptivität?
Literatur
1.
Helmert U, Strube H (2004) Die Entwicklung der Adipositas in Deutschland im Zeitraum von 1985 bis 2002. Gesundheitswesen 66:409–415PubMed
2.
3.
Prugger C, Keil U (2007) Entwicklung der Adipositas in Deutschland – Größenordnung, Determinanten und Perspektiven. Dtsch Med Wochenschr 132:892–897PubMed
4.
Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalance and trends on obesity among US adults, 1999–2000. JAMA 288:1723–1727PubMed
5.
Bjorntorp P (1993) Visceral obesity: a “civilization syndrome”. Obes Res 1:206–222PubMed
6.
De Boer H, Blok G‑J, Van der Veen EA (1995) Clinical aspects of growth hormone deficiency in adults. Endocr Rev 16:63–86PubMed
7.
Landin-Wilhelmsen K, Wilhelmsen L, Lappas G et al (1994) Serum insulinlike growth factor I in a random population sample of men and women: relationship to age, sex, smoking habits, coffee consumption and physical activity, blood pressure and concentrations of plasma lipids, fibrinogen, parathyroid hormone and osteocalcin. Clin Endocrinol (Oxf) 41:351–357
8.
Bl H, Berg C, Vogel E, Nowak T, Renzig-Koehler K, Mann K, Saller B (2004) Effects of a combination of recombinant human growth hormone with metformin on glucose metabolism and body composition in patients with metabolic syndrome. Horm Metab Res 36(1):54–61
9.
Van der Klaauw AA et al (2007) The Prevalence of the metabolic syndrome is incerased in patients with GH deficiency, irrespective of long-term substitution with recombinant GH. Eur J Endocrinol 156(4):455–462PubMed
10.
Beauregard C, Utz AL, Schaub AE, Nachtigall L, Biller BM, Miller KK et al (2008) Growth hormone decreases visceral fat and improves cardiovascular risk markers in women with hypopituitarism: a randomized, placebo-controlled study. J Clin Endocrinol Metab 93:2063–2071PubMedPubMedCentral
11.
Blackman MR, Sorkin JD, Münzer T, Bellantoni MF, Busby-Whitehead J, Stevens TE et al (2002) Growth hormone and sex steroid administration in healthy aged women and men: a randomized controlled trial. JAMA 288:2282–2292PubMed
12.
Johannsson G, Marin P, Lonn L et al (1997) Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure. J Clin Endocrinol Metab 82(3):727–734PubMed
13.
Angelin B, Rudling M (1994) Growth hormone and hepatic lipoprotein metabolism. Curr Opin Lipidol 5:160–165PubMed
14.
Mekala KC, Tritos NA (2009) Effects of recombinant human growth hormone therapy in obesity in adults: a meta analysis. J Clin Endocrinol Metab 94(1):130–137PubMed
15.
Bolli GB, Gerich JE (1984) The “dawn phenomenon”—A common occurrence in both non-insulin-dependent and insulin-dependent diabetes mellitus. N Engl J Med 310:746–750PubMed
16.
Kotler DP, Muurahainen N, Grunfeld C et al (2004) Effects of growth hormone on abnormal visceral adipose tissue accumulation and dyslipidemia in HIV-infected patients. J Acquir Immune Defic Syndr 35(3):239–252PubMed
17.
Bengtsson B‑Å (1993) The consequences of growth hormone deficiency in adults. Acta Endocrinol 128(Suppl 2):2–5
18.
Lund S, Flyvbjerg A, Holman GD, Larsen FS, Pedersen O, Schmitz O (1994) Comparative effects of IGF-I and insulin on the glucose transporter system in rat muscle. Am J Physiol 267:E461–E466PubMed
19.
Rudling M, Norstedt G, Olivecrona H, Reihne’r E, Gustafsson J‑Å, Angelin B (1992) Importance of growth hormone for the induction of hepatic low density lipoprotein receptors. Proc Natl Acad Sci Usa 89:6983–6987PubMedPubMedCentral
20.
Bengtsson B‑Å, Ede’n S, Lönn L et al (1993) Treatment of adults with growth hormone (GH) deficiency with recombinant human GH. J Clin Endocrinol Metab 76:309–317PubMed
21.
Richelsen B, Pedersen SB, Børglum JD, Møller-Pedersen T, Jørgensen J, Jørgensen JO (1994) Growth hormone treatment of obese women for 5 wk; effect on body composition and adipose tissue LPL activity. Am J Physiol 266:E211–E216PubMed
22.
Rasmussen MH (2010) Obesity, growth hormone and weight loss. Mol Cell Endocrinol 316(2):147–153PubMed
23.
Cordido F et al (2010) The decreased growth hormone resposne to growth hormone relasing hormone in obesity is associated to cardiometabolic factors. Mediators Inflamm 2010:434562PubMedPubMedCentral
24.
Shadid S, Jensen M (2003) Effects of growth hormone administration in human obesity. Obes Res 11:170–175PubMed
25.
Franco C, Brandberg J et al (2005) Growth hormone treatment reduces abdominal visceral fat in postmenopausal women with abdominal obesity :a 12-month placebo controlled trial. J Clin Endocrinol 90(3):1466–1474
26.
Rasmussen MH (2009) Obesity, growth hormone and weight loss. Mol Cell Endocrinol 316(2):147–201PubMed
27.
Lewitt MS (2017) The role of the growth hormone/insulin-like growth factor system in visceral adiposity. Biochem Insights 10:1178626417703995PubMedPubMedCentral
28.
Bredella MA, Gerweck AV, Lin E, Landa MG, Torriani M, Schoenfeld DA, Hemphill LC, Miller KK (2013) Effects of GH on body composition and cardiovascular risk markers in young men with abdominal obesity. J Clin Endocrinol Metab 98(9):3864–3872PubMedPubMedCentral
29.
Bondanelli M, Ambrosio MR, degli Uberti EC (2001) Pathogenesis and prevalence of hypertension in acromegaly. Pituitary 4(4):239–249PubMed
30.
Tivesten A, Barlind A, Caidahl K, Klintland N, Cittadini A, Ohlsson C, Isgaard J (2004) Growth hormone-induced blood pressure decrease is associated with increased mRNA levels of the vascular smooth muscle KATP channel. J Endocrinol 183(1):195–202PubMed
31.
Climent Payá V, Marín Ortuño F, Valencia VP, Picó AAM, Martínez Martínez GJ, Quiles Llorens AJ, García de Burgos F, Sogorb Garri F (2001) The Influence of the growth hormone in the profile of blood pressure. Results in adult patients with deficiency in this hormone. Rev Esp Cardiol 54(4):469–475PubMed
32.
Hunt KJ, Lukanova A, Rinaldi S et al (2006) A potential inverse association between Insulin like growth factor −1 and hypertension in a cross sectional study. Ann Epidemiol 16(7):563–571PubMed
33.
Colao A, Terzolo M, Bondanelli M et al (2008) GH and IGF-1 excess control contributes to blood pressure control: results of an observational , retrospective, multicenter study in 105 hypertensive acromegalic patients on heypertensive treatments. Clin Endocrinol (Oxf) 69(4):613–620
34.
Caidahl K, Ede’n S, Bengtsson B‑Å (1994) Cardiovascular and renal effects of growth hormone. Clin Endocrinol (Oxf) 40:393–400
35.
Copeland KC, Nair KS (1994) Recombinant human insulin-like growth factor—I increases forearm blood flow. J Clin Endocrinol Metab 79:230–232PubMed
36.
37.
Friberger P, Knos M, Gustavsson S, Aurell L, Claeson G (1978) Methods for determination of plasmin, antiplasmin and plasminogen by means of substrate S‑2251. Haemostasis 7:138–145PubMed
38.
Landin-Wilhelmsen K, Tengborn L, Wilhelmsen L, Bengtsson BA (1997) Elevated fibrinogen levels decrease following treatment of acromegaly. Clin Endocrinol (Oxf) 46:69–74
39.
Vague P, Juhan-Vague I, Aillaud MF et al (1986) Correlation between blood fibrinolytic activity, plasminogen activator inhibitor level, plasma insulin level, and relative body weight in normal and obese subjects. Metabolism 35:250–253PubMed
40.
Landin K, Stigendal L, Eriksson E et al (1990) Abdominal obesity is associated with impaired fibrinolytic activity and elevated plasminogen activator inhibitor-1. Metabolism 39:1044–1048PubMed
41.
Holloway L, Butterfield G, Hintz RL, Gesundheit N, Marcus R (1994) Effects of recombinant human growth hormone on metabolic indices, body composition, and bone turnover in healthy elderly women. J Clin Endocrinol Metab 79:470–479PubMed
42.
43.
Williams RD (2011) Clinical Brief: acrmegaly in adults. Top Integr Health Care 2(2):4005
44.
van Bunderen CC, van Varsseveld NC, Erfurth EM, Ket JC, Drent ML (2014) Efficacy and safety of growth hormone treatment in adults with growth hormone deficiency: a systematic review of studies on morbidity. Clin Endocrinol (Oxf) 81(1):1–14
45.
Wong JH, Dukes J, Levy RE, Sos B, Mason SE, Fong TS, Weiss EJ (2008) Sex differences in thrombosis in mice are mediated by sex-specific growth hormone secretion patterns. J Clin Invest 118(8):2969–2978PubMedPubMedCentral
46.
Rudman D, Kutner MH, Rogers CM et al (1981) Impaired growth hormone secretion in the adult population: relation to age and adiposity. J Clin Invest 67(5):1361–1369PubMedPubMedCentral
47.
Duchaine D (1984) The underground steroid handbook. HLR Technical Books, Venice
48.
Holt RI, Sonksen PH (2008) Growth hormone, IGF-I and insulin and their abuse in sport. Br J Pharmacol 154(3):542–556PubMedPubMedCentral
49.
Sonksen P (2013) Idiopathic growth hormone deficiency in adults, Ben Johnson and the Somatopause. J Clin Endocrinol Metab 98(6):2270–2273PubMed
50.
Perls TT, Reisman NR, Olshansky SJ (2005) Provision or distribution of growth hormone for “antiaging”: clinical and legal issues. JAMA 294(16):2086–2090PubMed
51.
52.
53.
Clemmons DR, Van Wyk JJ (1984) Factors controlling blood concentration of somatomedin C. Clin Endocrinol Metab 13:113–143PubMed
54.
Bates AS, Evans AJ, Jones P, Clayton RN (1995) Assessment of GH status in adults with GH deficiency using serum growth hormone, serum insulin-like growth factor-I and urinary growth hormone excretion. Clin Endocrinol (Oxf) 42:425–430
55.
56.
Ghigo E, Mazza E, Imperiale E, Rizzi G, Benso L, Muller EE et al (1987) The enhancement of the cholinergic tone by pyridostigmine promotes both basal and growth hormone (GH)-releasing hormone-induced GH secretion in children of short stature. J Clin Endocrinol Metab 65:452–456PubMed
57.
Ghigo E, Imperiale E, Buffano GM, Mazza E, Bellone J, Arvat E et al (1990) A new test for the diagnosis of growth hormone deficiency due to primary pituitary impairment: combined administration of pyridostigmine and growth hormone-releasing hormone. J Endocrinol Invest 13:307–316PubMed
58.
Bellone J, Valente F, Aimaretti G, Loche S, Cappa M, Bartolotta E et al (1993) Peak GH response to various provocative stimuli in children with normal and familial short stature. Pediatr Res 5(Suppl):S25
59.
Greenwood FC, Landon J, Stamp TC (1965) The plasma sugar, free fatty acid, cortisol and growth hormone response to insulin in control subjects. J Clin Invest 45(4):429
60.
Biller BM, Samuels MH, Zagar A, Cook DM, Arafah BM, Bonert V et al (2002) Sensitivity and specificity of six tests for the diagnosis of adult GH deficiency. J Clin Endocrinol Metab 87:2067–2079PubMed
61.
Isidori AM, Kaltsas GA, Perry L, Burrin JM, Besser GM, Monson JP (2003) The effect of growth hormone replacement therapy on adrenal androgen secretion in adult onset hypopituitarism. Clin Endocrinol (Oxf) 58(5):601–611
62.
Mantzoros CS, Tzonou A, Signorello LB, Stampfer M, Trichopoulos D, Adami HO (1997) Insulin-like growth factor 1 in relation to prostate cancer and benign prostatic hyperplasia. Br J Cancer 76:1115–1118PubMedPubMedCentral
63.
Chan JM, Stampfer MJ, Giovannucci E, Gann PH, Ma J, Wilkinson P et al (1998) Plasma insulin like growth factor-I and prostate cancer risk: a prospective study. Science 279:563–566PubMed
64.
Hankinson SE, Willett WC, Colditz GA et al (1998) Circulating concentrations of insulin-like growth factor-I and risk of breast cancer. Lancet 351:1393–1396PubMed
65.
Webb SM (2008) Measurements of quality of life in patients with growth hormone deficiency. J Endocrinol Invest 31(Suppl 9):52–55PubMed
66.
Grimberg A, DiVall SA, Polychronakos C, Allen DB, Cohen LE, Quintos JB, Rossi WC, Feudtner C, Murad MH (2016) Guidelines for growth hormone and insulin-like growth factor-I treatment in children and adolescents: growth hormone deficiency, idiopathic short stature, and primary insulin-like growth factor-I deficiency. Horm Res Paediatr 86:361–397PubMed
67.
Toogood AA, O’Neill PA, Shalet SM (1996) Beyond the somatopause: growth hormone deficiency in adults over the age of 60 years. J Clin Endocrinol Metab 81(2):460–465PubMed
68.
Williams T, Berelowitz M, Joffe SN (1984) Impaired growth hormone responses to growth hormone-releasing factor in obesity. A pituitary defect reversed with weight reduction. N Engl J Med 311(22):1403–1407PubMed
69.
Pontiroli E, Lanzi R, Monti LD, Sandoli E, Pozza G (1991) Growth hormone (GH) autofeedback on GH response to GH-releasing hormone. Role of free fatty acids and somatostatin. J Clin Endocrinol Metab 72(2):492–495PubMed
70.
Friend KE, Hartman ML, Pezzoli SS, Clasey JL, Thorner MO (1996) Both oral and transdermal estrogen increase growth hormone release in postmenopausal women—a clinical research center study. J Clin Endocrinol Metab 81(6):2250–2256PubMed
71.
Weissberger J, Ho KKY, Lazarus L (1991) Contrasting effects of oral and transdermal routes of estrogen replacement therapy on 24-hour growth hormone (GH) secretion, insulin-like growth factor I, and GH-binding protein in postmenopausal women. J Clin Endocrinol Metab 72(2):374–381PubMed
72.
73.
74.
Malozowski S, Tanner LA, Wysowski D, Fleming GA (1993) Growth hormone, insulin-like growth factor I, and benign intracranial hypertension. N Engl J Med 329:665–666PubMed
75.
Cohn L, Feller AG, Draper MW, Rudman IW, Rudman D (1993) Carpal tunnel syndrome and gynaecomastia during growth hormone treatment of elderly men with low circulating IGF-I concentrations. Clin Endocrinol (Oxf) 39:417–425
76.
Munzer T, Harman SM, Hees P, Shapiro E, Christmas C, Bellantoni MF, Stevens TE, O’Connor KG, Pabst KM, St Clair C, Sorkin JD, Blackman MR (2001) Effects of GH and/or sex steroid administration on abdominal subcutaneous and visceral fat in healthy aged women and men. J Clin Endocrinol Metab 86:3604–3610PubMed
77.
Weltman A, Weltman JY, Veldhuis JD, Hartman ML (2001) Body composition, physical exercise, growth hormone and obesity. Eat Weight Disord 6:28–37PubMed
78.
Broussard JL, Chapotot F, Abraham V, Day A, Delebecque F, Whitmore HR, Tasali E (2015) Sleep restriction increases free fatty acids in healthy men. Diabetologia 58(4):791–798PubMedPubMedCentral
79.
Tannenbaum GS, Martin JB (1976) Growth induced by pulsatile infusion of an amidated fragment of human growth hormone releasing factor in normal and GHRF-deficient rats. Endocrinology 98:562–570PubMed
80.
Tannenbaum GS, Painson, La Pointe M, Gurd W, Mc Carthy G (1990) Interplay of somatostatin and growth hormone-releasing hormone in genesis of episodic growth hormone secretion. Metab Clin Exp 39(9, Suppl. 2):35–39PubMed
81.
Tannenbaum GS, Ling N (1984) The interrelationship of growth hormone(GH)-releasing factor and somatostatin in generation of the ultradian rhythm of GH secretion. Endocrinology. 115(5):1952–1957PubMed
82.
Lim CT, Grossman A, Khoo B (2014) Normal physiology of ACTH and GH release in the hypothalamus and anterior pituitary in man. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, Weickert MO (Hrsg) Endotext. MDText.com, Inc, South Dartmouth
83.
Jean-Louis G, von Gizycki H, Zizi F (1998) Melatonin effects on sleep, mood, and cognition in elderly with mild cognitive impairment. J Pineal Res 25:177–183PubMed
84.
Valcavi R, Zini M, Maestroni GJ, Conti A, Portioli I (1993) Melatonin stimulates growth hormone secretion through pathways other than the growth hormone-releasing hormone. Clin Endocrinol (Oxf) 39(2):193–199
85.
Nassar E, Mulligan C, Taylor L et al (2007) Effects of a single dose of N-Acetyl-5-methoxytryptamine (Melatonin) and resistance exercise on the growth hormone/IGF-1 axis in young males and females. J Int Soc Sports Nutr 4:14PubMedPubMedCentral
86.
Russell-Aulet M, Dimaraki EV, Jaffe CA et al (2001) Aging-related growth hormone (GH) decrease is a selective hypothalamic GH-releasing hormone pulse amplitude mediated phenomenon. J Gerontol A Biol Sci Med Sci 56:M124–M129PubMed
87.
Villalobos C, Núñez L, Frawley LS et al (1997) Multi-responsiveness of single anterior pituitary cells to hypothalamic-releasing hormones: a cellular basis for paradoxical secretion. Proc Natl Acad Sci USA 94:14132–14137PubMedPubMedCentral
88.
Walker RF (2006) Sermorelin: a better approach to management of adult-onset growth hormone insufficiency? Clin Interv Aging 1(4):307–308PubMedPubMedCentral
89.
Mathieni G (1980) Growth hormone secretion by arginine stimulus: the effect of both low doses and oral arginine. Boll Soc It Sper Biol 56:2254
90.
Marcell TJ, Taaffe DR, Hawkins SA, Tarpenning KM, Pyka G et al (1999) Oral arginine does not stimulate basal or augment exercise-induced GH secretion in either young or old adults. J Gerontol 54A(8):M395–M399
91.
Ohlsson C, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC (1998) Growth hormone and bone. Endocr Rev 19(1):55–79PubMed
92.
Wüster C, Abs R, Bengtsson BA, Bennmarker et al (2001) The influence of growth hormone deficiency, growth hormone replacement therapy, and other aspects of hypopituitarism on fracture rate and bone mineral density. J Bone Miner Res 16(2):398–405PubMed
93.
Raben MS (1958) Treatment of a pituitary dwarf with human growth hormone. J Clin Endocrinol Metab 18:901–903PubMed
94.
Evans HM, Long JA (1922) Characteristic effects upon growth, oestrus, and ovulation induced by the intra peritoneal administration of fresh anterior hypophyseal substance. Proc Natl Acad Sci USA 8:38–39PubMedPubMedCentral
95.
Perls TT, Reisman NR, Olshansky SJ (2005) Provision and distribution of growth hormone for “antiaging”: clinical and legal issues. JAMA 294:2086–2090PubMed
96.
Liu H et al (2007) Systematic review: the safety and efficacy of growth hormone in the healthy elderly. Ann Intern Med 146:104–115PubMed
97.
Landsmann MA (2006) Forever young? What role does human growth hormone play in the aging process? The question is rife with controversy. Adv Healthy Aging 2:54–61
98.
Shimon I (2003) Growth hormone replacement for adult growth hormone deficiency. Expert Opin Pharmacother 4(11):1977–1983PubMed
99.
Bartke A, Brown-Borg H, Kinney B, Mattison J, Wright C, Hauck St, Coschiogano K, Kopchick JM (2000) Growth hormone and aging. J Am Aging Assoc 23:219–225PubMedPubMedCentral
100.
101.
Jenkins PJ, Mukherjee A, Shalet SM (2006) Does growth hormone cause cancer ? Clin Endocrinol (Oxf) 64(2):115–121
102.
Sklar CA (2004) Growth hormone treatment: cancer risk. Horm Res 62(Suppl 3):30–34PubMed
103.
Banerjee I, Clayton PE (2007) Growth hormone treatment and cancer risk. Endocrinol Metab Clin North Am 36(1):247–263PubMed
104.
CohenP personal Informationan during a telephone discussion in Tegernesse 2004. Novo-Nordisk Conference on Growth Hormone, 2005, Tegernsee
105.
Grimberg A, Liu B, Bannerman P, El-Deiry WS, Cohen P (2002) IGFBP-3 mediates p53-induced apoptosis during serum starvation. Int J Oncol 21(2):327–335PubMed
106.
Blackman MR, Sorkin J, Münzer T, Bellantoni M, Busby-Whitehead J, Stevens T et al (2002) Growth hormone and sex steroid administration in healthy aged women and men: a randomized controlled trial. JAMA 288:2282–2292PubMed
107.
Bowers CY, Merriam GR, Veldhuis JD (2008) Validation of growth-hormone-releasing peptide 2 for the diagnosis of adult growth hormone deficiency. Nat Clin Pract Endocrinol Metab 4:68–69PubMed
Metadaten
Titel
Der Effekt von Wachstumshormon auf die menschlichen Alterungsprozesse. Teil 2
verfasst von
Prof. Dr. med. Michael Klentze
Publikationsdatum
12.06.2018
Verlag
Springer Vienna
Erschienen in
Gynäkologie in der Praxis / Ausgabe 4/2018
Print ISSN: 3005-0758
Elektronische ISSN: 3005-0766
DOI
https://doi.org/10.1007/s41974-018-0059-3

Weitere Artikel der Ausgabe 4/2018

Journal für Gynäkologische Endokrinologie/Österreich 4/2018 Zur Ausgabe

Die Mädchensprechstunde

UpDate 2018: Kupferspirale, Kupferkette, Kupferperlen-Ball

aktuell

Bakterielle Vaginose und Fluomizin

News-Screen Menopause

Alternative Therapien im Klimakterium

News-Screen Assistierte Reproduktion

News-Screen Assistierte Reproduktion

aktuell

Hormonelle Therapie bei Akne: wann, warum, wie oft?

Editorial

Editorial