Objective: To evaluate the influence of estriol administration on the hypothalamus-pituitary function and gonadotropins secretion in patients affected by functional hypothalamic amenorrhea (FHA). Design: Controlled clinical study. Setting: Patients with FHA in a clinical research environment. Patient(s): Twelve hypogonadotropic patients affected by FHA. Intervention(s): Pulsatility study of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and a gonadotropin-releasing hormone (GnRH) test (10 mg in bolus) at baseline condition and after 8 weeks of therapy with 2 mg/day of estriol. Main Outcome Measure(s): Measurements of plasma LH, FSH, estradiol (E-2), androstenedione (A), 17 alpha-hydroxyprogesterone (17-OHP), cortisol, androstenedione (A), testosterone (T), thyroid-stimulating hormone (TSH), free triiodothyronine (fT(3)), free thyroxine (fT(4)), and insulin, and pulse detection. Result(s): After treatment, the FHA patients showed a statistically significant increase of LH plasma levels (from 0.7 +/- 0.1 mIU/mL to 3.5 +/- 0.3 mIU/mL) and a statistically significant increase of LH pulse amplitude with no changes in LH pulse frequency. In addition, the LH response to the GnRH bolus was a statistically significant increase. Conclusion(s): Estriol administration induced the increase of LH plasma levels in FHA and improved GnRH-induced LH secretion. These findings suggest that estriol administration modulates the neuroendocrine control of the hypothalamus-pituitary unit and induces the recovery of LH synthesis and secretion in hypogonadotropic patients with FHA. (Fertil Steril(R) 2012;97:483-8. (C) 2012 by American Society for Reproductive Medicine.)
Estriol administration modulates luteinizing hormone secretion in women with functional hypothalamic amenorrhea
SIMONCINI, TOMMASO
2012-01-01
Abstract
Objective: To evaluate the influence of estriol administration on the hypothalamus-pituitary function and gonadotropins secretion in patients affected by functional hypothalamic amenorrhea (FHA). Design: Controlled clinical study. Setting: Patients with FHA in a clinical research environment. Patient(s): Twelve hypogonadotropic patients affected by FHA. Intervention(s): Pulsatility study of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and a gonadotropin-releasing hormone (GnRH) test (10 mg in bolus) at baseline condition and after 8 weeks of therapy with 2 mg/day of estriol. Main Outcome Measure(s): Measurements of plasma LH, FSH, estradiol (E-2), androstenedione (A), 17 alpha-hydroxyprogesterone (17-OHP), cortisol, androstenedione (A), testosterone (T), thyroid-stimulating hormone (TSH), free triiodothyronine (fT(3)), free thyroxine (fT(4)), and insulin, and pulse detection. Result(s): After treatment, the FHA patients showed a statistically significant increase of LH plasma levels (from 0.7 +/- 0.1 mIU/mL to 3.5 +/- 0.3 mIU/mL) and a statistically significant increase of LH pulse amplitude with no changes in LH pulse frequency. In addition, the LH response to the GnRH bolus was a statistically significant increase. Conclusion(s): Estriol administration induced the increase of LH plasma levels in FHA and improved GnRH-induced LH secretion. These findings suggest that estriol administration modulates the neuroendocrine control of the hypothalamus-pituitary unit and induces the recovery of LH synthesis and secretion in hypogonadotropic patients with FHA. (Fertil Steril(R) 2012;97:483-8. (C) 2012 by American Society for Reproductive Medicine.)I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.