ABSENCE OF POSITIVE FEEDBACK EFFECT OF OESTROGEN ON LH RELEASE IN PATIENTS WITH TESTICULAR FEMINIZATION SYNDROME

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Abstract
The response of serum LH [luteinizing hormone] to exogenous estrogen administration was studied in 5 patients with testicular feminization syndrome (TFS). The serum LH levels were elevated in all the patients, while serum testosterone levels were within the normal male range. Serum FSH [follicle stimulating hormone] levels were elevated in 4 patients and normal in 1 patient. I.v. administration of 100 .mu.g of LH-RH [luteinizing hormone releasing hormone] provoked a further increase in both LH and FSH. Following i.v. injection of 20 mg of conjugated estrogen (Premarin), the LH levels were serially determined until 120 h in TFS patients, 5 normal males, and 10 normal females during the mid-follicular phase. Both TFS patients and normal males showed no LH release following estrogen injection in contrast to normal females who displayed a significant increase in LH with a peak at 48-56 h after the injection. The insensitivity of the hypothalamus to androgen in TFS patients apparently does not affect the sex differentiation of the hypothalamus. The possible role of estradiol conversion from testosterone in the hypothalamus is discussed.