PITUITARY STIMULATION TEST IN AMENORRHOEIC PATIENTS WITH NORMAL OR LOW SERUM OESTRADIOL

Publisher Website
Google Scholar
Abstract
A group of 15 patients with secondary amenorrhea were studied. In 8 of these patients (hypothalamic-pituitary dysfunction, HPD) the baseline plasma E2 concentration (47.7 .+-. 6.0 pg ml) was similar to the early follicular phase levels of the 9 control subjects (48.8 .+-. 3.3 pg/ml). The remaining 7 patients (hypothalamic-pituitary failure, HPF) had significantly lower plasma E2 values (19.8 .+-. 2.6 pg/ml). Plasma LH [luteinizing hormone] and FSH [follicle stimulating hormone] levels were similar in the 2 groups of patients as well as the controls. All patients and control subjects were sequentially stimulated with insulin induced hypoglycemia, GnRH[gonadotropin releasing hormone]-TRH [thyrotropin releasing hormone] and then GnRH alone. Although abnormal GH [growth hormone] and PRL [prolactin] responses to hypoglycemia and blunted PRL responses to TRH were obtained in the 2 groups of patients the results could not be correlated with plasma E2 baseline values. In both groups of patients, cortisol and TSH responses were comparable to the control subjects. Following the administration of GnRH the maximum LH response in patients of the HPF group was significantly lower (P < 0.025) than the LH response in patients of the HPD group. No statistically significant difference was found in the FSH response between the 2 groups. Most of the patients with secondary amenorrhea due to HPD have been shown to have most probably a hypothalamic derangement. Patients with HPF may have either a more profound hypothalamic involvement or an intrinsic pituitary alteration.

This publication has 2 references indexed in Scilit: