INDUCTION OF OVULATION WITH LOW-DOSE ESTROGEN-PROGESTIN THERAPY IN AMENORRHEIC PATIENTS

  • 1 January 1982
    • journal article
    • research article
    • Vol. 27  (3) , 153-159
Abstract
Sixteen amenorrheic patients, 5 with ovarian and 11 with hypothalamic failure, were treated for 3 cycles with a biphasic low-dose estrogen-progestin regimen consisting of esterified estrogen, 1.5 mg/day for 21 days, combined for the last 7 days with norethisterone acetate, 5 mg/day. Serum FSH and LH [luteinizing hormone] decreased significantly (P < 0.01) during treatment in the ovarian failure group, and FSH in the hypothalamic failure group. Estradiol levels increased on average 2-fold during treatment and decreased again after treatment, these changes being slower in the hypothalamic than in the ovarian failure group. Withdrawal bleeding occurred in all patients during the treatment cycles. After treatment, 6 patients with hypothalamic failure had spontaneous menstrual bleedings. Judged by serum progesterone measurements, 1 ovulation occurred in each group during the treatment cycles, and in the hypothalamic failure group, 2 ovulations were observed 3 wk after treatment. Four women with secondary amenorrhea are presented, in whom conception occurred during biphasic estrogen-progestin treatment; 3 of these cases had hypergonadotrophic ovarian failure. Apparently low-dose estrogen-progestin treatment may induce ovulation in selected cases of hypothalamic and also of ovarian failure.