Authors

Alessandro D. Genazzani, M.D., Ph.D., Blazej Meczekalski, M.D., Agnieszka Podfigurna-Stopa, M.D., Susanna Santagni, M.D., Erica Rattighieri, M.D., Federica Ricchieri, M.D., Elisa Chierchia, M.D., Tommaso Simoncini, M.D., Ph.D.

Volume 97, Issue 2 , Pages 483-488

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 μg 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 (E2), androstenedione (A), 17α-hydroxyprogesterone (17-OHP), cortisol, androstenedione (A), testosterone (T), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), 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.

Read the full text at: http://www.fertstert.org/article/S0015-0282(11)02758-0/fulltext