Estriol administration modulates luteinizing hormone secretion in women with functional hypothalamic amenorrhea

Estriol administration modulates the hypothalamuspituitary unit and promotes the recovery of luteinizing hormone synthesis and secretion in functional hypothalamic amenorrhea.

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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



To evaluate the influence of estriol administration on the hypothalamus-pituitary function and gonadotropins secretion in patients affected by functional hypothalamic amenorrhea (FHA).


Controlled clinical study.


Patients with FHA in a clinical research environment.


Twelve hypogonadotropic patients affected by FHA.


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.


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.


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.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.