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

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

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, February 2012

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.

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