Clinical findings and hormonal responses in patients with polycystic ovarian disease with normal versus elevated LH levels.
The clinical features, ovarian pathology, and hormonal responses to dexamethasone (Dex), Dex + ethinyl estradiol (EE), and Dex + hCG were compared in 5 women with polycystic ovarian disease (PCOD) who have normal 24-hr urinary luteinizing hormone (LH levels to 5 who had elevated urinary LH levels. No differences were noted in the clinical features. There was no correlation between ovary size and LH levels. Three in the normal-LH group had hyperthecosis. Plasma androstenedione (A) was more frequently elevated in the high-LH group. Dex + EE markedly increased LH secretion in the high-LH group, suggesting increased responsiveness of the positive feedback control mechanism of LH secretion in the high-LH group. There was a greater response of A, testosterone (T), and 17-ketosteroids to Dex + hCG in the normal-LH group. Those with high-LH levels did not exhibit a significant increase in A, T,  and 17-KS with hCG. The limitations and usefulness of the Dex + hCG test are discussed. The hypothesis is advanced that the increased LH secretion in the high-LH group is due at least in part to positive feedback resulting from the increased A levels. The amount of 17beta-oxidoreductase activity in the ovary may influence LH secretion in PCOD.
D015068:17-Ketosteroids / Q000378:metabolism; D000328:Adult; D000735:Androstenedione / Q000378:metabolism; D006063:Chorionic Gonadotropin / Q000494:pharmacology; D004997:Ethinyl Estradiol / Q000494:pharmacology; D005260:Female; D006801:Humans; D007986:Luteinizing Hormone / Q000378:metabolism* / Q000652:urine; D010053:Ovary / Q000378:metabolism*; D010088:Oxidoreductases / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000378:metabolism* / Q000652:urine; D013739:Testosterone / Q000378:metabolism
D015068:17-Ketosteroids; D006063:Chorionic Gonadotropin; D013739:Testosterone; D000735:Androstenedione; D004997:Ethinyl Estradiol; D007986:Luteinizing Hormone; D010088:Oxidoreductases