[The influence of endogenous opioids in hypothalamic amenorrhea. Diagnostic and therapeutic aspects].
We investigated the possibility of induction of ovulation by means of chronic opioid receptor blockade with naloxone. Daily 4 mg were given as an intravenous bolus injection in 4 women suffering from hypothalamic amenorrhea till the 30th day of therapy. A possible maturation of ovarian follicles and a subsequent ovulation should be proved by means of daily determination of LH, FSH, estradiol and progesterone as well as of a sonographic folliculometry. The day prior to and the first day of naloxone treatment we took blood samples every 10 minutes during 4 hours for determination of LH pulse frequency and amplitude. Neither we found any alteration of the basal values of LH, FSH and estradiol, nor we observed a follicular growth. These results lead us to the conclusion to introduce a naloxone stimulation test as a further diagnostic step. In this way opioid mediated hypothalamic ovarian insufficiencies could be registered and a sufficient therapy could be reached.
Krause
B
B
Klinik und Poliklinik für Gynäkologie und Geburtshilfe, Bereichs Medizin der Ernst-Moritz-Arndt-Universität, Greifswald.
Möller
S
S
Ulrich
U
U
Göretzlehner
G
G
D000568:Amenorrhea / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007027:Hypothalamic Diseases / Q000097:blood / Q000188:drug therapy*; D007275:Injections, Intravenous; D007986:Luteinizing Hormone / Q000097:blood; D009270:Naloxone / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011374:Progesterone / Q000097:blood; D011957:Receptors, Opioid / Q000187:drug effects*
D011957:Receptors, Opioid; D009270:Naloxone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone
Der Einfluss endogener Opioide bei hypothalamischer Amenorrhoe. Diagnostische und therapeutische Aspekte.