Evidence for gonadal desensitization after pulsatile therapy in women with amenorrhoea?
Sixteen women with primary and secondary amenorrhoea were treated with pulsatile GnRH administered subcutaneously. Ovulation was successfully induced in 6/8 women with hypogonadotrophic hypogonadism; and in 2/2 women with idiopathic hyperprolactinaemia; but in only 3/6 women with amenorrhoea associated with an elevated LH:FSH ratio. Using serial blood sampling, we were unable to demonstrate the establishment of a physiological pattern of gonadotrophin secretion in the presence of an apparently normal menstrual cycle. Nor did we observe a consistent relationship between injection of GnRH and the resultant gonadotrophin response. A reduction or total cessation of both pituitary and gonadal sensitivity to GnRH was observed in four women. Possible reasons for these findings are discussed.
D000328:Adult; D000568:Amenorrhea / Q000188:drug therapy*; D003404:Creatinine / Q000097:blood; D004334:Drug Administration Schedule; D004967:Estrogens / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000187:drug effects*; D010906:Pituitary Hormone-Releasing Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D011276:Pregnanediol / Q000097:blood
D004967:Estrogens; D010906:Pituitary Hormone-Releasing Hormones; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D003404:Creatinine; D011276:Pregnanediol