Effects of a long-acting gonadotropin-releasing hormone analog on the pituitary-ovarian-adrenal axis in women with severe hirsutism.
We evaluated modifications in the pituitary-ovarian-adrenal axis in severely hirsute women after administration of the gonadotropin-releasing hormone analog (GnRHa), D-Trp-6-luteinizing hormone-releasing hormone (LHRH) (Triptorelin) in a prospective study at a tertiary hospital. A total of 20 hirsute women aged 19 to 38 years were included. Hyperandrogenism of adrenal origin was excluded in all subjects. Patients received 3.75 mg D-Trp-6-LHRH intramuscularly (Decapeptyl 3.75; Lasa-Ipsen, Barcelona, Spain). Serum levels of follicle-stimulating hormone (FSH), LH, estradiol (E2), prolactin (PRL), testosterone (T), androstenedione (delta 4 An), dehydroepiandrosterone sulfate (DHEAS), 17-OH-progesterone (17-OHP), and sex hormone-binding globulin (SHBG) were determined before GnRHa administration, 24 and 48 hours after, and on days 7, 15, 30, and 45. GnRHa suppresses FSH, LH, and E2 in all women. Unexpectedly, adrenal steroids showed a flare-up phenomenon in the first days and subsequent decrease to lower values than before GnRHa administration. SHBG showed slight changes. After GnRHa, patients showed a significant decrease in T and delta 4 An: these hormones were reduced to half the basal levels. We conclude that GnRHa can potentially be used in the treatment of hyperandrogenism to reduce androgen levels in hirsute women.
Department of Gynaecology and Obstetrics, Hospital Clínic i Provincial, University of Barcelona Medical School, Spain.
C
C
Castelo-Branco
M J
MJ
Martínez de Osaba
S
S
Martínez
A
A
Fortuny
D000293:Adolescent; D000328:Adult; D000735:Androstenedione / Q000097:blood; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006628:Hirsutism / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007273:Injections, Intramuscular; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism / Q000502:physiology; D010913:Pituitary-Adrenal System / Q000187:drug effects* / Q000502:physiology; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D011863:Radioimmunoassay; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D017329:Triptorelin Pamoate / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use
D012738:Sex Hormone-Binding Globulin; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D011374:Progesterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone