title: Cerebrospinal fluid levels of corticotropin-releasing hormone in women with functional hypothalamic amenorrhea.
abstract: OBJECTIVE
  Women with functional hypothalamic amenorrhea are anovulatory because of reduced gonadotropin-releasing hormone drive. Several studies have documented hypercortisolemia, which suggests that functional hypothalamic amenorrhea is stress-induced. Further, with recovery (resumption of ovulation), cortisol decreased and gonadotropin-releasing hormone drive increased. Corticotropin-releasing hormone can increase cortisol and decrease gonadotropin-releasing hormone. To determine its role in functional hypothalamic amenorrhea, we measured corticotropin-releasing hormone in cerebrospinal fluid along with arginine vasopressin, another potent adrenocorticotropic hormone secretagog, and beta-endorphin, which is released by corticotropin-releasing hormone and can inhibit gonadotropin-releasing hormone.
  
  
  METHODS
  Corticotropin-releasing hormone, vasopressin, and beta-endorphin levels were measured in cerebrospinal fluid from 14 women with eumenorrhea and 15 women with functional hypothalamic amenorrhea.
  
  
  RESULTS
  Levels of corticotropin-releasing hormone in cerebrospinal fluid and of vasopressin were comparable and beta-endorphin levels were lower in women with functional hypothalamic amenorrhea.
  
  
  CONCLUSIONS
  In women with established functional hypothalamic amenorrhea, increased cortisol and reduced gonadotropin-releasing hormone are not sustained by elevated cerebrospinal-fluid corticotropin-releasing hormone, vasopressin, or beta-endorphin. These data do not exclude a role for these factors in the initiation of functional hypothalamic amenorrhea.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Pittsburgh School of Medicine and Magee-Womens Research Institute, 15213, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Berga
authors.forename: T L
authors.initials: TL
authors.lastname: Loucks-Daniels
authors.forename: L J
authors.initials: LJ
authors.lastname: Adler
authors.forename: G P
authors.initials: GP
authors.lastname: Chrousos
authors.forename: J L
authors.initials: JL
authors.lastname: Cameron
authors.forename: K A
authors.initials: KA
authors.lastname: Matthews
authors.forename: M D
authors.initials: MD
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000134:cerebrospinal fluid* / Q000209:etiology*; D002940:Circadian Rhythm; D003346:Corticotropin-Releasing Hormone / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000134:cerebrospinal fluid; D007027:Hypothalamic Diseases / Q000150:complications*; D012016:Reference Values
chemical_list: D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone