Follicular phase hypothalamic-pituitary-gonadal axis function in women with fibromyalgia and chronic fatigue syndrome.
OBJECTIVE
Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are clinically overlapping stress associated disorders. Neuroendocrine perturbations have been noted in both syndromes, and they are more common in women, suggesting abnormalities of gonadal steroid hormones. We tested the hypothesis that women with FM and CFS manifest abnormalities of the hypothalamic-pituitary-gonadal (HPG) hormonal axis.


METHODS
We examined the secretory characteristics of estradiol, progesterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH), including a detailed analysis of LH in premenopausal women with FM (n = 9) or CFS (n = 8) during the follicular phase of the menstrual cycle compared to matched healthy controls. Blood was collected from an indwelling intravenous catheter every 10 min. over a 12 h period. LH was assayed from every sample; pulses of LH were identified by a pulse-detection program. FSH and progesterone were assayed from a pool of hourly samples for the 12 h period and estradiol from samples pooled over four 3 h time periods.


RESULTS
There were no significant differences in FSH, progesterone, or estradiol levels in patients versus controls. There were no significant differences in pulsatile secretion of LH.


CONCLUSIONS
There is no indication of abnormal gonadotropin secretion or gonadal steroid levels in this small, but systematic, study of HPG axis function in patients with FM and CFS.
Korszun
A
A
Department of Psychological Medicine, University of Wales College of Medicine, Cardiff, UK. akorszun@umich.edu
Young
E A
EA
Engleberg
N C
NC
Masterson
L
L
Dawson
E C
EC
Spindler
K
K
McClure
L A
LA
Brown
M B
MB
Crofford
L J
LJ
D000293:Adolescent; D000328:Adult; D002940:Circadian Rhythm / Q000502:physiology; D004958:Estradiol / Q000097:blood / Q000172:deficiency; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005356:Fibromyalgia / Q000097:blood / Q000503:physiopathology*; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000502:physiology*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D010053:Ovary / Q000502:physiology*; D010902:Pituitary Gland / Q000502:physiology*; D011374:Progesterone / Q000097:blood
D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone