title: Evidence that termination of the estradiol-induced luteinizing hormone surge in women is regulated by ovarian factors.
abstract: BACKGROUND
  The endogenous LH surge is the result of the estrogen-positive feedback effect. However, the factors that are responsible for the termination of LH surge are not known.
  
  
  OBJECTIVE
  The objective of the study was to investigate the mechanism that terminates the LH surge in women.
  
  
  METHODS
  Eight normally cycling women (aged 42-48 yr) were investigated in two cycles, i.e. cycle 1 (control) and cycle 2. In cycle 2 total abdominal hysterectomy plus bilateral salpingooophorectomy was performed on d 3. In both cycles, estradiol was administered transdermally at the dose of 100 microg on d 3 and 150 microg on d 4 and 5. Blood samples were obtained every 12 h from d 3 to 5 and every 6 h thereafter until d 9.
  
  
  RESULTS
  In both cycles, after suppression of gonadotropins, the women displayed an endogenous LH surge. The time intervals between the commencement of estradiol treatment and the LH surge onset (73.5 +/- 1.5 vs. 76.5 +/- 2.5 h) and peak LH values (11.4 +/- 1.9 vs. 12.4 +/- 3.1 IU/liter) were comparable in the two cycles (mean +/- sem). After peaking, LH values decreased gradually in cycle 1, whereas in cycle 2 they remained stable and were higher than the corresponding values in cycle 1 (P < 0.05). Before the LH surge onset, estradiol values showed in both cycles a preovulatory pattern of changes, but starting 24 h after the onset of the LH surge, they were lower in cycle 2 (P < 0.05). Progesterone levels were similar in both cycles until the day of the LH surge onset, but in cycle 2 they declined thereafter and were lower than in cycle 1 (P < 0.05).
  
  
  CONCLUSIONS
  It is suggested that ovarian factors rather than exhaustion of pituitary reserves are important for termination of the endogenous LH surge during the normal menstrual cycle.
authors.affiliation: Department of Obstetrics and Gynecology, University of Thessalia, 22 Papakiriazi Street, 41222 Larissa, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Dafopoulos
authors.forename: I
authors.initials: I
authors.lastname: Mademtzis
authors.forename: P
authors.initials: P
authors.lastname: Vanakara
authors.forename: A
authors.initials: A
authors.lastname: Kallitsaris
authors.forename: G
authors.initials: G
authors.lastname: Stamatiou
authors.forename: C
authors.initials: C
authors.lastname: Kotsovassilis
authors.forename: I E
authors.initials: IE
authors.lastname: Messinis
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D019540:Area Under Curve; D004958:Estradiol / Q000097:blood / Q000494:pharmacology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000502:physiology*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood / Q000502:physiology*; D008597:Menstrual Cycle / Q000187:drug effects / Q000502:physiology*; D008875:Middle Aged; D010053:Ovary / Q000187:drug effects / Q000502:physiology*
chemical_list: D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone