Short-term estriol administration modulates hypothalamo-pituitary function in patients with functional hypothalamic amenorrhea (FHA)

Abstract

Objective: To evaluate the influence of short-term estriol administration (10 d) on the hypothalamus-pituitary function and gonadotropins secretion in patients affected by functional hypothalamic amenorrhea (FHA).

Study design: Controlled clinical study on patients with FHA (n = 12) in a clinical research environment.

Intervention(s): Hormonal determinations and gonadotropin (luteinizing hormone [LH] and FSH) response to a gonadotropin-releasing hormone (GnRH) bolus (10 μg) at baseline condition and after 10 d of therapy with 2 mg/d of estriol per os.

Main outcome measure(s): Measurements of plasma LH, FSH, prolactin, estradiol, androstenedione, 17α-hydroxyprogesterone, insulin, cortisol, thyroid-stimulating hormone, free triiodothyronine, and free thyroxine.

Result(s): After treatment, the FHA patients showed a statistically significant increase of both LH and FSH plasma levels and the significant increase of their responses to the GnRH bolus.

Conclusion(s): Estriol short-term therapy modulates within 10 d of administration the neuroendocrine control of the hypothalamus-pituitary unit and induces the recovery of both gonadotropins synthesis and secretion in hypogonadotropic patients with FHA.

Chinese abstract

目地：评估短期雌三醇治疗（10天）对功能性下丘脑性闭经患者下丘脑-垂体功能和促性腺激素分泌的影响。

实验设计：在临床研究环境下对功能性下丘脑性闭经患者(n=12)的对照性临床研究。

干预：在用雌三2mg/天口服10天后，测定激素和促性腺激素(黄体生成素[LH]和卵泡刺激素[FSH])对促性腺激素释放激素(GnRH) (基线及治疗后推注10ｕg))的反应。

主要测定指标：测定血清黄体生成素、卵泡刺激素、催乳素、雌二醇、雄烯二酮、17α-羟孕酮、胰岛素、皮质醇、促甲状腺素、游离三碘甲状腺原氨酸和游离甲状腺素。

结果：治疗后，功能性下丘脑性闭经患者的黄体生成素和卵泡刺激素血清水平显著增加，对促性腺激素释放激素(GnRH)的反应显著增加。

结论：在促性腺激素分泌不足的功能性下丘脑性闭经患者，10天的雌三醇短期治疗可调节下丘脑-垂体的神经内分泌功能，诱导促性腺激素合成和分泌的恢复。

• Estriol
• functional hypothalamic amenorrhea
• GnRH-stimulating test
• hypothalamic function

Acknowledgements

The authors are grateful to Riccardo Bonacini for the clinical assistance during the study.

Declaration of interest

All authors declare no conflict of interest.