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Evidence of altered dopaminergic modulation of prolactin luteinizing hormone and tsh secretion in patients with normo prolactinemic amenorrhea


, : Evidence of altered dopaminergic modulation of prolactin luteinizing hormone and tsh secretion in patients with normo prolactinemic amenorrhea. Acta Endocrinologica 106(1): 8-14

Basal plasma concentrations of Prl, [prolactin], LH [luteinizing hormone], FSH, growth hormone, TSH, T3, T4, [triiodothyronine, thyroxine] resin T3 uptake (RT3U), and estradiol as well as hormone responses to i.v. metoclopramide (MTC) were investigated in 16 consecutive patients with normoprolactinemic, normogonadotropic amenorrhea. The control group consisted of 17 normal menstruating women between day 3 and 6 of the menstrual cycle. The mean age of the amenorrheic patients was 24.0 yr (range 19-34) and the mean duration of amenorrhea was 31 mo. (range 12-60). Amenorrheic patients had significantly (P < 0.05) lower basal levels of LH, estradiol and RT3U, whereas other hormone levels were similar in the 2 groups. Plasma Prl and TSH concentrations rose significantly (P < 0.05) after the administration of MTC in the 2 groups. A significant positive correlation (r = 0.69 P < 0.01) was found between the TSH response to MTC and basal TSH levels in controls, but not in amenorrheic patients. Plasma LH levels increased significantly (P < 0.05) in amenorrheic patients, but not in controls. The Prl and TSH responses to MTC were significantly (P < 0.001) lower in amenorrheic patients than in normal women. In amenorrheic patients none of the hormonal parameters correlated significantly (P > 0.05) with the percentage of ideal body weight. The hormonal changes in amenorrheic patients may in part be caused by a raised dopaminergic activity leading to a depression of central ovulatory mechanisms.

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