[The effect of estrogens on serum gonadotropins, prolactin and testosterone in postmenopausal women].
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Biomedical subjects
Publications and source records attributed to I Klepsch.
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Investigation of the gonadotropic function by radioimmunoassay of serum LH and FSH in 62 women with hypophyseal chromophobe adenoma and acromegaly in relation to age and by comparison with 40 normal women revealed low values for LH and FSH during the reporduction period (20--43 years) and increased values in the postmenopausal period (48--84 years) like in physiologic postmenopause. The increase of the gonadotropic function in the hypophyseal tumoral syndrome of the chromophobe adenoma and acromegaly type above the age of 48 from low values compared to the normal to high values like those in physiologic menopause (a gonadotropic turning phenomenon) demonstrate an alteration of the hypothalamic receptors in relation to age and to these diseases.
Using RIA for determining the plasmatic renin activity in orthostatism according to the method of Fyhrquist we obtained in the control group of adult subjects nonsignificant variations in relation with sex and age, and in the group with Cushing's syndrome associated with arterial hypertension nonsignificantly increased values as against the controls. In pathologic pregnancy (toxemic pregnancy with arterial hypertension and edemas), the plasmatic renin (PR) activity was significantly higher ( less than 0.001) than in the group with physiologic pregnancy.
The dynamics of the serum FSH, LH, GH, T, TSH, T3, T4, prolactin (PRL) and insulin levels was studied in 50 healthy boys aged between 8 and 18 years, in correlation with the development of the gonad (sexualization) assessed through the five-stage classification (G I-G V) proposed by Tanner. The results reveal the role of gonadotropins (especially LH) and testosterone in the growth and development of the child and especially in the sexualization process through a progressive increase from stage GI to GV. In stage GV, LH and T reach the values of an adult. GH shows a peak during the maximum height and weight increase. Thyroid hormones T3 and T4 also prove their role, showing higher values in the span of accelerated growth and significantly lower levels in the final stages of puberty (G IV-GV). The dynamics of prolactin secretion during the pubertal development shows (in all the 5 stages of sexualization) close serum levels. Serum insulin level also shows a progressive increase all along the pubertal years (from G I to G V).
Eight patients with sexual impotence, fertile and clinically normal, average age of 41, were given TU orally for 46 days, in a dose of 120 mg/day. The mean (+/- SE) plasma FSH, LH and testosterone levels were significantly lower than in a group of 20 healthy adult men, average age 36. In the course of treatment there were no significant changes of mean serum FSH and LH concentrations, while circulating testosterone levels rose significantly to normal levels throughout the whole study. Almost all patients reported a marked increase in sexual and mental activities. The identical pattern as in hypogonadotrophic hypogonadal patients is considered and a possible hypothalamo-hypophyseal deficiency in the pathogenesis of sexual impotence in all 8 subjects is envisaged.
Long-term variation (21-30 days) in the gonadotropic hormones level and testosterone was followed up in Klinefelter's syndrome (chromatine positive). Clinically, the authors followed up the development of the androgen-dependent target tissues before and after administration of 400 mg testosterone/month for 6 months. It was also found a fluctuation in the gonadotropic hormones secretion on a 21-30-day trial which differs from that of the normal adult male. We noticed a great variability of the androgen-dependent structures development in one and the same subject or in different subjects, and a low response to the action of big and prolonged doses of testosterone. The authors interpret these findings as a decrease in the sensitivity of the androgen-dependent target structures (hypothalamus and peripheral tissues) induced genetically and fundamenting the concept of the existence of a receptivity pathology.
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A study was carried out on a number of 17 subjects concerning the dynamics of LH and FSH response after stimulation with Gn-RH-LH/FSH. The results show a stimulation 10 minutes after quick i.v. injection of synthetic RH, with a peak at 20-30 minutes and a persistence of the response of up to 180 min. The variation of the response is proportional with the dose, the response to stimulation being higher for LH than for FSH. The response in the normal adult male is of 82-858% for LH and of 157-250% for FSH. In aged subjects there is an increased response capacity showing that the hypophysis still reacts at an advanced age, with variations depending on the individual characteristics. In Sheehan's syndrome the basal values of FSH and LH are low, with a slight response after stimulation with RH, suggesting the possibility of a partial regeneration of the hypophysis if any intact areas were left after the initial necrotic process.
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