[The main directions of hormonal therapy of the service women].
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Biomedical subjects
Publications and source records attributed to S V Beskrovnyĭ.
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Blood thyrotropic hormone, thyroxin, tri-iodothyronine, FSH, LH, estradiol and progesterone levels were examined in 14 patients with primary hypothyroidism and 11 normal women of reproductive age. All the women under study were subjected to functional tests with intravenous thyroliberin (TRH) and metoclopramide. All hypothyroid patients had anovulatory infertility. Hyperprolactinemia was detected in 8 of 14 patients. It is demonstrated that hyperprolactinemia, developing in cases of primary hypothyroidism, is associated with impaired dopaminergic inhibition of pituitary lactotropics. Substitution thyroidin therapy resulted in the recovery of the normal ovulatory cycle in all but one patient with secondary pituitary microprolactinoma, and 8 patients became pregnant. It is believed that damaged dopaminergic regulation of hypothalamic luliberin (RH) secretion is a direct cause of ovarian dysfunction associated with primary hypothyroidism.
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Functional tests with i.v. injection of metoclopramide (10 mg) and thyroliberin (200 micrograms) with a record of PRL and TSH levels for 120 min. were performed in 87 women of reproductive age (19 healthy nonpregnant women, 9 women in the early postnatal period, 10 patients with primary hypothyroidism, and 30 patients with PRL secreting chromophobe adenomas). Hyperprolactinemic anovulation was noted in 35 examinees. Comparison of the results of thyroliberin and metoclopramide tests in different groups of examinees was suggestive of a decrease in dopaminergic inhibition of the hypophysis in postnatal and adenomatous hyperprolactinemia. The presence and a degree of hyperprolactinemia in patients with primary hypothyroidism depends, probably, on the ratio of a stimulating effect of endogenous thyroliberin and inhibitory action of dopamine on hypophyseal lactotrophs.
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