FSH secretory pattern and degree of concordance with LH in amenorrheic, fertile, and postmenopausal women Downloaded from

FSH secretory pattern and degree of concordance with LH in amenorrheic, fertile, and postmenopausal women. Am. J. Physiol. 264 (Endocrinol. Metab. 27): E776-E781, 1993.-Pulsatile secretion of gonadotropin was investigated in amenorrheic patients and in fertile and postmenopausal women to assess both follicle-stimulating hormone (FSH) episodic secretion and its temporal coupling with luteinizing hormone (LH). Three groups of amenorrheic patients were studied: hyperandrogenic (n = 20), hypogonadotropic (n = 51), and normogonadotropic (n = 31). Nineteen fertile women (during the follicular and luteal phases of the cycle) and sixteen postmenopausal women were investigated as reference groups. All subjects demonstrated the presence of a distinct pulsatile pattern with LH and FSH pulses/4 h as follows: hyperandrogenie 3.95 t 0.26 and 3.85 t 0.2, hypogonadotropic 3.76 t 0.26 and 3.9 t 0.16, normogonadotropic 3.5 2 0.2 and 3.9 t 0.17 LH and FSH pulses/4 h, respectively (means t SE). Normal controls showed 4.1 t 0.2 and 3.1 & 0.2 pulses/4 h for LH (P < 0.05) and 3.2 * 0.1 and 3.6 t 0.3 pulses/4 h for FSH, during follicular and luteal phases, respectively. Postmenopausal women showed 3.6 & 0.2 and 3.0 t 0.3 pulses/4 h for LH and FSH, respectively. Specific concordance (SC) index demonstrated that LH and FSH were significantly and simultaneously secreted in all groups. Conversely, LH and FSH were not temporally related during the luteal phase. In conclusion, we report a distinct FSH episodic secretion and its temporal linkage with LH pulses irrespective of plasma concentrations of gonadal steroids in secondary amenorrhea. amenorrhea; luteinizing hormone and follicle-stimulating hormone concomitant secretion; pulsatile secretion; menstrual cycle; menopause MANY NEUROTRANSMITTERS, secretagogues, and hormones are secreted in an episodic manner Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) episodic secretions have been studied and reported to be temporally coupled both in men (30) and in women MATERIALS AND METHODS Subjects. Among the patients clinically evaluated in our department in the last 3 yr, 137 women were selected for this study after informed consent was obtained. The women underwent the regular procedure of hormonal analysis to assess the causes of their disturbances. All subjects showed normal thyroid and adrenal function and had not received any hormonal treatment for at least 3 mo. Amenorrheic patients were selected on the basis of the disappearance of menses at least 6 mo before the study and the absence of depression or psychiatric diseases assessed according to the Diagnostical Statistical Manual-III (revised) criteria. On the basis of the clinical evaluation and the hormonal results Reference groups consisted of 19 normally cycling (group 4) and 16 postmenopausal (group 5) women. Normal subjects were selected on the basis of the presence of normal menstrual cycles for the previous 12 mo, whereas postmenopausal women were enrolled only when natural menopause had occurred within the last 5 yr and the women had low estradiol plasma levels. All subjects underwent a pulsatility study of 4 h (sampling every 10 min) from 8 A.M. to 12 P.M., as previously described (12). Normally cycling women underwent the test twice, during the follicular (between day 6 and day 10) and the luteal phases (between day 19 and day 24) of the cycle. All samples were immediately centrifuged, and serum was stored frozen at -20°C until assayed. The study protocol was approved by the Human Studies Committee of the University of Modena, Italy. Assays. To determine LH and FSH concentrations an immunofluorimetric assay (Pharmacia, Uppsala, Sweden) was used because a highly sensitive assaying system was required. The assay was a time-resolved measurement, which is a sandwich fluorescence technique with two monoclonal antibodies raised against different epitopes of cy-and ,&subunits of LH and FSH E776 0193-1849/93 $2.0