SERUM FSH AND LH MEASUREMENTS IN EVALUATION OF MENSTRUAL DISORDERS

Serum FSH and LH levles were measured serially, for 30 days, in primary, oligo-, secondary amenorrheas, and amenorrheas associated with galactorrhea or obesity. Comparison with normal subjects revealed a lack of the characteristic midcycle FSH and LH hypersecretion in amenorrheic patients. Comparison among the amenorrheic patients, most of whom exhibited normal levels of FSH and LH, revealed differences in absolute levels and ratios of FSH and LH. Striking differences in the day-to-day patterns of serum FSH and LH were also noted. A significant correlation existed between the nature of these gonadotropin patterns and responsiveness of gonadotropins to clomiphene citrate. Thus, amenorrheic patients with either low or normal but unfluctuating gonadotropin levels responded poorly to clomiphene citrate, while those with normal levels which did fluctuate from day to day exhibited an ovulatory-type of gonadotropic response to clomiphene citrate. A hypothesis relating serum gonadotropin patterns to the intensity of hypothalamic regulation of gonadotropins is presented. © 1969.