van Hooff M H, Voorhorst F J, Kaptein M B, Hirasing R A, Koppenaal C, Schoemaker J
Research Institute for Endocrinology, Reproduction and Metabolism, Division of Reproductive Endocrinology and Fertility, Vrije Universiteit Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Hum Reprod. 1999 Sep;14(9):2223-9. doi: 10.1093/humrep/14.9.2223.
Hospital based studies have shown that oligomenorrhoeic adolescents have high luteinizing hormone (LH) and androgen concentrations, endocrine signs of polycystic ovary syndrome (PCOS). The prevalence of these abnormalities in an unselected population of adolescents is not known. We determined LH, follicle stimulating hormone (FSH), androstenedione, testosterone, dehydroepiandrosterone sulphate (DHEAS), oestradiol and prolactin concentrations in unselected population samples of adolescents with oligomenorrhoea, secondary amenorrhoea and regular menstrual cycles. A total of 2248 white, west European adolescents, aged 15.3 +/- 0.6 (mean +/- SD) years, participated. Blood was taken from 107 adolescents with regular menstrual cycles, 52 with oligomenorrhoea and four with secondary amenorrhoea. Oligomenorrhoeic adolescents had higher mean LH, androstenedione, testosterone, DHEAS and oestradiol concentrations compared with girls with regular menstrual cycles; 57% of the oligomenorrhoeic girls had LH or androgen concentrations above the 95th centile of adolescents with regular menstrual cycles. None of the 52 oligomenorrhoeic girls and only one of four girls with secondary amenorrhoea had a hypogonadotrophic endocrine pattern. The present study and available literature support the view that oligomenorrhoea in adolescents is not a stage in the physiological maturation of the hypothalamic pituitary-ovarian axis but an early sign of PCOS associated with subfertility. Physicians should consider endocrine evaluation before reassuring oligomenorrhoeic girls or prescribing oral contraceptives to these girls.
基于医院的研究表明，月经过少的青少年促黄体生成素（LH）和雄激素浓度较高，这是多囊卵巢综合征（PCOS）的内分泌特征。在未经过挑选的青少年人群中，这些异常情况的发生率尚不清楚。我们测定了未经过挑选的月经过少、继发性闭经和月经周期正常的青少年人群样本中的LH、促卵泡生成素（FSH）、雄烯二酮、睾酮、硫酸脱氢表雄酮（DHEAS）、雌二醇和催乳素浓度。共有2248名年龄在15.3±0.6（均值±标准差）岁的西欧白人青少年参与。从107名月经周期正常的青少年、52名月经过少的青少年和4名继发性闭经的青少年中采集了血液。与月经周期正常的女孩相比，月经过少的青少年的LH、雄烯二酮、睾酮、DHEAS和雌二醇平均浓度更高；57%的月经过少女孩的LH或雄激素浓度高于月经周期正常的青少年的第95百分位数。52名月经过少的女孩中没有一人，4名继发性闭经的女孩中只有一人具有低促性腺激素性内分泌模式。本研究及现有文献支持这样一种观点，即青少年月经过少并非下丘脑 - 垂体 - 卵巢轴生理成熟的一个阶段，而是与生育力低下相关的PCOS的早期迹象。医生在让月经过少女孩放心或给这些女孩开口服避孕药之前，应考虑进行内分泌评估。
