Kletzky O A, Davajan V, Nakamura R M, Mishell D R
J Clin Endocrinol Metab. 1975 Oct;41(4):660-8. doi: 10.1210/jcem-41-4-660.
Patients with secondary amenorrhea have been classified into 4 clincal groups. In order to further investigate these 4 groups, LH, FSH, and estradiol (E2) were measured at 15 min intervals for 4 h in 21 patients with secondary amenorrhea. Patients within each group had similar hormonal patterns, but there was a distinct variation among the groups. Three patients in group 1 (polycystic ovaries [PCO]) had elevated basal levels of only LH with marked irregular fluctuations. Seven patients in group II (hypothalamic-pituitary dysfunction) had normal basal levels of LH, FSH, and E2. Only LH showed oscillations of varying mahnitude and frequency. Eight patients in group III (hypothalamic-pituitary failure) had low or low-normal levels of LH, FSH, and low E2 with minimal or absent fluctuations. Three patients in group IV (ovarian failure) had high basal levels of FSH and LH and irregular fluctuations. This study confirmed the rationality of separating patients with secondary amenorrhea into 4 different groups. In addition, it was found that in group III patients, the total amount of LH secreted in a 4-hour period of time appears to be insufficient to stimulate E2 production from the ovary even when a single sample was found to be in the normal range.
继发性闭经患者已被分为4个临床组。为了进一步研究这4组患者，对21例继发性闭经患者每隔15分钟测量一次促黄体生成素（LH）、促卵泡生成素（FSH）和雌二醇（E2），共测量4小时。每组患者的激素模式相似，但组间存在明显差异。第1组（多囊卵巢[PCO]）中的3例患者仅LH基础水平升高，波动明显不规则。第II组（下丘脑-垂体功能障碍）中的7例患者LH、FSH和E2的基础水平正常。只有LH表现出幅度和频率各异的波动。第III组（下丘脑-垂体功能衰竭）中的8例患者LH、FSH水平低或低至正常，E2水平低，波动极小或无波动。第IV组（卵巢功能衰竭）中的3例患者FSH和LH基础水平高，波动不规则。本研究证实了将继发性闭经患者分为4个不同组的合理性。此外，研究发现，在第III组患者中，即使发现单个样本处于正常范围内，4小时内分泌的LH总量似乎也不足以刺激卵巢产生E2。
