Nippoldt T B, Reame N E, Kelch R P, Marshall J C
Department of Internal Medicine, University of Michigan, Ann Arbor 48109.
J Clin Endocrinol Metab. 1989 Jul;69(1):67-76. doi: 10.1210/jcem-69-1-67.
During the luteal phase of the menstrual cycle, plasma progesterone (P) and estradiol (E2) concentrations are elevated, and LH (and by inference GnRH) pulse frequency is slow. In contrast, LH pulse frequency increases during the early follicular phase when plasma E2 and P are lower. To examine the mechanism(s) responsible for the slower GnRH pulse frequency in the luteal phase, we maintained plasma P, E2, or both at midluteal concentrations from the midluteal phase to the time of the next early follicular phase and measured the effects on LH secretion. Thirteen normal women with regular menstrual cycles were studied during two or three cycles. Blood was obtained every 10 min during 10-h studies. Control cycle luteal and early follicular studies were followed by a second control study in the luteal phase of the treatment cycle. P (six women), E2 (seven women), or both (five women) then were given twice daily by im injection for 6-12 days until the day corresponding to the early follicular study of the control cycle (EF + P, EF + E2, or EF + E2 + P). A final study was performed 1 week after the injections were discontinued (F). LH pulse frequency was low in the midluteal phase [3.2 +/- 0.2 (+/- SE) pulses/10 h] and increased by the early follicular phase (8.0 +/- 0.8 pulses/10 h) in the control cycles. The increase in LH pulse frequency was not significantly inhibited by administration of P (6.7 +/- 0.7 pulses/10 h; EF + P). However, during both E2 alone and E2 + P, LH pulse frequency remained low (EF + E2, 3.6 +/- 0.8; EF + E2 + P, 2.0 +/- 0.7 pulses/10 h). The mean plasma FSH concentrations paralleled changes in LH pulse frequency, increasing from the luteal to the early follicular phase in the control cycles and during P injections and remaining low during E2 and E2 + P injections. We conclude that continued exposure to P alone does not maintain GnRH pulse frequency at midluteal phase values and that any effect of P requires the presence of E2. As E2 alone maintained lower LH pulse frequency, E2 may act directly to decrease the pulsatile GnRH secretion or it may potentiate the effects of low (less than 3.2 nmol/L) P concentrations.
在月经周期的黄体期,血浆孕酮(P)和雌二醇(E2)浓度升高,促黄体生成素(LH,由此推断促性腺激素释放激素[GnRH])脉冲频率减慢。相比之下,在卵泡期早期,当血浆E2和P浓度较低时,LH脉冲频率增加。为了研究黄体期GnRH脉冲频率减慢的机制,我们从黄体中期到下一个卵泡期早期,将血浆P、E2或两者维持在黄体中期浓度,并测量其对LH分泌的影响。对13名月经周期规律的正常女性进行了两到三个周期的研究。在10小时的研究期间,每10分钟采集一次血液。在对照周期的黄体期和卵泡期早期研究之后,在治疗周期的黄体期进行第二次对照研究。然后,对6名女性给予P、7名女性给予E2、5名女性给予P和E2,每天肌肉注射两次,持续6 - 12天,直到与对照周期的卵泡期早期研究相对应的那天(EF + P、EF + E2或EF + E2 + P)。在停药1周后进行最后一项研究(F)。在对照周期中,黄体中期LH脉冲频率较低[3.2±0.2(±标准误)次脉冲/10小时],到卵泡期早期增加(8.0±0.8次脉冲/10小时)。给予P后,LH脉冲频率的增加未受到显著抑制(6.7±0.7次脉冲/10小时;EF + P)。然而,单独给予E2以及给予E2 + P时,LH脉冲频率均保持较低水平(EF + E2,3.6±0.8;EF + E2 + P,2.0±0.7次脉冲/10小时)。血浆促卵泡生成素(FSH)平均浓度与LH脉冲频率变化平行,在对照周期中从黄体期到卵泡期早期增加,在给予P期间也增加,而在给予E2和E2 + P期间保持较低水平。我们得出结论,单独持续暴露于P并不能使GnRH脉冲频率维持在黄体中期水平,P的任何作用都需要E2的存在。由于单独给予E2可维持较低的LH脉冲频率,E2可能直接作用以减少GnRH的脉冲式分泌,或者它可能增强低浓度(低于3.2 nmol/L)P的作用。