Vaughan Williams C A
Clin Endocrinol (Oxf). 1987 Jan;26(1):17-24. doi: 10.1111/j.1365-2265.1987.tb03634.x.
Seven women with secondary hypogonadism who had been previously unresponsive to two 5-d courses of clomiphene citrate, were treated with clomiphene citrate 100 mg daily for 10 d. LH and FSH concentrations were measured in serum collected at 15-min intervals for 5 h before and on the 10th day of treatment and oestradiol was measured in the first two samples on each day. Four women responded with an increase in the amplitude of LH pulses and in mean LH values and in three there was a marked increase in serum oestradiol concentrations. Three women who showed no gonadotrophin response were subsequently unresponsive to pulsatile LHRH therapy. These preliminary data are consistent with the hypothesis that hypothalamic hypogonadotrophism may result from hypersensitivity of the hypothalamus to oestrogen negative feedback and that the hypothalamic potential for secretion of LHRH is unimpaired. Prolonged treatment with clomiphene may provide a simple test of hypothalamic function in women with normal pituitary function.
7名继发性性腺功能减退的女性，此前对两个5天疗程的枸橼酸氯米芬均无反应，她们接受了每日100毫克枸橼酸氯米芬治疗10天。在治疗前5小时及治疗第10天，每隔15分钟采集血清检测促黄体生成素（LH）和促卵泡生成素（FSH）浓度，每天前两个样本检测雌二醇。4名女性LH脉冲幅度、平均LH值升高，3名女性血清雌二醇浓度显著升高。3名对促性腺激素无反应的女性随后对脉冲式促性腺激素释放激素（LHRH）治疗也无反应。这些初步数据符合以下假设：下丘脑性性腺功能减退可能是由于下丘脑对雌激素负反馈超敏所致，且下丘脑分泌LHRH的潜能未受损。对于垂体功能正常的女性，长期使用枸橼酸氯米芬可能提供一种简单的下丘脑功能测试方法。
