Smiljanić N
Acta Obstet Gynecol Scand. 1977;56(1):9-13. doi: 10.3109/00016347709158331.
The effect of estradiol on FSH and LH secretion in 5 women with hypothalamic amenorrhea are presented. The functional capacity of the pituitary to secrete FSH and LH had been proved by testing with synthetic luteinizing hormone-releasing hormone (LH-RH) 100 mug i.m. The thyroid and adrenal functions were normal. In 3 patients estrogens were low-normal and in the other 2 extreme hypoestrogenism was found. Twelve days after the appearance of withdrawal bleeding each patient was given 10 mg estradiol benzoat (EB) i.m. In 3 patients a significant increase in the LH and a slightly smaller increase in the FSH concentration were noted, with an LH peak 60 to 84 hours after injection of EB. The first of these 3 patients became pregnant, in the second the biphasic BBT curve, urine pregnanediol excretion above 2.5 mg/24 hr and the histological finding of secretory endometrium indicated that ovulation had been successfully induced, while in the third patient, despite a satisfactory increase in the LH and FSH concentration, ovulation could not be induced. In the remaining 2 patients no increase in the LH and FSH concentrations was noted even as late as 96 hours after the injection of EB. In these women bleeding began on the 18th and 22nd day of the cycle, respectively, when histological examination revealed proliferative endometrium. The first 3 cases are classified as hypothalamic amenorrhea with dysfunction of the cyclic centre and the other 2 as hypothalamic amenorrhea with dysnfunction of the tonic centre. The effect of exogenous estrogens in patients with hypothalamic amenorrhea depends both on the functional capacity of the hypophysis and the capacity and condition of the tonic and cyclic centres in the hypothalamus.
本文介绍了雌二醇对5例下丘脑性闭经女性促卵泡生成素（FSH）和促黄体生成素（LH）分泌的影响。通过肌肉注射100μg合成促黄体生成素释放激素（LH-RH）进行检测，证实了垂体分泌FSH和LH的功能能力。甲状腺和肾上腺功能正常。3例患者雌激素水平略低于正常，另外2例则存在极度雌激素缺乏。在撤退性出血出现12天后，每例患者肌肉注射10mg苯甲酸雌二醇（EB）。3例患者LH显著升高，FSH浓度升高幅度略小，注射EB后60至84小时出现LH峰值。这3例患者中的第一例怀孕，第二例双相基础体温曲线、尿孕二醇排泄量高于2.5mg/24小时以及分泌期子宫内膜的组织学检查结果表明成功诱导排卵，而第三例患者尽管LH和FSH浓度有令人满意的升高，但仍无法诱导排卵。在其余2例患者中，即使在注射EB后96小时，LH和FSH浓度也未升高。在这些女性中，分别在周期的第18天和第22天出现出血，此时组织学检查显示为增殖期子宫内膜。前3例被归类为下丘脑性闭经伴周期中枢功能障碍，另外2例为下丘脑性闭经伴紧张中枢功能障碍。外源性雌激素对下丘脑性闭经患者的影响既取决于垂体的功能能力，也取决于下丘脑紧张中枢和周期中枢的能力及状态。
