The effect of oral estrogen therapy on serum FSH and LH levels in young women with hyper-gonadotrophic ovarian failure.

Fourteen women, 18--46 years old (median age: 28 years) with hypergonadotrophic ovarian failure were each treated daily for 21 days with 10 micrograms, 20 micrograms, 40 micrograms, and 60 micrograms ethinyl estradiol, 2,000 micrograms estriol, and 1,250 micrograms conjugated estrogens in six or more consecutive treatment cycles in a randomly assigned sequences. Before treatment and at the beginning of the 3rd week of each of the mentioned estrogen regimens, basal serum FSH and LH levels were measured. During the last 5 days of each treatment cycle, 10 mg of oral norethisterone acetate were given in addition to the estrogen, and after a treatment-free interval of 7 days the next estrogen regimen was begun according to the random list. FSH values were inversely related to the various dosages of ethinyl estradiol; the upper normal range with the exception of the periovulatory phase was reached with 40--60 micrograms ethinyl estradiol. FSH levels during treatment with 1250 micrograms of conjugated estrogens were similar to those found during treatment with 20 micrograms ethinyl estradiol. When 2,000 micrograms of estriol were given daily, FSH levels rose of pretreatment values. LH behaved similarly except that during treatment with 2,000 micrograms of estriol and 10 micrograms of ethinyl estradiol values above pretreatment levels were found.