Initiation of gonadotropin responsiveness in hypothalamic hypogonadism: comparison of pulsatile and continuous nocturnal subcutaneous administration of LH-RH.

An enhanced secretion of LH and FSH was observed in two patients with hypothalamic hypogonadism following treatment with nocturnal s.c. administration of LH-RH. Using portable infusion pumps two forms of therapy were used for 9 nights with a two months interval in between: A) continuous nocturnal s.c. LH-RH; B) pulsatile nocturnal s.c. LH-RH with administration of a bolus dose at 90 min intervals. Both therapeutical regimens induced a rise in the 8:00 h concentrations of LH. The secretory response of LH during an infusion of LH-RH (200 micrograms i.v.; t = 4 hours) was increased after both forms of therapy, whereas FSH secretion was enhanced only after the pulsatile mode of LH-RH application.