Gonadotropins and gonadal steroids in androgen insensitivity (testicular feminization) syndrome: effects of castration and sex steroid administration.

Gonadotropin control mechanisms were examined in 12 subjects with the complete syndrome of androgen insensitivity (testicular feminization). This study confirmed the presence of elevated luteinizing hormone (LH) and normal follicle-stimulating hormone (FSH) values in these subjects and suggests an intact feedback mechanism for FSH but not LH. This gives further credence to the opinion that estrogens and a nonsteroidal inhibin are important in FSH control. Because of an exaggerated pulsatile pattern of gonadotropins in intact and gonadectomized subjects, there were dramatic variations in gonadotropin levels. After gonadectomy, there was a marked rise in FSH and a further rise in LH. Administered estradiol benzoate and, to a lesser degree, testosterone propionate were capable of lowering LH levels. The effect of testosterone could be via conversion to estrogen(s) in the testes or elsewhere.