Bohnet H G, Dahlén H G, Wuttke W, Schneider H P
J Clin Endocrinol Metab. 1976 Jan;42(1):132-43. doi: 10.1210/jcem-42-1-132.
The functional status of the hypothalamo-pituitary-gonadal axis was investigated in 127 women with anovulatory disease. Radioimmunoassayable circulating LH, FSH, and prolactin concentrations were measured. An attempt was made to localize the functional lesion by utilizing the following criteria: 1. Hypothalamic function: a) clomiphene test based upon hormonal parameters; b) recording of the pulsatile LH fluctuation (spiking) and of basal FSH. 2. Pituitary function: determination of the gonadotropin reserve by means of a standardized LRH test. 3. Ovarian function: a) measurement of plasma E2 and progesterone levels by RIA; b) gestagen bleeding test. All patients had amenorrhea of up to 14 years duration. A total of 17 hyperprolactinemic patients (13.4%) was found. Eight of these patients never experienced galatorrhea, in 7 only transient galactorrhea was reported, and in 2 cases galactorrhea persisted. All hyperprolactinemic patients were found to be clomiphene non-responders as well as nonspikers. The pituitary LH reserve varied from practically none to normal. Baseline LH was low whereas that of FSH was normal. In accordance with this observation E2 levels, with two exceptions, were found to be in the lower range of normal female concentrations. Thus, all but two patients exhibited gestagen withdrawal bleeding. In conclusion, the hyperprolactinemic anvoluatory syndrome is not necessarily associated with galactorrhea. In all cases of amenorrhea syndromes with or without galactorrhea, hyperprolactinemia should be excluded as it is very often associated with anovulation. The hyperprolactinemic anovulatory syndrome includes the following features: 1. gestagen withdrawal bleeding. 2. subnormal to normal E2 levels. 3. clomiphene nonresponsiveness. 4. LH-hypogonadotropism. 5. lack of LH secretory episodes. 6. FSH-normogonadotropism.
对127例无排卵性疾病的女性患者的下丘脑 - 垂体 - 性腺轴功能状态进行了研究。检测了可通过放射免疫法测定的循环促黄体生成素（LH）、促卵泡生成素（FSH）和催乳素浓度。尝试通过以下标准定位功能损害：1. 下丘脑功能：a）基于激素参数的氯米芬试验；b）记录LH的脉冲波动（峰值）和基础FSH。2. 垂体功能：通过标准化的促性腺激素释放激素（LRH）试验测定促性腺激素储备。3. 卵巢功能：a）通过放射免疫分析法测量血浆雌二醇（E2）和孕酮水平；b）孕激素撤退试验。所有患者闭经时间长达14年。共发现17例高催乳素血症患者（13.4%）。其中8例患者从未出现溢乳，7例仅报告有短暂溢乳，2例溢乳持续存在。所有高催乳素血症患者对氯米芬无反应且无LH脉冲分泌。垂体LH储备从几乎没有到正常不等。基础LH水平较低，而FSH水平正常。根据这一观察结果，除两例外，E2水平均在正常女性浓度的较低范围内。因此，除两名患者外，所有患者均出现孕激素撤退性出血。总之，高催乳素血症性无排卵综合征不一定与溢乳有关。在所有有或无溢乳的闭经综合征病例中，都应排除高催乳素血症，因为它常与无排卵相关。高催乳素血症性无排卵综合征具有以下特征：1. 孕激素撤退性出血。2. E2水平低于正常至正常。3. 对氯米芬无反应。4. LH低促性腺激素血症。5. 缺乏LH分泌峰。6. FSH正常促性腺激素血症。
