[Possibility of ovulation induction using naloxone in women with hypothalamic amenorrhea]

Within the study we treated 6 women suffering from hypothalamic amenorrhea with 4 mg naloxone intravenous daily. The duration of the study was at most 30 days. The estimation of hormonal baseline and changes occurs daily, furthermore everyday sonographic folliculometry. In 2 patients the chronic opiate receptor blockade leads to a drastic stimulation of gonadotropin secretion. One of these women (responder in Naloxone-Test) has a long standing elevation of LH and FSH resulting in an ovulation 2 days past end of the therapy. The other women (non-responder in Naloxone-Test) reaches a follicular growth till 17 mm follicle diameter following in preterm atresia during therapy. In another woman (minimal-responder in Naloxone-Test) occurs a short and weak elevation of gonadotropins without any basic stimulation of the hypothalamic-pituitary-ovary axis. The results of this study show that: 1. it's possible to discern an opioid mediated hypothalamic amenorrhea and 2. a Naloxone-Test or Naloxone-Stimulation-Test should be put before starting a therapy with opiate antagonists in hypothalamic amenorrhea.