Hypergonadotropinemia with estradiol secretion in peri- and postmenopausal period

Plasma gonadotropins and estradiol levels were evaluated in 155 peri- and postmenopausal women. The average menopausal age was 52.5 years in 56 postmenopausal women. Plasma FSH and LH levels showed hypergonadotropinemia in many premenopausal women 45-49 years old, whose plasma estradiol levels, however, sometimes remained higher than 25 pg/ml. It was observed that 19 of 38 women (50%) had an estradiol level exceeding 25 pg/ml, of those 50-59 years old, whose gonadotropin level showed hypergonadotropinemia in 29 cases (76.3%). Ovarian vein levels of estradiol obtained during laparotomy of 21 patients were significantly higher than peripheral vein concentrations. In 3 of 5 climacteric women with irregular menstrual intervals and whose plasma gonadotropin level was within the postmenopausal range, some degree of estradiol secretion in the ovarian vein was detected. Estradiol was still present in the ovarian vein blood of some postmenopausal women. These data show that the basal gonadotropin level may become high several years before the menopause and that some ovarian function may be preserved after the menopause. Furthermore, it is possible that estrogen secretion may be disturbed by consistent hypersecretion of gonadotropins in the climacteric period.