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Related Experiment Videos

Hypercortisolism in patients with functional hypothalamic-amenorrhea.

B Y Suh1, J H Liu, S L Berga

  • 1Department of Reproductive Medicine, School of Medicine, University of California-San Diego, La Jolla 92093.

The Journal of Clinical Endocrinology and Metabolism
|April 1, 1988
PubMed
Summary
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Women with functional hypothalamic amenorrhea (HA) exhibit elevated daytime cortisol levels due to increased secretion duration and amplitude. This neuroendocrine imbalance, alongside reduced LH pulse frequency, suggests a reversible functional hypothalamic disorder.

Area of Science:

  • Endocrinology
  • Neuroendocrinology
  • Reproductive Medicine

Background:

  • Preliminary studies indicated hypercortisolism in functional hypothalamic amenorrhea (HA) patients during morning hours.
  • This prompted a detailed investigation into the circadian and pulsatile patterns of cortisol and luteinizing hormone (LH) in HA.

Purpose of the Study:

  • To characterize 24-hour circadian and pulsatile patterns of serum cortisol and LH in women with functional HA.
  • To compare these patterns with those of normal cycling women.

Main Methods:

  • Collected serum cortisol and LH levels at 15-minute intervals for 24 hours in 10 women with functional HA and 7 normal women.
  • Analyzed mean integrated 24-hour levels, daytime and nighttime levels, secretory episode characteristics, and response to a noon meal.

Related Experiment Videos

  • Assessed LH pulse frequency, amplitude, and 24-hour mean levels.

    • Main Results:

    • Significantly higher mean 24-hour cortisol levels in HA patients (P < 0.01).
    • Elevated daytime cortisol in HA patients, linked to increased duration and amplitude of secretory episodes, not pulse frequency.
    • Impaired cortisol response to a noon meal in HA patients (P < 0.01).
    • Reduced mean LH pulse frequency by 30% in HA patients, with individual variations suggesting GnRH pulse generator dysfunction.

    Conclusions:

    • Neuroendocrine activation of the ACTH-adrenal axis and inhibition of the GnRH pulse generator are associated with functional HA.
    • Functional HA appears to be a reversible hypothalamic disorder, as evidenced by spontaneous resumption of normal cyclicity in most patients without treatment.