Opioid peptides in pseudocyesis

Five women with pseudocyesis were evaluated during a two-year period. A random, nontimed blood sample was obtained from each woman at the time of initial encounter that revealed a hormone pattern most consistent with polycystic ovarian disease; mean (+/- SE) concentration of luteinizing hormone (LH) was 14.2 +/- 2.1 mIU/mL, follicle-stimulating hormone (FSH) was 3.3 +/- 0.7 mIU/mL, prolactin (PRL) was 23.5 +/- 1.3 ng/mL, estrone was 74.7 +/- 15.0 pg/mL, and estradiol was 54.7 +/- 13.0 pg/mL. In four of these patients, serum progesterone concentration was elevated over expected follicular phase values. The opiate antagonist, naloxone, was administered to four women before disclosure of their diagnosis. Naloxone treatment failed to induce LH or PRL release. Because naloxone did not cause a change in hormone concentration, naloxone-sensitive opioid mechanisms are apparently not involved in this disorder. After resolution of pseudocyesis, naloxone-induced LH release was appropriate for the phase of the cycle in which the narcotic blocking agent was administered.