[Arginine-GnRH-TRH test in patients with primary hypothalamic amenorrhea]

In 8 patients with hypothalamic primary amenorrhea aged from 16 to 23 years (average age 19,4 years) a sequential stimulations test was performed with 0,5 g arginine hydrochloride per kg body weight, 25 micrograms gonadotropin-releasing hormone (GnRH) and 200 micrograms thyreotropin-releasing hormone (TRH). The response of the lactotropic, gonadotropic, thyreotropic and somatotropic cells of the pituitary was investigated. Serum levels of PRL, LH, FSH, TSH and HGH were determined by RIA. In all women hypoplastic ovaries were found by laparoscopy. In 7 patients tissue biopsies showed primordial follicles or primordial and secondary follicles, respectively. Investigations point to, that in hypothalamic primary amenorrhea at first the function of the gonadotropic and lactotropic cells of the pituitary is injured. The somatotropic cells could not be stimulated in 3 of 8 patients, the function of hypothalamo-pituitary-thyroid-axis in the stimulations test was normal in all women.