Oestrogens induce an LH surge in a prepubertal patient with 45,X gonadal dysgenesis under prolonged pulsatile LRH...

A nine year old prepubertal patient with 45,X gonadal dysgenesis received pulsatile LRH administration for 3 weeks, every 90 min 10 micrograms iv. In the first week LH and FSH levels increased from prepubertal levels into the castrate range. Under 2.5 micrograms ethinyloestradiol (EE) LH levelled off for 3 days, followed by an LH surge. FSH showed an ethinyloestradiol dose-dependent decrease. These data suggest that: 1) pulsatile LRH administration may help to distinguish prepubertally those Turner patients with potential ovarian function from those without; 2) oestrogens exert both a negative and positive feedback action at the pituitary level in the LRH treated human; 3) the pituitary does not need 'pubertal maturation' for developing positive feedback to oestrogens. This supports the notion that pubertal maturation is confined to suprapituitary changes.