Pituitary gonadotropins and ovarian function in adolescent dysfunctional uterine bleeding

Abstract

Pituitary-ovarian relationships were assessed over a 3-month period in 4 patients with adolescent dysfunctional uterine bleeding by serial measurements of estrogen and pregnanediol excreted in the urine, and plasma concentrations of LH and FSH. Three of the 4 patients showed two spontaneous anovulatory cycles with marked increases in estrogen excretion but with a failure of the normal midcycle surge of LH. Clomiphene initiated a rise in plasma FSH and LH with subsequent follicular development suggesting that the negative feedback relationship between estrogens and gonadotropins was intact. The concentrations of estradiol-17β and estrone in peripheral venous plasma were within normal limits for women in the reproductive age group. These results suggest that the absence of ovulation in these patients may be associated with a failure to discharge LH in response to increasing levels of estrogen. © 1973 by The Endocrine Society.