Abstract
Menstrual disorders are frequent in women with CAH. With the purpose to analyze the effect of the hyperandrogenism on gonadotropin secretion, we have studied 12 women with 21 hidroxilase defiency, X age 19. 3years;six had amenorrhea, 4 oligomenorrhea and 2 were eumenorrheic. One of them had never received treatment, 2 stopped treatment 2-3 years before and 9 were on corticoid replacement. Serum E2, 17OH progesterone (17 OHP), urinary 17-Ketosteroids (17-KS)and pregnanotriol (triol), and spontaneous LH and FSH levels every 20 minutes during 12 nocturnal hours (5 studies) or 4-6 diurnal hours (8 studies), were measured. Results: Three patterns of gonadotropin secretion were detected: 1)Apulsatile, n=7: X LH 1.2±0.3 IU/L; 2)Low pulsatility n=4: X LH 2.7±1.1 IU/L, X pulse amplitude (P.A.) 3.2±1.6, X pulse frecuency (P.F.) 0.23±0.08 p/hour;3) Normal pulsatility n=2 X LH 7.6 IU/L, P.A. × 4.9 IU/L, P.F. × 0.43 p/hour. No correlation was observed between gonadotropin levels and 17OHP, 17-KS or triol at the moment of study; a weak(ns)correlation was found with those values1-2 years before the study. Two patients with optimal corticoid replacement since birth, and two untreated patients presented an apulsatile gonadotropin secretion pattern. Conclusion: CAH due to 21 hydroxylase deficiency is associated with variable degrees of impaired gonadotropin secretion, even in patients with adequate corticoid treatment, suggesting an hypothalamic alteration as a consecuence of the prenatal exposure to high androgen levels.
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Escobar, M., Domené, H., Ropelato, G. et al. 4 GONADOTROPIN SECRETION IN CONGENITAL ADRENAL HYPERPLASIA (CAH). Pediatr Res 36, 672 (1994). https://doi.org/10.1203/00006450-199411000-00028
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DOI: https://doi.org/10.1203/00006450-199411000-00028