Endocrine Abstracts (2003) 5 P199

Treatment of hypogonadotropic hypogonadism in women with neuroendocrine disorders

IA Ilovaiskaia, AA Pischulin & EI Marova


Research Centre for Endocrinology, Moscow, Russia.


We observed 26 women from 19 to 40 years old (mean age 27) with hypogonadotropic hypogonadism (HH) due to different causes excluding prolactinomas. The continuance of HH was from 1 to 23 years (mean 6 years 4 months). Main complains were amenorrhea (all patients), urogenital disorders (18 patients), ingravescent memory and fatigue (17 patients). Biochemical blood test relieved increased cholesterol and high density lipoprotein levels in all patients, increased triglyceride levels in 13 women. DEXA showed loss of bone mineral density in lumbar vertebra minus1.0/3.8 SD, in femoral neck minus1.0/2.8 SD. Patients were treated with 2 mg of 17-beta-estradiol and 10 mg of dydrogesteron in sequenced manner for 12 months. After treatment the normalization of cholesterol and high density lipoprotein levels was observed in 18 patients. BMD increased on 5 to 8 percent in lumbar vertebra and on 3 to 6 percent in femoral neck. From 18 patients with initial urogenital disorders 14 women had no such clinical symptoms and other 4 women noted a great regress of them. All patients noticed subjective improvement of memory and well-being. Six women from 17 patients with secondary hypothyroidism demonstrated on HRT a decrease of free thyroxin levels in blood without TSH changes. Five women from 13 patients with hyperprolactinemia in previous anamnesis showed an increase of prolactin leves up to 1200 - 3000 mE/l within 3 months of treatment. There were not negative dynamic changes on brain MRI in patients with previous anamnesis of pituitary/brain tumours after 12 months of treatment.
Women with hypogonadotropic hypogonadism are at a high risk of dislipidemia, urogenital disorders and osteopenia. Hormonal replacement therapy provides positive effects on BMD, lipid profile, urogenital status and well-being of these patients. Women with associated hypothyroidism and/or hyperprolactinemia have to be under additional control of free thyroxin and prolactin levels.

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