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Endocrine Abstracts (2025) 109 OC3.1 | DOI: 10.1530/endoabs.109.OC3.1

1Imperial College London, London, United Kingdom; 2Newcastle Hospitals Trust, Newcastle, United Kingdom; 3University College London Hospitals NHS Trust, London, United Kingdom


Background: Polycystic Ovary Syndrome (PCOS) and Functional Hypothalamic Amenorrhoea (FHA) are the two commonest causes of menstrual disturbance. A fundamental abnormality that underpins these conditions is altered hypothalamic function, being increased in PCOS but reduced in FHA. Kisspeptin is a potent stimulator of hypothalamic GnRH secretion, and thus could be a novel tool to interrogate hypothalamic function in women presenting with menstrual disturbance.

Methods: Healthy women (n=43), women with PCOS (n=65), FHA (n=44), or congenital hypogonadotropic hypogonadism (CHH) (n=10) aged 18-35yrs not currently taking hormonal treatments, underwent two study visits, where they received an intravenous bolus of kisspeptin to interrogate hypothalamic function, and of GnRH to interrogate the pituitary response. Serum reproductive hormones were monitored 15-minutely for 8hrs.

Results: The mean (SD) of the maximal rise in LH (IU/l) after kisspeptin was 9.1 (10.3) in healthy women, 6.7 (5.7) in women with PCOS, 18.8 (12.5) in women with FHA, and 0.9 (1.0) in women with CHH. The mean (SD) of the maximal rise in FSH (IU/l) after kisspeptin was 3.7 (3.2) in healthy women, 2.1 (1.6) in women with PCOS, 9.3 (3.2) in women with FHA, and 0.6 (0.5) in women with CHH. The maximal rise in FSH after kisspeptin could differentiate women with lean PCOS (BMI <25 kg/m2) from those with FHA (area under ROC 0.95, P<0.0001). The maximal rise in FSH after kisspeptin could differentiate women with FHA from women with CHH (auROC 0.99, P<0.0001), whereas the equivalent auROC for FSH rise after GnRH was 0.74 (P=0.027).

Conclusion: Kisspeptin offers a novel approach to assessing hypothalamic function in patients presenting with different reproductive disorders causing oligo / amenorrhoea. Our data reveals for the first time that the hormonal response to kisspeptin has promising diagnostic potential to aid in the evaluation of women presenting with menstrual disturbance.

Volume 109

Society for Endocrinology BES 2025

Harrogate, UK
10 Mar 2025 - 12 Mar 2025

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