Gonadal function and morphology in non-cirrhotic female alcoholics: a controlled study with hormone measurements and ultrasonography

Abstract

Objective: To study the occurrence and mechanisms of gonadal dysfunction in women with alcohol abuse.

Design: Prospective study.

Setting: Helsinki University Central Hospital.

Subjects: Fifteen consecutive chronic female alcoholics without liver cirrhosis admitted for withdrawal treatment, were studied after cessation of alcohol intake. Twelve women had regular menstrual cycles, two appeared to be menopausal and one had hypothalamic amenorrhoea. The women with regular cycles were compared with eleven healthy controls.

Intervention: Blood was sampled for hormone measurements three times on cycle days 5 to 7, 11 to 14, and 19 to 22, and ultrasonography was performed on the same days as the first two hormonal studies.

Main outcome measures: Serum LH, FSH, prolactin, estrone, estradiol, progesterone, testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), the ovarian volume, the follicular diameter, the endometrial thickness.

Results: During the luteal phase of the menstrual cycle the serum concentration of testosterone was 65% (p < 0.01) higher and that of progesterone 23% (p > 0.05) lower in patients than in controls. During the follicular phase serum DHEAS level was decreased by 39% (p < 0.05) in patients. Otherwise the serum concentrations of the hormones studied were similar in patients and in controls. As assessed by ultrasonography, patients and controls did not differ with regard to size of the ovaries, follicle development, or the endometrial thickness.

Conclusions: Even heavy alcohol use has only minor permanent effects on ovarian function, at least until development of liver cirrhosis.