Progesterone-induced augmentation of pituitary gonadotrophin responses to luteinizing hormone-releasing hormone in oestrogen-pre-treated amenorrhoeic women

Abstract

Modulating effects of oestradiol--17 beta and progesterone on the pituitary responsiveness in luteinizing hormone-releasing hormone (LRH) were investigated in 12 women with functional amenorrhoea. The pituitary reserve capacity for gonadotrophin section was investigated with repeated intravenous LRH tests before and after administration of oestradiol-1 beta followed by either progesterone or saline. Intramuscular injection of 1 mg of oestradiol-17 beta benzoate resulted in a suppression of both the basal gonadotrophin levels in serum and the gonadotrophin responses to LRH 24 h later. Progesterone, 25 mg im, was then administered in eleven experiments. Six h later, when the mean serum progesterone level had increased to levels similar to those seen in the early post-ovulatory phase of the menstrual cycle, there was a marked augmentation of the pituitary capacity to release both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in response to LRH. This was not found in eight experiments where saline was given instead of progesterone after oestrogen pretreatment. These findings suggest that the greatly increased pituitary sensitivity to LRH at midcycle may be caused not only by the oestradiol increase in blood during the late follicular phase but also in part by the small pre-ovulatory rise of progesterone during the mid-cyclic LH peak. Furthermore, they add further support to the hypothesis that progesterone as well as oestradiol is involved in the induction of the LH peak at mid-cycle. Progesterone may be of importance to secure the release of enought LH for ovulation and normal corpus luteum formation to occur.