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The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1983 Feb;71(2):248–257. doi: 10.1172/JCI110765

Selective inhibition of follicle-stimulating hormone secretion by estradiol. Mechanism for modulation of gonadotropin responses to low dose pulses of gonadotropin-releasing hormone.

J C Marshall, G D Case, T W Valk, K P Corley, S E Sauder, R P Kelch
PMCID: PMC436863  PMID: 6401767

Abstract

Prepubertal girls and gonadotropin-releasing hormone (GnRH)-deficient females secrete follicle-stimulating hormone (FSH) preferentially in response to intravenous GnRH. With continued pulsatile GnRH stimulation, FSH secretion is reduced when plasma estradiol (E2) is increasing. To delineate the mechanisms involved in these changing gonadotropin responses, e studied the effect of low dose (0.025 micrograms/kg) pulsatile injections of GnRH in females with varying degrees and/or duration of endogenous GnRH deficiency (idiopathic panhypopituitarism, PHP; isolated growth hormone deficiency, IGHD; isolated gonadotropin deficiency, IGD; and anorexia nervosa, AN; both at low body weight and after weight regain). In patients presumed to have the most severe GnRH deficiency (PHP), responses of both FSH and luteinizing hormone (LH) were small and delayed, and no increase in plasma estradiol occurred during the 5 d of GnRH injections. In patients previously exposed to prepubertal or adult levels of endogenous GnRH secretion (IGHD, IGD, AN at low body weight), a rapid initial FSH response occurred that subsequently declined when plasma estradiol rose to concentrations greater than 40-50 pg/ml. Prior therapy with estrogen (micronized estradiol, Estrace) abolished FSH responses but LH responses were only slightly impaired. The degree of FSH response was dependent upon the time of initiation of estrogen relative to the onset of GnRH injections. Administration of estrogen after the first GnRH injection inhibited gonadotropin responses, whereas later estrogen therapy (after 1 d of GnRH pulses) blunted the GnRH induced FSH secretion without significantly impairing the LH response. In weight-regained anorexic patients who had spontaneous pulsatile LH secretion and a mean basal plasma estradiol concentration of 53 +/- 15 pg/ml, administration of GnRH pulses did not change plasma LH and a minimal FSH response was seen. The data indicate that the pattern of gonadotropin responses to low dose GnRH injections depends upon the degree of previous exposure of the pituitary to endogenous GnRH. Furthermore, estradiol selectively inhibits FSH secretion by a direct action on the pituitary gland. This action of estradiol provides an explanation for the selective reduction in FSH responses to GnRH seen during pubertal maturation in girls and during the mid-follicular stage of the menstrual cycle.

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Selected References

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  1. Beumont P. J., Carr P. J., Gelder M. G. Plasma levels of luteinizing hormone and of immunoreactive oestrogens (oestradiol) in anorexia nervosa: response to clomiphene citrate. Psychol Med. 1973 Nov;3(4):495–501. doi: 10.1017/s0033291700054301. [DOI] [PubMed] [Google Scholar]
  2. Corley K. P., Valk T. W., Kelch R. P., Marshall J. C. Estimation of GnRH pulse amplitude during pubertal development. Pediatr Res. 1981 Feb;15(2):157–162. doi: 10.1203/00006450-198102000-00015. [DOI] [PubMed] [Google Scholar]
  3. Crowley W. F., Jr, McArthur J. W. Simulation of the normal menstrual cycle in Kallman's syndrome by pulsatile administration of luteinizing hormone-releasing hormone (LHRH). J Clin Endocrinol Metab. 1980 Jul;51(1):173–175. doi: 10.1210/jcem-51-1-173. [DOI] [PubMed] [Google Scholar]
  4. England B. G., Niswender G. D., Midgley A. R., Jr Radioimmunoassay of estradiol-17beta without chromatography. J Clin Endocrinol Metab. 1974 Jan;38(1):42–50. doi: 10.1210/jcem-38-1-42. [DOI] [PubMed] [Google Scholar]
  5. Goldenberg R. L., Vaitukaitis J. L., Ross G. T. Estrogen and follicle stimulation hormone interactions on follicle growth in rats. Endocrinology. 1972 Jun;90(6):1492–1498. doi: 10.1210/endo-90-6-1492. [DOI] [PubMed] [Google Scholar]
  6. Huseman C. A., Kelch R. P. Gonadotropin responses and metabolism of synthetic gonadotropin-releasing hormone (GnRH) during constant infusion of GnRH in men and boys with delayed adolescence. J Clin Endocrinol Metab. 1978 Dec;47(6):1325–1331. doi: 10.1210/jcem-47-6-1325. [DOI] [PubMed] [Google Scholar]
  7. Jacobson R. I., Seyler L. E., Jr, Tamborlane W. V., Jr, Gertner J. M., Genel M. Pulsatile subcutaneous nocturnal administration of GnRH by portable infusion pump in hypogonadotropic hypogonadism: initiation of gonadotropin responsiveness. J Clin Endocrinol Metab. 1979 Oct;49(4):652–654. doi: 10.1210/jcem-49-4-652. [DOI] [PubMed] [Google Scholar]
  8. Jaffe R. B., Keye W. R., Jr Estradiol augmentation of pituitary responsiveness to gonadotropin-releasing hormone in women. J Clin Endocrinol Metab. 1974 Nov;39(5):850–855. doi: 10.1210/jcem-39-5-850. [DOI] [PubMed] [Google Scholar]
  9. Job J. C., Garnier P. E., Chaussain J. L., Milhaud G. Elevation of serum gonadotropins (LH and FSH) after releasing hormone (LH-RH) injection in normal children and in patients with disorders of puberty. J Clin Endocrinol Metab. 1972 Sep;35(3):473–476. doi: 10.1210/jcem-35-3-473. [DOI] [PubMed] [Google Scholar]
  10. Katz J. L., Boyar R. M., Roffwarg H., Hellman L., Weiner H. LHRH responsiveness in anorexia nervosa: intactness despite prepubertal circadian LH pattern. Psychosom Med. 1977 Jul-Aug;39(4):241–251. doi: 10.1097/00006842-197707000-00005. [DOI] [PubMed] [Google Scholar]
  11. Leyendecker G. The pathophysiology of hypothalamic ovarian failure. Diagnostic and therapeutical considerations. Eur J Obstet Gynecol Reprod Biol. 1979;9(3):175–186. [PubMed] [Google Scholar]
  12. Leyendecker G., Wildt L., Hansmann M. Pregnancies following chronic intermittent (pulsatile) administration of Gn-RH by means of a portable pump ("Zyklomat")--a new approach to the treatment of infertility in hypothalamic amenorrhea. J Clin Endocrinol Metab. 1980 Nov;51(5):1214–1216. doi: 10.1210/jcem-51-5-1214. [DOI] [PubMed] [Google Scholar]
  13. Marshall J. C., Kelch R. P. Low dose pulsatile gonadotropin-releasing hormone in anorexia nervosa: a model of human pubertal development. J Clin Endocrinol Metab. 1979 Nov;49(5):712–718. doi: 10.1210/jcem-49-5-712. [DOI] [PubMed] [Google Scholar]
  14. Midgley A. R., Jr Radioimmunoassay: a method for human chorionic gonadotropin and human luteinizing hormone. Endocrinology. 1966 Jul;79(1):10–18. doi: 10.1210/endo-79-1-10. [DOI] [PubMed] [Google Scholar]
  15. Midgley A. R. Radioimmunoassay for human follicle-stimulating hormone. J Clin Endocrinol Metab. 1967 Feb;27(2):295–299. doi: 10.1210/jcem-27-2-295. [DOI] [PubMed] [Google Scholar]
  16. Moon Y. S., Dorrington J. H., Armstrong D. T. Stimulatory action of follice-stimulating hormone on estradiol-17 beta secretion by hypophysectomized rat ovaries in organ culture. Endocrinology. 1975 Jul;97(1):244–247. doi: 10.1210/endo-97-1-244. [DOI] [PubMed] [Google Scholar]
  17. Reitano J. F., Caminos-Torres R., Snyder P. J. Serum LH and FSH responses to the repetitive administration of gonadotropin-releasing hormone in patients with idiopathic hypogonadotropic hypogonadism. J Clin Endocrinol Metab. 1975 Dec;41(06):1035–1042. doi: 10.1210/jcem-41-6-1035. [DOI] [PubMed] [Google Scholar]
  18. Reiter E. O., Kulin H. E., Hamwood S. M. The absence of positive feedback between estrogen and luteinizing hormone in sexually immature girls. Pediatr Res. 1974 Aug;8(8):740–745. doi: 10.1203/00006450-197408000-00002. [DOI] [PubMed] [Google Scholar]
  19. Reiter E. O., Root A. W., Duckett G. E. The response of pituitary gonadotropes to a constant infusion of luteinizing hormone-releasing hormone (LHRH) in normal prepubertal and pubertal children and in children with abnormalities of sexual development. J Clin Endocrinol Metab. 1976 Aug;43(2):400–411. doi: 10.1210/jcem-43-2-400. [DOI] [PubMed] [Google Scholar]
  20. Richards J. S., Ireland J. J., Rao M. C., Bernath G. A., Midgley A. R., Jr, Reichert L. E., Jr Ovarian follicular development in the rat: hormone receptor regulation by estradiol, follicle stimulating hormone and luteinizing hormone. Endocrinology. 1976 Dec;99(6):1562–1570. doi: 10.1210/endo-99-6-1562. [DOI] [PubMed] [Google Scholar]
  21. Roth J. C., Kelch R. P., Kaplan S. L., Grumbach M. M. FSH and LH response to luteinizing hormone-releasing factor in prepubertal and pubertal children, adult males and patients with hypogonadotropic and hypertropic hypogonadism. J Clin Endocrinol Metab. 1972 Dec;35(6):926–930. doi: 10.1210/jcem-35-6-926. [DOI] [PubMed] [Google Scholar]
  22. Sauder S. E., Corley K. P., Hopwood N. J., Kelch R. P. Subnormal gonadotropin responses to gonadotropin-releasing hormone persist into puberty in children with isolated growth hormone deficiency. J Clin Endocrinol Metab. 1981 Dec;53(6):1186–1192. doi: 10.1210/jcem-53-6-1186. [DOI] [PubMed] [Google Scholar]
  23. Sherman B. M., Halmi K. A., Zamudio R. LH and FSH response to gonadotropin-releasing hormone in anorexia nervosa: Effect of nutritional rehabilitation. J Clin Endocrinol Metab. 1975 Jul;41(1):135–142. doi: 10.1210/jcem-41-1-135. [DOI] [PubMed] [Google Scholar]
  24. Sherman B. M., Korenman S. G. Measurement of serum LH, FSH, estradiol and progesterone in disorders of the human menstrual cycle: the inadequate luteal phase. J Clin Endocrinol Metab. 1974 Jul;39(1):145–149. doi: 10.1210/jcem-39-1-145. [DOI] [PubMed] [Google Scholar]
  25. Strickler R. C., Borth R., Woolever C. A. The pulsatile pattern of gonadotropin release in normal men, normal women, and amenorrheic women. Obstet Gynecol. 1977 Sep;50(3):340–346. [PubMed] [Google Scholar]
  26. Valk T. W., Corley K. P., Kelch R. P., Marshall J. C. Hypogonadotropic hypogonadism: hormonal responses to low dose pulsatile administration of gonadotropin-releasing hormone. J Clin Endocrinol Metab. 1980 Oct;51(4):730–738. doi: 10.1210/jcem-51-4-730. [DOI] [PubMed] [Google Scholar]
  27. Valk T. W., Corley K. P., Kelch R. P., Marshall J. C. Pulsatile gonadotropin-releasing hormone in gonadotropin deficient and normal men: suppression of follicle-stimulating hormone responses by testosterone. J Clin Endocrinol Metab. 1981 Jul;53(1):184–191. doi: 10.1210/jcem-53-1-184. [DOI] [PubMed] [Google Scholar]
  28. Valk T. W., Marshall J. C., Kelch R. P. Simulation of the follicular phase of the menstrual cycle by intravenous administration of low-dose pulsatile gonadotropin-releasing hormone. Am J Obstet Gynecol. 1981 Dec 1;141(7):842–843. doi: 10.1016/0002-9378(81)90717-1. [DOI] [PubMed] [Google Scholar]
  29. Wang C. F., Lasley B. L., Lein A., Yen S. S. The functional changes of the pituitary gonadotrophs during the menstrual cycle. J Clin Endocrinol Metab. 1976 Apr;42(4):718–728. doi: 10.1210/jcem-42-4-718. [DOI] [PubMed] [Google Scholar]
  30. Warren M. P., Jewelewicz R., Dyrenfurth I., Ans R., Khalaf S., Vande Wiele R. L. The significance of weight loss in the evaluation of pituitary response to LH-RH in women with secondary amenorrhea. J Clin Endocrinol Metab. 1975 Apr;40(4):601–611. doi: 10.1210/jcem-40-4-601. [DOI] [PubMed] [Google Scholar]
  31. Wildt L., Häusler A., Marshall G., Hutchison J. S., Plant T. M., Belchetz P. E., Knobil E. Frequency and amplitude of gonadotropin-releasing hormone stimulation and gonadotropin secretion in the rhesus monkey. Endocrinology. 1981 Aug;109(2):376–385. doi: 10.1210/endo-109-2-376. [DOI] [PubMed] [Google Scholar]
  32. Zeleznik A. J. Premature elevation of systemic estradiol reduces serum levels of follicle-stimulating hormone and lengthens the follicular phase of the menstrual cycle in rhesus monkeys. Endocrinology. 1981 Aug;109(2):352–355. doi: 10.1210/endo-109-2-352. [DOI] [PubMed] [Google Scholar]
  33. Zeleznik A. J., Schuler H. M., Reichert L. E., Jr Gonadotropin-binding sites in the rhesus monkey ovary: role of the vasculature in the selective distribution of human chorionic gonadotropin to the preovulatory follicle. Endocrinology. 1981 Aug;109(2):356–362. doi: 10.1210/endo-109-2-356. [DOI] [PubMed] [Google Scholar]
  34. diZerega G., Nixon W. E., Hodgen G. D. Intercycle serum follicle-stimulating hormone elevations: significance in recruitment and selection of the dominant follicle and assessment of corpus luteum normalcy. J Clin Endocrinol Metab. 1980 Jun;50(6):1046–1048. doi: 10.1210/jcem-50-6-1046. [DOI] [PubMed] [Google Scholar]

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