Hypothalamic amenorrhea: Evidence for a central derangement of hypothalamic-pituitary-adrenal cortex axis activity

R. E. Nappi, F. Petraglia, A. D. Genazzani, G. D'Ambrogio, C. Zara, A. R. Genazzani

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the activity of the hypothalamic-pituitary-adrenal axis (HPA) in patients with hypothalamic amenorrhea. Patients, Participants: Amenorrheic women with a history of emotional stressful events and eumenorrheic women as control group were studied. Design: Pulsatile cortisol (F) secretion over a 4-hour period of time and plasma F responses to various neuroendocrine tests (naloxone, fenfluramine, corticotropin-releasing hormone [CRH], adrenocorticotropic hormone) were investigated. Results: Women with hypothalamic amenorrhea showed a F secretory pattern higher than normal women. In addition, the lack of naloxone or fenfluramine-induced release of F and a blunted F response to CRH test were observed. Conclusion: The increased activity of HPA in patients with hypothalamic amenorrhea is associated with an impaired activity of some central pathways (opioids and serotonin), suggesting multiple alterations in the hypothalamic control of pituitary- adrenal axis in amenorrheic women.

Original languageEnglish
Pages (from-to)571-576
Number of pages6
JournalFertility and Sterility
Volume59
Issue number3
Publication statusPublished - 1993

Keywords

  • adrenocorticotropic hormone
  • corticotropin-releasing hormone
  • cortisol
  • Hypothalamic amenorrhea
  • hypothalamus-pituitary-adrenal axis
  • opioids
  • pulsatility
  • serotonin

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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