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Cited by 146Hypothalamic control of reproductive hormonesAdrenal Hormones and DisordersStress Responses and Cortisol

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Hypercortisolism in patients with functional hypothalamic-amenorrhea

SUH, B. Y., LIU, J. H., BERGA, S. L., QUIGLEY, M. E., LAUGHLIN, G. A., YEN, S. S.·1988·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem-66-4-733
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Abstract

Hypercortisolism was found in patients with functional hypothalamic amenorrhea (HA) in preliminary short term studies conducted during the morning hours (0800-1100 h). This observation prompted us to characterize the circadian and pulsatile patterns of serum cortisol and LH levels at 15-min intervals for 24 h in 10 women with functional HA and in 7 normal women during the early follicular phase of their cycles. The mean integrated 24-h serum cortisol levels (area under the curve) were significantly (P less than 0.01) higher in the HA patients than in normal women. The mean cortisol levels in the HA patients were elevated (P less than 0.005) compared to those in the normal women during the daytime hours (0800-1600 h), but not during the evening (1600-2400 h) and sleeping hours (2400-0800 h). This selective hypercortisolism during the waking period of the day was almost entirely related to increased duration and amplitude of secretory episodes (peak area) rather than a change in pulse frequency. The serum cortisol increments in response to a noon meal that occurred in normal women were markedly impaired (P less than 0.01) in the HA patients. Compared with that in the normal women, mean LH pulse frequency was reduced by 30% in the HA patients. The 24-h mean LH levels and mean LH pulse amplitude were not significantly different from those in the normal women. However, among the HA patients there were marked individual differences in LH pulse frequency and amplitude, with prolonged interpulse quiescent periods, indicative of dysfunction of the hypothalamic GnRH pulse generator. We conclude that neuroendocrine activation of the ACTH-adrenal axis and inhibition of the GnRH pulse generator in women are associated with HA. Further, spontaneous resumption of normal cyclicity occurred in the majority (8 of 10) of the HA patients with no medical treatment, suggesting that this syndrome is a reversible hypothalamic disorder of a functional nature.

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Metadata

Authors
SUH, B. Y., LIU, J. H., BERGA, S. L., QUIGLEY, M. E., LAUGHLIN, G. A., & YEN, S. S.
Affiliations
University of California San Diego (US)
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1988-04
Volume
66
Issue
4
Pages
733-739
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem-66-4-733
OpenAlex
W1987131378
Cited by
146
References
0
Citations by year
2025: 2 · 2023: 1 · 2022: 4 · 2020: 7 · 2018: 2 · 2017: 3 · 2016: 2 · 2014: 5 · 2013: 3
FWCI
7.33
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Center for Research Resources (RR00827)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD-21198, HD-12303-08)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
functional hypothalamic amenorrhea, hypercortisolism, diurnal cortisol rhythm, luteinizing hormone pulsatility, menstrual cycle resumption, hypothalamic-pituitary-adrenal axis
MeSH terms
Adrenocortical Hyperfunction, Adult, Amenorrhea, Circadian Rhythm, Female, Food, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Luteinizing Hormone, Pituitary-Adrenal System, Pulsatile Flow

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