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Decreased Follicular Phase Gonadotropin Secretion Is Associated with Impaired Estradiol and Progesterone Secretion during the Follicular and Luteal Phases in Normally Menstruating Women^*

Division of Psychoneuroendocrinology, Max Planck Institut für Psychiatrie Munich, West Germany

Address all correspondence and requests for reprints to: Dr. U. Schweiger, Max Planck Institut für Psychiatrie, Kraepelinstr. 10, D-8000 Munich 40, West Germany.

We tested the hypothesis that disturbed follicular development and disturbed luteal progesterone (P₄) secretion are associated with reduced gonadotropin secretion in the early follicular phase by measuring pulsatile LH and FSH secretion at that time in 53 normally menstruating women. Three groups of women were identified on the basis of serum sex steroid concentrations (measured daily throughout the cycle) and luteal phase length. Group A (n = 27) had normal ovarian hormone secretion with peak serum estradiol (E₂) concentrations of 440 pmol/L or more, peak serum P₄ concentrations of 19 nmol/L or more, and luteal phase length of 9 days or more. Group B (n = 16) had normal peak serum E₂ values, but peak serum P₄ values less than 19 nmol/L and/or luteal phase length less than 9 days. Group C (n = 10) had peak serum E₂ values below 440 pmol/L. Risk factors for the disturbances found in groups B and C were exercise and/or intermittent dieting. Compared to group A, both groups B and C had reduced mean serum LH concentrations (3.1 ± 1.5 vs. 2.3 ± 1.4 and 2.0 ± 1.0 IU/L; P < 0.05) and reduced LH pulse frequencies (5.2 ± 2.1 vs. 3.5 ± 1.8 and 3.3 ± 2.3 pulses/12 h; P < 0.02). LH amplitude was similar in all 3 groups. Mean serum FSH concentrations were slightly but not significantly lower in group C. We conclude that reduced gonadotropin secretion during the follicular phase may indeed affect E₂ and P₄ secretion at later stages of the menstrual cycle. The patterns of alteration associated with disturbed E₂ and P₄ secretion in normally menstruating women are similar to those that occur in women with hypothalamic amenorrhea.

^* This work was supported by a grant from the Bundesministerium für Forschung und Technologie.

Received October 11, 1988.

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