Amenorrhea: Observations based on the analysis of luteninizing hormone–releasing hormone testing

Abstract

The basal serum gonadotropins--luteinizing hormone (LH) and follicle-stimulating hormone (FSH)--usually provide clues to the diagnosis of amenorrhea. This report analyzes the results of LHRH-testing (LH-releasing hormone) of a group of amenorrheic women at Duke University Medical Center between 1973 and '76. 130 patients with symptomatic amenorrhea underwent diagnostic testing with LHRH; extensive basal and dynamic laboratory tests and appropriate radiologic and operative studies were also performed. A control of 18 normally ovulatory women (18-35 years old) were tested during the early follicular phase of the menstrual cycle. The patients were grouped according to 13 diagnostic criteria for amenorrhea. Logarithms of 4 baseline and 13 response measurements were used to compare test results of both study and control groups. Gonadotropin measurements revealed a logarithmic distribution; each diagnostic category showed multiple significant differences when compared with the controls. The occurrence of significant changes in either positive or negative directions for both LH and FSH were the same in all the categories in the following response parameters: peak, mean change, area, and peak change, with exceptions for the FSH area and FSH peak in the postpill amenorrhea category. The findings in this study precludes the routine use of LHRH test as a differential diagnostic tool; rather its diagnostic use should be confined to pathophysiologic research.