Comparison of the estrogen feedback control mechanism between women with normal and polycystic ovaries

Abstract

A clinical assay was designed to test the functional capability of the internal feedback mechanisms of ovarian steroids on the hypothalamic-pituitary function in normal women and in those with the polycystic ovary syndrome. In the control group of normally menstruating women, the aim of the experimental design was to inhibit the preovulatory estrogen peak and thereby inhibit the LH flood and corpus luteum formation. This was accomplished partially in 4 of the 5 subjects, as judged by their deficient pregnanediol excretion and by their inability to increase progesterone production under HCG stimulation. The assumption that a decrease in 17-ketosteroid values following a dexamethasone and simultaneous stilbestrol suppression test can be construed as indicating a suppression of pituitary gonadotropin is invalidated by examination of urinary estrogen excretion. The results obtained in patients with the Stein-Leventhal syndrome are compatible with the assumption that there is in fact a disruption of the estrogen negative feedback mechanism which allows for a persistent FSH and ICSH stimulation.