Gonadotropic patterns in psychogenic amenorrhea.

Abstract

Luteinizing hormone (LH) and follicle stimulating hormone (FSH) patterns were studied in 16 patients with psychogenic estrogen-deficient amenorrhea of at least 1 year duration to determine whether or not these patterns illuminate the mechanism of estrogen deficiency. Each subject had a history of profound emotional stress. Gonadotropin levels by radioimmunoassay were (in milliinternational units per milliliter): 1) high LH (41-76) and low-normal FSH (7-10) in 4 subjects; 2) high LH (40-70) and high FSH (83-102) in 2 patients; 3) high-normal LH (31-33) and FSH (24-25) in 2 subjects; and 4) normal to low LH (3-18) and FSH (5-15) in 8 subjects. These various gonadotropin patterns may be mistaken for 1) polycystic ovarian disease or 2) premature menopause so diagnostic care is emphasized. Findings reveal no correlation between estrogen levels as determined by vaginal cytology and gonadotropin levels in psychogenic amenorrhea and psychogenic stress can induce a variety of gonadotropin patterns without the modulating effect of estrogen.