Inadequate Luteal Phase Research Articles

Effects of Prolonged Luteinizing Hormone-releasing Hormone Therapy on Follicular Maturation, Ovulation and Corpus Luteum Function in Amenorrhoeic Women with Anorexia Nervosa

Nine amenorrhoeic women with anorexia nervosa (AN) were given long-term treatment with 500 microgram of synthetic luteinizing hormone-releasing hormone (LRH) every 8 h. All the women had impaired luteinizing hormone (LH) secretion and no evidence of endogenous oestrogen production. Three of them also had deficient follicle-stimulating hormone (FSH) secretion. The pituitary reserve capacity for gonadotrophin secretion was normal but the response pattern to LRH was similar to that described in prepubertal girls. The constant administration of LRH normalized basal LH and FSH secretion and induced a cyclical gonadotrophin secretory pattern with differential changes of the LH and FSH responses to LRH during the treatment. LRH-induced gonadotrophin secretion produced follicular growth and maturation in all the women. Presumptive ovulation also occurred during the 8 treatment courses in which only LRH was administered. However, inadequate luteal phases were observed during 6 of these 8 cycles. Combined therapy with LRH and human chorionic gonadotrophin (HCG) during 5 treatment courses resulted in normal ovulatory cycles with adequate corpus luteum function.

Clinical Investigation of the Menstrual Cycle. II. Neuroendocrine Investigation and Therapy of the Inadequate Luteal Phase

Nonhormonal drugs--diphenylhydantoin and nialamide, which act on the central nervous system and have no known endocrine activity--were given to two groups of women with distinct types of electroencephalographic patterns in an effort to regulate menstrual disorders. Equalization of the lengths of both the follicular phase and the luteal phase to the normal range was observed during the drug therapy. Forty-five per cent of the pregnancy rate was achieved in 36 of the 80 infecund patients within 4 months of treatment. The mode of action of these drugs is still unknown.

Plasma Progesterone in Women with a History of Recurrent Early Abortions

Basal body temperature, vaginal hormonocytology, and plasma progesterone concentrations were studied serially in consecutive menstrual cycles of 8 normal subjects and of 10 patients with a history of recurrent early abortions. The menstrual patterns and characteristics of basal body temperature of the patients did not differ significantly from those of control subjects. The mean plasma progesterone concentrations at the midluteal phase of the study cycles of three patients were below those of the lower limit of the control group (4 ng/ml). The results of this study support the conviction that an inadequate luteal phase is more likely to occur in women with a history of recurrent early abortions.

Investigation of Danazol as a contraceptive agent

Danazol, the 2,3-isoxasol derivative of 17 α-ethinyl testosterone, was administered to 17 healthy volunteers during the first 7 days of the menstrual cycle, to see if an inadequate luteal phase would result. The follicular span was lengthened, and FSH levels either did not increase or were lowered during Danazol dosage in most women. Although delayed, the LH surge was normal, and a normal progesterone output was documented during the luteal phase. Thus, an inadequate luteal phase was not induced by inhibition of FSH-stimulated follicular development.

Measurement of serum LH, FSH, estradiol and progesterone in disorders of the human menstrual cycle: the inadequate luteal phase.

ABSTRACT The irregular menses experienced by obese and/or hirsute women were studied by daily measurement of serum LH, FSH, estradiol (E2) and progesterone (P). During 8 cycles of 24 to 157 days, each episode of menstrual bleeding was preceded by hormonal evidence of follicular maturation and corpus luteum formation. The premenstrual fluctuations of LH and E2 were not different from those observed in normal cycles. Although the luteal phase was of more than 10 days' duration, progesterone secretion was subnormal during each cycle. Serum FSH was low throughout the time preceding the LH/FSH surge. These data suggest that inadequate corpus luteum progesterone secretion may be characteristic of the menstrual cycles in oligomenorrheic, obese infertile women.

Inadequate corpus luteum function: a pathophysiological interpretation of human breast cancer epidemiology.

Inadequate corpus luteum function is discussed in a pathophysiological interpretation of human breast cancer epidemiology. Detailed hormonal studies of normal and abnormal human reproductive cycles have given evidence that inadequate corpus luteum secretory function is 1 of the characteristic features of infertile and/or irregular menstrual cycles. Age at menarche and menopause parity and androgen and estrogen secretion have all been related to breast cancer development. Treated independently these risk factors have been of little assistance in the identification of individuals with a predisposition to breast cancer development. The hypothesis that breast cancer risk factors are the manifestation of inadequate corpus luteum function can be tested epidemiologically. If correct an attempt can be made early in reproductive life to identify and treat those who manifest luteal phase inadequacy. The hypothesis was strongly suggested that estrogenic stimulation in the absence of sufficient cyclic progesterone secretion may provide a setting favorable to the development of mammary carcinoma. It is apparent that limited luteal phase progesterone secretion occurs in the presence or absence of gross irregularity of the menstrual cycle. The importance of these findings was strengthened by a study of premenstrual endometrial biopsies from 87 women with breast cancer and 50 normal women. Normal secretory endometrium was found in 68% of controls and only 17% of breast cancer patients.

Change of Ovarian Function with Age

It is recognized statistically and clinically that the lowering of female fertility appears with age. During the climacteric, there is frequent to happen ovarian dysfunction, such as menstrual disorders or dysfunctional uterine bleeding, and the climacteric symptoms as somatic and psychic changes. These clinical changes suggest the lowering of ovarian function according to aging. However, from the aspects of urinary estrogen level, the strinkig decrease of the level is not observed before menopause. In postmenopausal women, it is low value, as general, but the higher levels are revealed in some cases. In any event, very low level as in childhood is not observed.From the recording of 18,213 menstrual cycles, it is observed that the length of cycle shortens with age. Basal temperature records of 3,000 ovulatory cycles shows that the average length of follicular phase shortens with age, although that of luteal phase does not change in women of over 20 years old. So it is clear that the shortening of menstrual cycle is a result of shortening of follicular phase. The shortening of period and decrease of flow are also observed in women of over 35 years old, and the increase of inadequate luteal phase or anovulatory cycle especially in women of over 40 years old.Lowering of ovarian function with age does not mean only the decrease of estrogen secretion, but irregularity of ovarian cycle function that induces umblance of estrogen and progesterone secretion. The fact that the endometrial hyperplasia induced by prolonged or profuse estrogen action frequently takes place in climacteric women supports the abovementioned opinion.Urinary total gonadotrophins increase in some cases of menopausal women, and rise remarkably in postmenopausal women. Follicle stimulating hormone is within normal value or a little higher before menopause, and rises usually in postmenopausal women. Then, in more than five years after menopause, FSH tends to return to normal range. LH increases to ovulatory level in postmenopausal women. Urinary 17KS value increases during menopause.With age, ovarian size becomes smaller, and following histological changes appear : appearance of germinal inclusion cyst or corpus albicans cyst, disappearance of corpus luteum, decrease of atretic follicle, disappearance of graafian follicle, decrease of a number of a internal theca cell and interstitial cell, accumulation of Sudan IV strain in ovarian cortex, and increase of Sudan IV strain in wand of ovarian vessels. From these phenomenon, it is supposed that structual ovarian atrophy begins between 35 and 40 years old. Especially blood vessels in ovary change remarkably after 35 years old. So, the change of ovarian vessel is suggested to play an important role to lowering of ovarian function.

The inadequate luteal phase

The inadequate luteal phase