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Gonadotropin Deficiency

Differential Diagnosis and Treatment

  • Chapter
Diseases of the Pituitary

Part of the book series: Contemporary Endocrinology ((COE,volume 3))

Abstract

Gonadotropin deficiency is the manifestation of a heterogeneous group of disorders affecting the hypothalamic-pituitary-gonadal axis. Abnormal patterns of gonadotroph stimulation, deficiency of gonadotropin production, inappropriate feedback loops, and genetic defects resulting in abnormal gonadotropin structure encompass the variety of pathophysiologic mechanisms underlying gonadotropin deficiency (Table 1). Despite diverse etiologies, the resulting clinical characteristics are shared among the disorders. It is only through understanding the underlying mechanisms that accurate diagnoses can be made and appropriate treatment administered.

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References

  1. Belchetz PE, Plant TM, Nakai Y, et al. Hypophysial responses to continuous and intermittent delivery of hypothalamic gonadotropin-releasing hormone. Science 1978; 202:631–633.

    PubMed  CAS  Google Scholar 

  2. Hall JE, Brodie TD, Badger TM, et al. Evidence of differential control of FSH and LH secretion by gonadotropin-releasing hormone (GnRH) from the use of a GnRH antagonist. J Clin Endocrinol Metab 1988;67:524–531.

    PubMed  CAS  Google Scholar 

  3. Hall JE, Whitcomb RW, Rivier JE, et al. Differential regulation of luteinizing hormone, follicle-stimulating hormone, and free oc-subunit secretion from the gonadotrope by gonadotropin-releasing hormone (GnRH): evidence from the use of two GnRH antagonists. J Clin Endocrinol Metab 1990; 70:328–335.

    PubMed  CAS  Google Scholar 

  4. Pavlou SN, Debold CR, Island DP, et al. Single subcutaneous doses of a luteinizing hormone-releasing hormone antagonist suppress serum gonadotropin and testosterone levels in normal men. J Clin Endocrinol Metab 1986; 63:303–308.

    PubMed  CAS  Google Scholar 

  5. DePaolo LV, Bicsak TA, Erickson GF, Shimisaki S, Ling N. Follistatin and activin: a potential intrinsic regulatory system within diverse tissues. Proc Soc Exp Med 1991; 198:500–512.

    CAS  Google Scholar 

  6. Sugino K, Kurosawa N, Nakamura T, et al. Molecular heterogeneity of follistatin, an activin-binding protein. J Biol Chem 1992; 68:15,579–15,587.

    Google Scholar 

  7. Nakamura T, Takio K, Eto Y, Shibai H, Titani K, Sugino H. Activin-binding protein from rat ovary is follistatin. Science 1990; 247:836–838.

    PubMed  CAS  Google Scholar 

  8. Schneyer A, Rzucidlo DA, Sluss PM, Crowley WF Jr. Characterization of unique binding kinetics of follistatin and activin or inhibin in serum. Endocrinology 1994; 135:667–674.

    PubMed  CAS  Google Scholar 

  9. Lumpkin MD, Moltz JH, Yu WH, et al. Purification of FSH-releasing hormone: its dissimilarity from LHRH of mammalian, avian, and piscian origin. Brain Res Bull 1987; 18:175–178.

    PubMed  CAS  Google Scholar 

  10. Spratt DI, O’Dea LSL, Schoenfeld D, et al. Neuroendocrine-gonadal axis in men: frequent sampling of LH, FSH, and testosterone. Am J Physiol 1988; 254:E658–E666.

    PubMed  CAS  Google Scholar 

  11. Okamoto MC, Setaish K, Nadagawa Y, Hriuchi K, Moriya K, Itoh S. Diurnal variations in the levels of plasma and urinary androgens. J Clin Endocrinol Metab 1971; 32:846–851.

    PubMed  CAS  Google Scholar 

  12. Faiman C, Winter JSD. Diurnal cycles in plasma FSH, testosterone and Cortisol in men. J Clin Endocrinol Metab 1971; 33:186–192.

    PubMed  CAS  Google Scholar 

  13. Filicori M, Santoro N, Merriam GR, Crowley Jr WF. Characterization of the physiological pattern of episodic gonadotropin secretion throughout the human menstrual cycle. J Clin Endocrinol Metab 1986; 62:1136–1144.

    PubMed  CAS  Google Scholar 

  14. Backstrom CT, McNeilly AS, Leask RM, Baird DT. Pulsatile secretion of LH, FSH, prolactin, oestradiol and progesterone in the human menstrual cycle. Clin Endocrinol (Oxf) 1982; 17:29–42.

    CAS  Google Scholar 

  15. Reame N, Sauder SE, Kelch RP, Marshall JC. Pulsatile gonadotropin secretion during the human menstrual cycle: evidence for altered frequency of gonadotropin-releasing hormone secretion. J Clin Endocrinol Metab 1984; 59:328–337.

    PubMed  CAS  Google Scholar 

  16. Yen SSC, Tsai CC, Naftolin F, Vandenberg G, Ajabor L. Pulsatile patterns of gonadotropin release in subjects with and without ovarian function. J Clin Endocrinol Metab 1972; 34:671–675.

    PubMed  CAS  Google Scholar 

  17. Evans WS, Sollenberger MJ, Booth Jr RA, et al. Contemporary aspects of discrete peak-detection algorithms. II. The paradigm of the luteinizing hormone pulse signal in women. Endocr Rev 1992; 13:81–104.

    PubMed  CAS  Google Scholar 

  18. Soules MR, Steiner RA, Cohen NL, Bremner WJ, Clifton DK. Nocturnal slowing of pulsatile luteinizing hormone secretion in women during the follicular phase of the menstrual cycle. J Clin Endocrinol Metab 1985;61:43–49.

    PubMed  CAS  Google Scholar 

  19. Rossmanith WG, Boscher S, Kern W, Fehm HL. Impact of sleep on the circadian excursions in the pituitary gonadotropin responsiveness of early follicular phase in women. J Clin Endocrinol Metab 1993; 76:330–336.

    PubMed  CAS  Google Scholar 

  20. Hall JE, Richardson GS, Sullivan JP, Kaplowitz L, Welsh DK. Nocturnal slowing of GnRH secretion in the early follicular phase is specifically related to slow wave sleep: evidence from sleep reversal studies. Endocrine Soc 74th Annual Program and Abstracts. 1992; 873:270 (abstract).

    Google Scholar 

  21. Ross GT, Cargille CM, Lipsett MB. Pituitary and gonadal hormones in women during spontaneous and induced ovulatory cycles. Recent Prog Horm Res 1970; 26: 1–62.

    PubMed  CAS  Google Scholar 

  22. Hall JE, Taylor AE, Martin KA, Rivier J, Schoenfeld DA, Crowley Jr WF. Decreased release of gonadotropin-releasing hormone during the preovulatory midcycle luteinizing hormone surge in normal women. Proc Natl Acad Sci 1994; 91:6894–6898.

    PubMed  CAS  Google Scholar 

  23. Filicori M, Butler JP, Crowley Jr WF. 1984 Neuroendocrine regulation of the corpus luteum in the human. J Clin Invest 1984; 73:1638–1647.

    PubMed  CAS  Google Scholar 

  24. Rossmanith WG, Laughlin GA, Mortola JF, Johnson ML, Veldhuis JD, Yen SSC. Pulsatile cosecretion of estradiol and progesterone by the midluteal phase corpus luteum: temporal link to luteinizing hormone pulses. J Clin Endocrinol Metab 1990; 70:990–995.

    PubMed  CAS  Google Scholar 

  25. LeNestour E, Marraoui J, Lahlou N, Roger M, de Ziegler D, Bouchard Ph. Role of estradiol in the rise in follicle-stimulating hormone levels during the luteal-follicular transition. J Clin Endocrinol Metab 1993; 77:439–442.

    CAS  Google Scholar 

  26. McLachlan RE, Robertson DM, Healy DL, Burger HG, deKretser DM. Circulating immunoreactive inhibin levels during the normal human menstrual cycle. J Clin Endocrinol Metab 1987; 65:954–961.

    PubMed  CAS  Google Scholar 

  27. Roseff SH, Bangah ML, Kettel LM, et al. Dynamic changes in circulating inhibin levels during the luteal-follicular transition of the human menstrual cycle. J Clin Endocrinol Metab 1989; 69:1033–1039.

    PubMed  CAS  Google Scholar 

  28. Welt CK, Martin KA, Smith JA, Taylor AE, Crowley Jr WF, Hall JE. GnRH pulse frequency: a key determinant of the luteal-follicular rise in FSH. 10th Int Cong of Endocrin 1996; 397:854 (abstract).

    Google Scholar 

  29. Post KD, McCormick PC, Bello JA. Differential diagnosis of pituitary tumors. Endocrinol Metab Clin North Am 1987; 16:609–645.

    PubMed  CAS  Google Scholar 

  30. Samaan NA, Bakdash MM, Caderao JB, Cangir A, Jesse Jr RH, Ballantyne AJ. Hypopituitarism after external irradiation. Ann Intern Med 1975; 83:771–777.

    PubMed  CAS  Google Scholar 

  31. Shalet SM, Morris-Jones PH, Beardwell CG, Pearson D. Pituitary function after treatment of intracranial tumours in children. Lancet 1975; 2:104–107.

    PubMed  CAS  Google Scholar 

  32. Lam KSL, Tse VKC, Wang C, Yeung RTT, Ho JHC. Effects of cranial irradiation on hypothalamic-pituitary function-a 5-year longitudinal study in patients with nasopharyngeal carcinoma. Q J Med 1991;78:165–176.

    PubMed  CAS  Google Scholar 

  33. Constine LS, Woolf PD, Cann D, et al. Hypothalamic-pituitary dysfunction after radiation for brain tumors. N Engl J Med 1993; 328:87–94.

    PubMed  CAS  Google Scholar 

  34. Christensen RB, Matsumoto AM, Bremner WJ. Idiopathic hypogonadotropic hypogonadism with anosmia (Kallmann’s syndrome). Endocrinologist 1992; 2:332–340.

    Google Scholar 

  35. Waldstreicher J, Seminara SB, Jameson JL, et al. The genetic and clinical heterogeneity of gonadotropin-releasing hormone deficiency in the human. 1996; 81:4388–4395.

    CAS  Google Scholar 

  36. Kallmann F, Schoenfeld WA, Barrera SE. The genetic aspects of primary eunuchoidism. Am J Mental Defic 1944; 48:203–236.

    Google Scholar 

  37. Santen RJ, Paulsen CA. Hypogonadotropic eunuchoidism. I. Clinical study of the mode of inheritance. J Clin Endrinol Metab 1973; 36:47–54.

    Google Scholar 

  38. White BJ, Rogol AD, Brown KS, et al. The syndrome of anosmia with hypogonadotropic hypogonadism: a genetic study of 18 families and a review. Am J Med Genetics 1983; 15:417–435.

    CAS  Google Scholar 

  39. Weiss J, Adams E, Whitcomb RW, et al. Normal sequence of the gonadotropin-releasing hormone gene in patients with idiopathic hypogonadotropic hypogonadism. Biol Reprod 1991; 45:743–747.

    PubMed  CAS  Google Scholar 

  40. Weiss J, Crowley WF, Jameson JL. Structure of the GnRH gene in patients with idiopathic hypogo-nadotropic hypogonadism. J Clin Endocrinol Metab 1989; 69:299–303.

    PubMed  CAS  Google Scholar 

  41. Franco B, Guioli S, Pragliola A, et al. A gene deleted in Kallmann’s syndrome shares homology with neural cell adhesion and axonal path-finding molecules. Nature 1991; 353:529–536.

    PubMed  CAS  Google Scholar 

  42. Legouis R, Hardelin J-P, Levilliers J, et al. The candidate gene for the X-linked Kallmann syndrome encodes a protein related to adhesion molecules. Cell 1991; 67:423–435.

    PubMed  CAS  Google Scholar 

  43. Bick D, Franco B, Sherins RJ, et al. Intragenic deletion of the KALIG-1 gene in Kallmann’s syndrome. N Engl J Med 1992; 326:1752–1777.

    PubMed  CAS  Google Scholar 

  44. Hardelin J-P, Levilliers J, del Castillo I, et al. X chromosome-linked Kallmann syndrome: stop mutations validate the candidate gene. Proc Natl Acad Sci USA 1992; 2:311–314.

    Google Scholar 

  45. Rugarli EI, Ballabio A. Kallmann syndrome: from genetics to neurobiology. JAMA 1993; 270:2713–2716.

    PubMed  CAS  Google Scholar 

  46. Schwanzel-Fukada M, Bick M, Pfaff DW. Luteinizing hormone-releasing hormone (LHRH)-expressing cells do not migrate normally in an inherited hypogonadal (Kallmann) syndrome. Mol Brain Res 1989; 6:311–326.

    Google Scholar 

  47. Bray GA, Dahms WT, Swerdloff RS, Fiser RH, Atkinson RL, Carrel RE. The Prader-Willi Syndrome: a study of 40 patients and a review of the literature. Medicine 1983; 62:59–80.

    PubMed  CAS  Google Scholar 

  48. Green JS, Parfrey PS, Harnett JD, et al. The cardinal manifestations of Bardet-Biedl syndrome, a form of Laurence-Moon-Biedl syndrome. N Engl J Med 1989; 321:1002–1009.

    PubMed  CAS  Google Scholar 

  49. Berciano J, Amando JA, Freijanes J, Rebollo M, Vaquero A. Familial cerebellar ataxia and hypogo-nadotropic hypogonadism: evidence for hypothalamic LHRH deficiency. J Neurol Neurosurg Psychiatry 1982;45:747–751.

    PubMed  CAS  Google Scholar 

  50. Abs R, Van Vleymen E, Parizel PM, Van Acker K, Martin M, Martin J. Congenital cerebellar hypoplasia and hypogonadotropic hypogonadism. J Neurol Sciences 1990; 98:259–265.

    Google Scholar 

  51. Kruse K, Sippell WG, Schnakenburg KV Hypogonadism in congenital adrenal hypoplasia: evidence for a hypothalamic origin. J Clin Endocrinol Metab 1984; 58:12–17.

    PubMed  CAS  Google Scholar 

  52. Kikuchi K, Kaji M, Momoi T, et al. Failure to induce puberty in a man with X-linked congenital adrenal hypoplasia and hypogonadotropic hypogonadism by pulsatile administration of low dose gonadotropin-releasing hormone. Acta Endocrinol 1987; 114: 153–160.

    PubMed  CAS  Google Scholar 

  53. Zanaria E, Muscatelli F, Bardoni B, et al. An unusual member of the nuclear hormone receptor superfamily responsible for X-linked adrenal hypoplasia congenita. Nature 1994; 372:635–641.

    PubMed  CAS  Google Scholar 

  54. Muscatelli F, Strom TM, Walker AP, et al. Mutations in the DAX-1 gene give rise to both X-linked adrenal hypoplasia congenita and hypogonadotropic hypogonadism. Nature 1994; 372:672–676.

    PubMed  CAS  Google Scholar 

  55. Albright F, Halstead J. Studies on ovarian dysfunction. II. The application of the “hormonal measuring sticks” to the sorting out and to the treatment of the various types of amenorrhea. N Engl J Med 1935; 212:250–257.

    Google Scholar 

  56. Santoro N, Filicori M, Crowley Jr WF. Hypogonadotropic disorders in men and women: diagnosis and therapy with pulsatile gonadotropin-releasing hormone. Endocr Rev 1986; 7:11–23.

    PubMed  CAS  Google Scholar 

  57. Reame NE, Sauder SE, Case GS, et al. Pulsatile gonadotropin secretion in women with hypothalamic amenorrhea: evidence that reduced frequency of gonadotropin-releasing hormone secretion is the mechanism of persistent anovulation. J Clin Endocrinol Metab 1985; 61:851–858.

    PubMed  CAS  Google Scholar 

  58. Khoury SA, Reame NE, Kelch RP, Marshall JC. Diurnal patterns of pulsatile luteinizing hormone secretion in hypothalamic amenorrhea: reproducibility and responses to opiate blockage and an (α2–adrenergic agonist. J Clin Endocrinol Metab 1987; 64:755–762.

    PubMed  CAS  Google Scholar 

  59. Crowley Jr WF, Filicori M, Spratt DE, Santoro NF. The physiology of gonadotropin-releasing hormone (GnRH) secretion in men and women. Recent Prog Horm Res 1985; 41:473–531.

    PubMed  CAS  Google Scholar 

  60. Boyar RM, Katz J, Finkelstein JW, et al. Anorexia nervosa: immaturity of the 24-hour luteinizing hormone secretory pattern. N Engl J Med 1974; 291:861–865.

    PubMed  CAS  Google Scholar 

  61. Pirke KM, Fichter MM, Lund R, Doerr P. Twenty-four hour sleep-wake pattern of plasma LH in patients with anorexia nervosa. Acta Endocrinol 1979; 92: 193–204.

    PubMed  CAS  Google Scholar 

  62. Loucks AB, Mortola JF, Girton L, Yen SSC. Alterations in the hypothalamic-pituitary-ovarian and the hy-pothalamic-pituitary-adrenal axes in athletic women. J Clin Endocrinol Metab 1989; 68:402–411.

    PubMed  CAS  Google Scholar 

  63. Schweiger U, Pirke J, Laessle RG, Fichter MM. Gonadotropin secretion in bulimia nervosa. J Clin Endocrinol Metab 1992; 7:112–117.

    Google Scholar 

  64. Semple CC, Robertson WR, Mitchell R, et al. Mechanisms leading to hypogonadism in men with burns injuries. Br Med J 1987; 295:403–407.

    CAS  Google Scholar 

  65. Clarke JDA, Raggatt PR, Edwards OM. Abnormalities of the hypothalamo-pituitary-gonadal axis after head injury. Clin Endocrinol 1992; 36:481–485.

    Google Scholar 

  66. Woolf PD, Hamill RW, McDonald JV, Lee LA, Kelly M. Transient hypogonadotropic hypogonadism caused by critical illness. J Clin Endocrinol Metab 1985; 60:444–450.

    PubMed  CAS  Google Scholar 

  67. Spratt DI, Bigos ST, Beitins I, Cox P, Longcope C, Orav J. Both hyper- and hypogonadotropic hypogonadism occur transiently in acute illness: bio- and immunoactive gonadotropins. J Clin Endocrinol Metab 1992;75:1562–1570.

    PubMed  CAS  Google Scholar 

  68. Bullen BA, Skrinar GS, Beitins IZ, von Mering G, Turnbull BA, McArthur JW. Induction of menstrual disorders by strenuous exercise in untrained women. N Engl J Med 1985; 312:1349–1353.

    PubMed  CAS  Google Scholar 

  69. Warren MP. The effects of exercise on pubertal progression and reproductive function in girls. J Clin Endocrinol Metab 1980; 51:1150–1157.

    PubMed  CAS  Google Scholar 

  70. Loucks AB, Heath EM. Dietary restriction reduces luteinizing hormone (LH) pulse frequency during waking hours and increases LH pulse amplitude during sleep in young menstruating women. J Clin Endocrinol Metab 1994; 78:910–915.

    PubMed  CAS  Google Scholar 

  71. Loucks AB, Brown R, King K, Thuma JR, Verdun M. A combined regimen of moderate dietary restriction and exercise training alters luteinizing hormone pulsatility in regularly menstruating, young women. Proc 77th Ann Meeting Endo Soc 1995; P3–360 (Abstract).

    Google Scholar 

  72. MacConnie SE, Barkan A, Lampman RM, Schork MA, Beitins IZ. Decreased hypothalamic go-nadotropin-releasing hormone secretion in male marathon runners. N Engl J Med 1986; 315:411–417.

    PubMed  CAS  Google Scholar 

  73. Cameron JL, Weltzin TE, McConaha C, Helmreich DL, Kaye WH. Slowing of pulsatile luteinizing hormone secretion in men after forty-eight hours of fasting. J Clin Endocrinol Metab 1991; 73:35–41.

    PubMed  CAS  Google Scholar 

  74. Veldhuis JD, Iranmanesh A, Evans WS, Lizarralde G, Thorner MO, Vance ML. Amplitude suppression of the pulsatile mode of immunoradiometric luteinizing hormone release in fasting-induced hypoandrogenemia in normal men. J Clin Endocrinol Metab 1993; 76:587–593.

    PubMed  CAS  Google Scholar 

  75. Opstad PR. Androgenic hormones during prolonged physical stress, sleep, and energy deficiency. J Clin Endocrinol Metab 1992; 74:1176–1183.

    PubMed  CAS  Google Scholar 

  76. Martin KA, Hall JE, Santoro NF, Crowley Jr WF. Hypothalamic amenorrhea (HA): further neuroendocrine characterization. Clin Res 1990; 38:342A.

    Google Scholar 

  77. Berga SL, Loucks AB, Rossmanith WG, Kettel LM, Laughlin MA, Yen SSC. Acceleration of luteinizing hormone pulse frequency in functional hypothalamic amenorrhea by dopaminergic blockade. J Clin Endocrinol Metab 1991; 72:151–156.

    PubMed  CAS  Google Scholar 

  78. Berga SL, Mortola JF, Yen SSC. Amplification of nocturnal melatonin secretion in women with functional hypothalamic amenorrhea. J Clin Endocrinol Metab 1988; 66:242–244.

    PubMed  CAS  Google Scholar 

  79. Brzezinski A, Lynch HJ, Seibel MM, Deng MH, Nader TM, Wurtman RJ. The circadian rhythm of plasma melatonin during the normal menstrual cycle and in amenorrheic women. J Clin Endocrinol Metab 1988; 66:891–895.

    PubMed  CAS  Google Scholar 

  80. Gold PW, Gwirtsman H, Avgerinos PC, et al. Abnormal hypothalamic-pituitary-adrenal function in anorexia nervosa: pathophysiologic mechanisms in underweight and weight-corrected patients. N Engl J Med 1986; 314:1335–1342.

    PubMed  CAS  Google Scholar 

  81. Suh BY, Liu JH, Berga SL, Quigley ME, Laughlin GA, Yen SS. Hypercortisolism in patients with functional hypothalamic-amenorrhea. J Clin Endocrinol Metab 1988; 66:733–739.

    PubMed  CAS  Google Scholar 

  82. Villaneuva AL, Schlosser C, Hopper B, Liu JH, Hoffman DI, Regar RW. Increased Cortisol production in women runners. J Clin Endocrinol Metab 1986; 63:133–136.

    Google Scholar 

  83. Biller BMK, Federoff HJ, Koenig JI, Klibnaski A. Abnormal Cortisol secretion and responses to corti-cotropin-releasing hormone in women with hypothalamic amenorrhea. J Clin Endocrinol Metab 1990; 70:311–317.

    PubMed  CAS  Google Scholar 

  84. Luger A, Deuster PA, Kyle SB, et al. Acute hypothalamic-pituitary-adrenal responses to the stress of treadmill exercise: physiologic adaptations to physical training. N Engl J Med 1987; 316:1309–1315.

    PubMed  CAS  Google Scholar 

  85. Petraglia F, Sutton S, Vale W, Plotsky P. Corticotropin-releasing factor decreases plasma luteinizing hormone levels in female rats by inhibiting gonadotropin-releasing hormone release into hypophyseal portal circulation. Endocrinology 1987; 120:1083–1088.

    PubMed  CAS  Google Scholar 

  86. Rivier C, Vale W Influence of corticotropin-releasing factor on reproductive functions in the rat. Endocrinol 1984; 114:914–919.

    CAS  Google Scholar 

  87. Rivier C, Vale W Effect of the long-term administration of corticotropin releasing factor on the pituitary-adrenal and pituitary-gonadal axis in the male rat. J Clin Invest 1985; 75:689–694.

    PubMed  CAS  Google Scholar 

  88. Rivier C;, Rivier J, Vale W. Stress-induced inhibition of reproductive functions: role of endogenous corti-cotropin-releasing factor. Science 1986; 231:607–609.

    PubMed  CAS  Google Scholar 

  89. Barbarino A, De Marinis L, Tofani A, et al. Corticotropin-releasing hormone inhibition of gonadotropin release and the effect of opioid blockade. J Clin Endocrinol Metab 1989; 68:523–528.

    PubMed  CAS  Google Scholar 

  90. Bohnet HG, Dahlen HG, Wuttke W, Schneider HPG. Hyperprolactinemic anovulatory syndrome. J Clin Endocrinol Metab 1976; 42:132–143.

    PubMed  CAS  Google Scholar 

  91. Sauder SE, Frager M, Case GD, Kelch RP, Marshall JC. Abnormal patterns of pulsatile luteinizing hormone secretion in women with hyperprolactinemic and amenorrhea: responses to bromocriptine. J Clin Endocrinol Metab 1984; 59:941–948.

    PubMed  CAS  Google Scholar 

  92. Monroe SE, Levine L, Chang RJ, Keye Jr WR, Yamamoto M, Jaffe RB. Prolactin-secreting pituitary adenomas. V. Increased gonadotroph responsivity in hyperprolactinemic women with pituitary adenomas. J Clin Endocrinol Metab 1981; 52:1171–1178.

    PubMed  CAS  Google Scholar 

  93. Caro JF, Woolf PD. Pituitary-ovarian axis responsivity to prolonged gonadotropin-releasing hormone infusion in normal and hyperprolactinemic women. J Clin Endocrinol Metab 1980; 50:999–1004.

    PubMed  CAS  Google Scholar 

  94. Ho KY, Smythe GA, Lazarus L. Dopaminergic control of gonadotrophin secretion in normal women and in patients with pathological hyperprolactinemic. Clin Endocrinol 1984; 20:53–63.

    CAS  Google Scholar 

  95. Webb CB, Thominet JL, Barowsky H, Berelowitz M, Frohman LA. Evidence for lactotroph dopamine resistance in idiopathic hyperprolactinemic. J Clin Endocrinol Metab 1983; 56:1089–1093.

    PubMed  CAS  Google Scholar 

  96. Grossman A, Moult PJA, Gaillard RC, et al. The opioid control of LH and FSH release: effects of a met-enkephalin analogue and naloxone. Clin Endocrinol 1981; 14:41–47.

    CAS  Google Scholar 

  97. Luton J, Thieblot P, Valcke J, Mahoudeau JA, Bricaire H. Reversible gonadotropin deficiency in male Cushing’s disease. J Clin Endocrinol Metab 1977; 45:488–495.

    PubMed  CAS  Google Scholar 

  98. MacAdams MR, White RH, Chipps BE. Reduction of serum testosterone levels during chronic glucocorticoid therapy. Ann Int Med 1986; 104:648–651.

    PubMed  CAS  Google Scholar 

  99. Saketos M, Sharma N, Santoro NF. Suppression of the hypothalamic-pituitary-ovarian axis in normal women by glucocorticoids. Biol Reprod 1993; 49:1270–1276.

    PubMed  CAS  Google Scholar 

  100. Dubey AK, Plant TM. A suppression of gonadotropin secretion by Cortisol in castrated male Rhesus monkeys (Macaca mulatto) mediated by the interruption of hypothalamic gonadotropin-releasing hormone release. Biol Reprod 1985; 33:423–431.

    PubMed  CAS  Google Scholar 

  101. Van Thiel DH, Cobb CF, Herman GB, Perez I, Gavaler JS. An examination of various mechanisms for ethanol-induced testicular injury: studies utilizing the isolated perfused rat testes. Endocrinology 1981; 109:2009–2015.

    PubMed  Google Scholar 

  102. Mendelson JH, Mello NK. Chronic alcohol effects on anterior pituitary and ovarian hormones in healthy women. J Pharmacol Exp Ther 1988; 245:407–412.

    PubMed  CAS  Google Scholar 

  103. Iranmanesh A, Velhuis JD, Samojlik E, Rogol AD, Johnson ML, Lizarralde G. Alterations in the pulsatile properties of gonadotropin secretion in alcoholic men. J Androl 1988; 9:207–214.

    PubMed  CAS  Google Scholar 

  104. Swerdloff RS, Hever D. Effects of aging on male reproductive function. In Korenman SG, ed. Endocrine Aspects of Aging. Elsevier Biomedical; New York, 1982, pp. 119–135.

    Google Scholar 

  105. Neaves WB, Johnson L, Porter JC, Parker CR, Petty CS. Leydig cell numbers, daily sperm production and serum gonadotropin levels in aging men. J Clin Endocrinol Metab 1984; 59:756–763.

    PubMed  CAS  Google Scholar 

  106. Rubens R, Dhont M, Vermeulen A. Further studies on Leydig cell function in old age. J Clin Endocrinol Metab 1974; 39:40–45.

    PubMed  CAS  Google Scholar 

  107. Korenman SG, Morley JE, Mooradian AD, et al. Secondary hypogonadism in older men: its relation to impotence. J Clin Endocrinol Metab 1990; 71:963–969.

    PubMed  CAS  Google Scholar 

  108. Vermeulen A, Deslypere JP, Kaufman JM. Influence of antiopioids on luteinizing hormone pulsatility in aging men. J Clin Endocrinol Metab 1989; 68:68–72.

    PubMed  CAS  Google Scholar 

  109. Veldhuis JD, Urban RJ, Lizzaralde G, Johnson ML, Iranmanesh A. Attenuation of luteinizing hormone secretory burst amplitude as a proximate basis of hypoandrogenism of healthy aging men. J Clin Endocrinol Metab 1992; 75:52–58.

    CAS  Google Scholar 

  110. Snyder PJ. Gonadotroph cell adenomas of the pituitary. Endocr Rev 1985; 6:552–563.

    PubMed  CAS  Google Scholar 

  111. Arafah BM. Reversible hypopituitarism in patients with large nonfunctioning pituitary adenomas. J Clin Endocrinol Metab 1986; 62:1173–1179.

    PubMed  CAS  Google Scholar 

  112. Katznelson L, Alexander JM, Bikkal HA, Jameson JL, Hsu DW, Klibanski A. Imbalanced follicle-stimulating hormone beta-subunit hormone biosynthesis in human pituitary adenomas. J Clin Endocrinol Metab 1992; 74:1343–1351.

    PubMed  CAS  Google Scholar 

  113. Kelly TM, Edwards CQ, Meikle AW, Kushner JP. Hypogonadism in hemochromatosis: reversal with iron depletion. Ann Int Med 1984; 101:629–632.

    PubMed  CAS  Google Scholar 

  114. Wang C, Tso SC, Todd D. Hypogonadotropic hypogonadism in severe ß-thalassemia: effect of chelation and pulsatile gonadotropin-releasing hormone therapy. J Clin Endocrinol Metab 1989; 68:511–516.

    PubMed  CAS  Google Scholar 

  115. Cundy T, Butler J, Bomford A, Williams R. Reversibility of hypogonadotrophic hypogonadism associated with genetic haemochromatosis. Clin Endocrinol 1993; 38:617–620.

    CAS  Google Scholar 

  116. Cosman F, Post KD, Holub DA, Wardlaw SL. Lymphocytic hypophysitis: report of 3 new cases and review of the literature. Medicine 1989; 68:240–256.

    PubMed  CAS  Google Scholar 

  117. Bottazzo GF, Pouplard A, Florin-Christensen A, Doniach D. Autoantibodies to prolactin-secreting cells of human pituitary. Lancet 1975; 2:97–101.

    PubMed  CAS  Google Scholar 

  118. Beressi N, Cohen R, Beressi J, et al. Pseudotumoral lymphocytic hypophysitis successfully treated by corticosteroid alone: first case report. Neurosurgery 1994; 35:505–508.

    PubMed  CAS  Google Scholar 

  119. McGrail KM, Beyerl BD, Black PM, Klibanski A, Zervas NT. Lymphocytic adenohypophysitis of pregnancy with complete recovery. Neurosurgery 1987; 20:791–793.

    PubMed  CAS  Google Scholar 

  120. Scanarini M, D’Avella D, Rotilio A, Kitromilis N, Mingrino S. Giant-cell granulomatous hypophysitis: a distinct clinicopathological entity. J Neurosurg 1989; 71:681–686.

    PubMed  CAS  Google Scholar 

  121. Sheehan HL. Postpartum necrosis of the anterior pituitary. J Path Bact 1937; 45: 189–214.

    CAS  Google Scholar 

  122. Brennan CF, Malone RGS, Weaver JA. Pituitary necrosis in diabetes mellitus. Lancet 1956; 2:12–16.

    Google Scholar 

  123. Harvey JC, de Klerk J. The Houssay phenomenon in man. Amer J Med 1955; 19:327–336.

    PubMed  CAS  Google Scholar 

  124. Schalch DS, Burday SZ. Antepartum pituitary insufficiency in diabetes mellitus. Ann Intern Med 1971; 74:357–360.

    PubMed  CAS  Google Scholar 

  125. Neelon FA, Goree JA, Lebovitz HE. The primary empty sella: clinical and radiographic characteristics and endocrine function. Medicine 1973; 52:73–92.

    PubMed  CAS  Google Scholar 

  126. Brismar K, Efendic S. Pituitary function in the empty sella syndrome. Neuroendocrinology 1981; 32:70–77.

    PubMed  CAS  Google Scholar 

  127. Al-Ansari AAK, Khalil TH, Kelani Y, Mortimer CH. Isolated follicle-stimulating hormone deficiency in men: successful long-term gonadotropin therapy. Fertil Steril 1984; 42:618–626.

    PubMed  CAS  Google Scholar 

  128. Hargreave TB, Kyle KF, Kelly AM, England P. Releasing factor tests in men with oligozoospermia. Br J Urol 1979; 51:38–42.

    PubMed  CAS  Google Scholar 

  129. Matthews CH, Borgato S, Beck-Peccoz P, et al. Primary amenorrhoea and infertility due to a mutation in the ß-subunit of follicle-stimulating hormone. Nature Genetics 1993; 5:83–86.

    PubMed  CAS  Google Scholar 

  130. Haavisto AM, Pettersson K, Bergendahl M, Virkamaki A, Huhtaniemi I. Occurrence and biological properties of a common genetic variant of luteinizing hormone. J Clin Endocrinol Metab 1995; 80:1257–1263.

    PubMed  CAS  Google Scholar 

  131. Furui K, Suganuma N, Tsukahara S-I, et al. Identification of two point mutations in the gene coding luteinizing hormone (LH) ß-subunit, associated with immunologically anomalous LH variants. J Clin Endocrinol Metab 1994; 78:107–113.

    PubMed  CAS  Google Scholar 

  132. Weiss J, Axelrod L, Whitcomb RW, Harris PE, Crowley WF, Jameson JL. Hypogonadism caused by a single amino acid substitution in the ß subunit of luteinizing hormone. N Engl J Med 1992; 326: 179–183.

    PubMed  CAS  Google Scholar 

  133. Finkelstein JS, O’Dea LSL, Whitcomb RW, Crowley Jr WF. Sex steroid control of gonadotropin secretion in the human male. II. Effects of estradiol administration in normal and gonadotropin-releasing hormone-deficient men. J Clin Endocrinol Metab 1991; 73:621–628.

    PubMed  CAS  Google Scholar 

  134. Kuhn JM, Mahoudeau JA, Billaud L, et al. Evaluation of diagnostic criteria for Leydig cell tumours in adult men revealed by gynaecomastia. Clin Endocrinol 1987; 26:407–416.

    CAS  Google Scholar 

  135. Veldhuis JD, Sowers JR, Rogol AD, Klein FA, Miller N, Dufau ML. Pathophysiology of male hypogonadism associated with endogenous hyperestrogenism: evidence for dual defects in the gonadal axis. N Engl J Med 1985; 312:1371–1375.

    PubMed  CAS  Google Scholar 

  136. Stepanas AB, Samaan NA, Schultz PN, Holoye PY. Endocrine studies in testicular tumor patients with and without gynecomastia: a report of 45 cases. Cancer 1978; 41:369–376.

    PubMed  CAS  Google Scholar 

  137. Glass AR, Swerdloff RS, Bray GA, Dahms WT, Atkinson RL. Low serum testosterone and sex-hormone-binding-globulin in massively obese men. J Clin Endocrinol Metab 1977; 45:1211–1219.

    PubMed  CAS  Google Scholar 

  138. Schneider G, Kirschner MA, Berkowitz R, Eitel NH. Increased estrogen production in obese men. J Clin Endocrinol Metab 1979; 48:633–638.

    PubMed  CAS  Google Scholar 

  139. Zumoff B, Strain GW, Miller LK, et al. Plasma free and non-sex-hormone-binding-globulin-bound testosterone are decreased in obese men in proportion to their degree of obesity. J Clin Endocrinol Metab 1990; 71:929–931.

    PubMed  CAS  Google Scholar 

  140. Vermeulen A, Kaufman JM, Deslypere JP, Thomas G. Attenuated luteinizing hormone (LH) pulse amplitude but normal LH pulse frequency, and its relation to plasma androgens in hypogonadism of obese men. J Clin Endocrinol Metab 1993; 76:1140–1146.

    PubMed  CAS  Google Scholar 

  141. Santamaria JD, Prior JC, Fleetham JA. Reversible reproductive dysfunction in men with obstructive sleep apnoea. Clin Endocrinol 1988; 28:461–470.

    CAS  Google Scholar 

  142. Finkelstein JS, Whitcomb RW, O’Dea LSL, et al. Sex steroid control of gonadotropin secretion in the human male. I. Effects of testosterone administration in normal and gonadotropin-releasing hormone deficient men. J Clin Endocrinol Metab 1991; 73:609–620.

    PubMed  CAS  Google Scholar 

  143. Alen M, Suominen J. Effect of androgenic and anabolic steroids on spermatogenesis in power athletes. Int J Sports Med 1984; 5:189–192.

    Google Scholar 

  144. Alen M, Reinila M, Vihko R. Response of serum hormones to androgen administration in power athletes. Med Sci Sports 1985; 17:354–359.

    CAS  Google Scholar 

  145. Burris AS, Rodbard HW, Winters SJ, Sherins RJ. Gonadotropin therapy in men with isolated hypogo-nadotropic hypogonadism: the response to human chorionic gonadotropin is predicted by initial testicular size. J Clin Endocrinol Metab 1988; 66:1144–1151.

    PubMed  CAS  Google Scholar 

  146. Whitcomb RW, Crowley WE Diagnosis and treatment of isolated gonadotropin-releasing hormone deficiency in men. J Clin Endocrinol Metab 1990; 70:3–7.

    PubMed  CAS  Google Scholar 

  147. Schopohl J, Mehltretter G, von Zumbusch R, et al. Comparison of gonadotropin-releasing hormone and gonadotropin therapy in male patients with idiopathic hypothalamic hypogonadism. Fértil Steril 1991; 56:1143–1145.

    PubMed  CAS  Google Scholar 

  148. Martin KA, Santoro N, Hall J, Filicori M, Wierman M, Crowley Jr WF. Management of ovulatory disorders with pulsatile gonadotropin-releasing hormone. J Clin Endocrinol Metab 1990; 71:1081A-1081G.

    PubMed  Google Scholar 

  149. Martin KA, Hall JE, Adams JM, Crowley Jr WF. Comparison of exogenous gonadotropins and pulsatile gonadotropin-releasing hormone for induction of ovulation in hypogonadotropic amenorrhea. J Clin Endocrinol Metab 1993; 77:125–129.

    PubMed  CAS  Google Scholar 

  150. Hall JE, Martin KA, Whitney HA, Landy H, Crowley Jr WF. Potential for fertility with replacement of hypothalamic gonadotropin-releasing hormone in long term female survivors of cranial tumors. J Clin Endocrinol Metab 1994; 79:1166–1172.

    PubMed  CAS  Google Scholar 

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Authors
  1. Corrine K. Welt MD
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  2. Janet E. Hall MD
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Editors and Affiliations

  1. University of Colorado Health Sciences Center, Denver, CO, USA

    Margaret E. Wierman MD

  2. Veterans Affairs Medical Center, Denver, CO, USA

    Margaret E. Wierman MD

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© 1997 Humana Press Inc.

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Welt, C.K., Hall, J.E. (1997). Gonadotropin Deficiency. In: Wierman, M.E. (eds) Diseases of the Pituitary. Contemporary Endocrinology, vol 3. Humana Press. https://doi.org/10.1007/978-1-4612-3954-3_11

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  • DOI: https://doi.org/10.1007/978-1-4612-3954-3_11

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-4612-8438-3

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