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Menstrual Dysfunction

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Handbook of Diagnostic Endocrinology

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

A pattern of regular ovulatory menstrual cycles is achieved through the exquisite functional and temporal integration of hormonal secretion from the hypothalamus, the pituitary, and the ovary. This classic endocrine cascade is initiated by pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus into the pituitary portal venous system. The subsequent release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary stimulates ovarian follicular development, ovulation, and corpus luteum formation. The uterus in turn responds to ovarian steroids by endometrial proliferation, vascularization, and glandular development. In the absence of implantation, ovarian hormonal support wanes, and endometrial shedding ensues. This pattern of events is accompanied by dramatic changes in LH, FSH, estradiol, progesterone, inhibin A, and inhibin B across normal menstrual cycles (1) (Fig. 1). In addition, the pulsatile stimulation of pituitary hormone secretion by GnRH results in pulsatile secretion of LH and to a lesser extent FSH, which also varies across the cycle, reflecting changes in the frequency of the GnRH pulse generator (2) (Fig. 2).

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Authors
  1. Drew V. Tortoriello MD
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  2. Janet E. Hall MD
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Editors and Affiliations

  1. Reproductive Endocrine Unit, Division of Endocrinology, Massachusetts General Hospital, Boston, MA, USA

    Janet E. Hall MD

  2. Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    Lynnette K. Nieman MD

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Tortoriello, D.V., Hall, J.E. (2003). Menstrual Dysfunction. In: Hall, J.E., Nieman, L.K. (eds) Handbook of Diagnostic Endocrinology. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-293-7_15

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  • DOI: https://doi.org/10.1007/978-1-59259-293-7_15

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