Cerebrospinal fluid levels of corticotropin-releasing hormone in women with functional hypothalamic amenorrhea

Am J Obstet Gynecol. 2000 Apr;182(4):776-81; discussion 781-4. doi: 10.1016/s0002-9378(00)70326-7.

Abstract

Objective: Women with functional hypothalamic amenorrhea are anovulatory because of reduced gonadotropin-releasing hormone drive. Several studies have documented hypercortisolemia, which suggests that functional hypothalamic amenorrhea is stress-induced. Further, with recovery (resumption of ovulation), cortisol decreased and gonadotropin-releasing hormone drive increased. Corticotropin-releasing hormone can increase cortisol and decrease gonadotropin-releasing hormone. To determine its role in functional hypothalamic amenorrhea, we measured corticotropin-releasing hormone in cerebrospinal fluid along with arginine vasopressin, another potent adrenocorticotropic hormone secretagog, and beta-endorphin, which is released by corticotropin-releasing hormone and can inhibit gonadotropin-releasing hormone.

Study design: Corticotropin-releasing hormone, vasopressin, and beta-endorphin levels were measured in cerebrospinal fluid from 14 women with eumenorrhea and 15 women with functional hypothalamic amenorrhea.

Results: Levels of corticotropin-releasing hormone in cerebrospinal fluid and of vasopressin were comparable and beta-endorphin levels were lower in women with functional hypothalamic amenorrhea.

Conclusions: In women with established functional hypothalamic amenorrhea, increased cortisol and reduced gonadotropin-releasing hormone are not sustained by elevated cerebrospinal-fluid corticotropin-releasing hormone, vasopressin, or beta-endorphin. These data do not exclude a role for these factors in the initiation of functional hypothalamic amenorrhea.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Amenorrhea / cerebrospinal fluid*
  • Amenorrhea / etiology*
  • Circadian Rhythm
  • Corticotropin-Releasing Hormone / cerebrospinal fluid*
  • Female
  • Humans
  • Hydrocortisone / cerebrospinal fluid
  • Hypothalamic Diseases / complications*
  • Reference Values

Substances

  • Corticotropin-Releasing Hormone
  • Hydrocortisone