Estradiol and progesterone-induced slowing of gonadotropin-releasing hormone pulse frequency is not reversed by subsequent administration of mifepristone

Endocrine. 2009 Oct;36(2):239-45. doi: 10.1007/s12020-009-9215-x. Epub 2009 Jul 16.

Abstract

Subsequent to suppression of LH (GnRH) pulse frequency by progesterone (P) and estradiol (E(2)), LH pulse frequency remains slow for 7 days after P withdrawal if mid-luteal E(2) concentrations are maintained. This may reflect an ability of E(2) to potentiate the suppressive effects of low P levels. We explored this notion in a similar experimental paradigm by administering a P-receptor antagonist (mifepristone) after P withdrawal while continuing E(2). Studies were performed in seven ovulatory, non-obese women. Transdermal E(2) (0.2 mg/day) and oral micronized P (100 mg every 8 h) were started within 24 h of the LH surge and continued for 10 days. Subjects then underwent a 13-h blood sampling protocol for determination of LH pulse characteristics and various hormone concentrations. Oral P was then discontinued, and oral mifepristone (50, 100, or 200 mg daily) and transdermal E(2) (0.2 mg/day) were administered for 7 days, after which the above sampling protocol was repeated. Results with all mifepristone doses were similar and therefore pooled. Mean LH, LH amplitude, and mean FSH markedly decreased after 7 days of mifepristone, but LH pulse frequency did not change (3.3 +/- 1.5 vs. 2.4 +/- 1.5 pulses/13 h). Prolactin and androstenedione increased between the first and second admissions, with no changes in E(2), cortisol, testosterone, or DHEAS. In conclusion, blockade of P action by mifepristone does not reverse a suppressed LH pulse frequency within 7 days when E(2) concentrations are maintained, suggesting that P withdrawal alone may not explain the luteal-follicular increase of GnRH pulse frequency.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Circadian Rhythm / physiology
  • Drug Administration Routes
  • Drug Administration Schedule
  • Estradiol / administration & dosage
  • Estradiol / adverse effects
  • Estradiol / pharmacology*
  • Female
  • Follicle Stimulating Hormone / blood
  • Gonadotropin-Releasing Hormone / blood*
  • Gonadotropin-Releasing Hormone / metabolism
  • Hormone Antagonists / administration & dosage
  • Hormone Antagonists / adverse effects
  • Hormone Antagonists / pharmacology
  • Humans
  • Luteinizing Hormone / blood
  • Mifepristone / administration & dosage
  • Mifepristone / adverse effects
  • Mifepristone / pharmacology*
  • Progesterone / administration & dosage
  • Progesterone / adverse effects
  • Progesterone / pharmacology*
  • Pulsatile Flow / drug effects
  • Young Adult

Substances

  • Hormone Antagonists
  • Mifepristone
  • Gonadotropin-Releasing Hormone
  • Progesterone
  • Estradiol
  • Luteinizing Hormone
  • Follicle Stimulating Hormone