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Pituitary function is altered during the same cycle in women with polycystic ovary syndrome treated with continuous or cyclic oral contraceptives or a gonadotropin-releasing hormone agonist.
Fertil Steril. 1996 Jul; 66(1):54-60.FS

Abstract

OBJECTIVE

To determine if continuous oral contraceptive (OC) therapy was superior to a cyclic regimen in achieving persistent pituitary suppression of LH in patients with polycystic ovary syndrome (PCOS).

DESIGN

Fourteen women (ages 16 to 41 years) with PCOS received one of three treatment groups: continuous OC therapy (30 micrograms ethinyl E2 plus 150 micrograms desogestrel), cyclic OC therapy, or monthly injections of a GnRH agonist (GnRH-a, leuprolide acetate depot 3.75 mg) for 3 months. Basal hormone levels were obtained before initiating therapy, on days 15 to 17 of the 3rd month of treatment (study 1) and again on days 26 to 28 of the 3rd month (study 2). A GnRH stimulation test was also performed during study 1 and study 2.

RESULTS

After 3 months of treatment, LH levels were decreased significantly in all groups with less effective suppression observed in the cyclic OC group compared with the continuous OC or GnRH-a groups. A significant rise in LH was found only in the cyclic OC group after 5 to 7 days of placebo treatment (study 1 versus study 2). An increase in T was also observed in the cyclic OC group during study 2, whereas the continuous OC and GnRH-a groups showed continued inhibition of T levels. Although there was no significant difference in LH area under the curve (AUC) measurements after GnRH stimulation in study 1 versus study 2, the LH AUC was significantly greater in both studies in the cyclic OC group compared with the continuous OC or GnRH-a groups.

CONCLUSIONS

Increased LH secretion during the week of placebo in the cyclic OC group was associated with a concomitant increase in T. The striking rise in LH secretion after GnRH stimulation in the cyclic OC group may represent increased pituitary sensitivity in patients receiving cyclic OCs regardless of the phase of the treatment cycle, perhaps secondary to increased pituitary stores of LH in these women.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8752611

Citation

Ruchhoft, E A., et al. "Pituitary Function Is Altered During the Same Cycle in Women With Polycystic Ovary Syndrome Treated With Continuous or Cyclic Oral Contraceptives or a Gonadotropin-releasing Hormone Agonist." Fertility and Sterility, vol. 66, no. 1, 1996, pp. 54-60.
Ruchhoft EA, Elkind-Hirsch KE, Malinak R. Pituitary function is altered during the same cycle in women with polycystic ovary syndrome treated with continuous or cyclic oral contraceptives or a gonadotropin-releasing hormone agonist. Fertil Steril. 1996;66(1):54-60.
Ruchhoft, E. A., Elkind-Hirsch, K. E., & Malinak, R. (1996). Pituitary function is altered during the same cycle in women with polycystic ovary syndrome treated with continuous or cyclic oral contraceptives or a gonadotropin-releasing hormone agonist. Fertility and Sterility, 66(1), 54-60.
Ruchhoft EA, Elkind-Hirsch KE, Malinak R. Pituitary Function Is Altered During the Same Cycle in Women With Polycystic Ovary Syndrome Treated With Continuous or Cyclic Oral Contraceptives or a Gonadotropin-releasing Hormone Agonist. Fertil Steril. 1996;66(1):54-60. PubMed PMID: 8752611.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pituitary function is altered during the same cycle in women with polycystic ovary syndrome treated with continuous or cyclic oral contraceptives or a gonadotropin-releasing hormone agonist. AU - Ruchhoft,E A, AU - Elkind-Hirsch,K E, AU - Malinak,R, PY - 1996/7/1/pubmed PY - 1996/7/1/medline PY - 1996/7/1/entrez KW - Americas KW - Androgens KW - Biology KW - Clinical Research KW - Comparative Studies KW - Contraception KW - Contraceptive Methods KW - Developed Countries KW - Diseases KW - Endocrine System KW - Family Planning KW - Gonadotropins KW - Gonadotropins, Pituitary KW - Hirsutism KW - Hormones KW - Luteinizing Hormone KW - North America KW - Northern America KW - Oral Contraceptives KW - Oral Contraceptives, Combined KW - Ovarian Cysts KW - Physiology KW - Pituitary Hormone Releasing Hormones KW - Research Methodology KW - Research Report KW - Signs And Symptoms KW - Studies KW - Testosterone KW - Texas KW - Treatment KW - United States SP - 54 EP - 60 JF - Fertility and sterility JO - Fertil Steril VL - 66 IS - 1 N2 - OBJECTIVE: To determine if continuous oral contraceptive (OC) therapy was superior to a cyclic regimen in achieving persistent pituitary suppression of LH in patients with polycystic ovary syndrome (PCOS). DESIGN: Fourteen women (ages 16 to 41 years) with PCOS received one of three treatment groups: continuous OC therapy (30 micrograms ethinyl E2 plus 150 micrograms desogestrel), cyclic OC therapy, or monthly injections of a GnRH agonist (GnRH-a, leuprolide acetate depot 3.75 mg) for 3 months. Basal hormone levels were obtained before initiating therapy, on days 15 to 17 of the 3rd month of treatment (study 1) and again on days 26 to 28 of the 3rd month (study 2). A GnRH stimulation test was also performed during study 1 and study 2. RESULTS: After 3 months of treatment, LH levels were decreased significantly in all groups with less effective suppression observed in the cyclic OC group compared with the continuous OC or GnRH-a groups. A significant rise in LH was found only in the cyclic OC group after 5 to 7 days of placebo treatment (study 1 versus study 2). An increase in T was also observed in the cyclic OC group during study 2, whereas the continuous OC and GnRH-a groups showed continued inhibition of T levels. Although there was no significant difference in LH area under the curve (AUC) measurements after GnRH stimulation in study 1 versus study 2, the LH AUC was significantly greater in both studies in the cyclic OC group compared with the continuous OC or GnRH-a groups. CONCLUSIONS: Increased LH secretion during the week of placebo in the cyclic OC group was associated with a concomitant increase in T. The striking rise in LH secretion after GnRH stimulation in the cyclic OC group may represent increased pituitary sensitivity in patients receiving cyclic OCs regardless of the phase of the treatment cycle, perhaps secondary to increased pituitary stores of LH in these women. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/8752611/Pituitary_function_is_altered_during_the_same_cycle_in_women_with_polycystic_ovary_syndrome_treated_with_continuous_or_cyclic_oral_contraceptives_or_a_gonadotropin_releasing_hormone_agonist_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(16)58387-3 DB - PRIME DP - Unbound Medicine ER -