Regulation of Human Gonadotropins

Abstract
Serum LH, FSH and progesterone concentrations and urinary pregnanediol excretion were quantitated in 5 regularly menstruating women who received 0.5 mg chlormadinone acetate for periods ranging from 51 to 60 days. These gonadotropic hormone and steroid hormones were also measured during the months before and after medication administration. An additional group of 5 women were studied who had been receiving 0.5 mg chlormadinone acetate continuously for at least 6 months prior to having hormone determinations performed, and who continued on this regimen during the entire study period. All of these subjects had serum LH and FSH determinations, and 4 had progesterone measurements performed for 22, 29, 30, 34 and 60 days. In the ‘short-term studies’, while receiving chlormadinone acetate, a typical surge of neither LH nor FSH was observed. However, 4 of the 5 subjects demonstrated atypical, multiple elevations of baseline concentrations of LH at varying times, but usually at the middle of the treatment cycles. Concomitant rises in FSH were not observed. The quantities of pregnanediol excreted during the latter half of treatment cycles were below values normally seen during the luteal phase. During the first treatment cycle, only 1 subject had a relatively normal luteal phase progesterone profile. The concentrations in the other subjects were only slightly elevated, with peak levels between 3 and 4 ng/ml. During the second treatment cycle, 2 of the 4 subjects in whom progesterone determinations were performed had elevated values compatible with normal luteal phase concentrations. Biphasic basal body temperatures were observed in 3 of the 10 treatment cycles. In the ‘long-term studies’, no ‘typical’ LH or FSH profiles were observed. FSH concentrations were frequently elevated for extended periods, and were usually higher than LH concentrations. In only 1 of the subjects was a typical luteal phase elevation in progesterone concentration observed. These data indicate that, unlike other synthetic progestogenic and estrogenic steroids, marked variability in the profiles of the hormones studied is observed in the presence of 0.5 mg chlormadinone, and that typical luteal phase progesterone concentrations may occur in the absence of an antecedent gonadotropin surge.