Disorders of Gonadotropin Secretion

Abstract

Gonadal function sufficient to support gametogenesis requires appropriate gonadotropin-releasing hormone (GnRH) input to drive appropriate pituitary secretion of LH and FSH. Alterations in GnRH drive either cause or reflect gonadal dysfunction. Hypothalamic hypogonadism in men and women results from functional, theoretically reversible, reductions in GnRH drive that are linked to stress, that is, cognitions and behaviours that activate the limbic hypothalamic–pituitary–adrenal axis. Common manifestations of insufficient GnRH drive in women include anovulation and amenorrhea. Amelioration of adrenal activation has been shown to restore ovulatory ovarian function in women with functional hypothalamic amenorrhea.