Blood Production and Ovarian Secretion Rates of Estradiol-17β and Estrone in Women with Dysfunctional Uterine Bleeding

The dynamics of estrogen secretion and production were studied using isotope dilution techniques combined with direct sampling of ovarian venous blood and follicular fluid in 10 women with a clinical history of anovulatory dysfunctional uterine bleeding. The mean metabolic clearance rate of estradiol (1198 ± 97 SE 1 plasma/24 hr), conversion ratio of estradiol to estrone (0.089 ± 0.010), and the blood production rates of estradiol (PEE2) were within the same range as those found in normal women. The patient with the highest PEE2 (497 μg/24 hr) had cystic glandular hyperplasia of the endometrium. All three patients who ovulated in the cycle studied had a corpus luteum on each ovary and one further patient had bilateral functional follicles. In the luteal phase estrogen secretion and metabolism was normal. In 6 of the 10 patients significant amounts of estradiol were secreted by both ovaries. The concentrations of estradiol and estrone in follicular fluid collected before ovulation were generally much higher than normal. It is suggested that in women with dysfunctional uterine bleeding inappropriate estrogen secretion may result from multiple follicular development due to abnormalities in gonadotropin release.