Effect of clomiphene citrate on prolactin and gonadotropin release during GnRH-analog treatment

Martikainen H, Hannu Martikainen, H Martikainen, L Rönnberg, Lars Rönnberg, Rönnberg L, Aimo Ruokonen, A Ruokonen, Ruokonen A, Antti Kauppila, A Kauppila, Kauppila A
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 1988 · vol. 2(1) , pp. 53–58 · doi:10.3109/09513598809029339 · PMID:3140590 · W2160431888
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Clomiphene citrate priming reduced pituitary lactotrope PRL secretion and increased LH but not FSH response to GnRH stimulation in endometriosis patients on GnRH-agonist therapy.

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Abstract

The capacity of the anterior pituitary to secrete prolactin (PRL) and gonadotropins was evaluated by TRH and GnRH stimulation, followed by metoclopramide (MC) administration 1 hour later, before and after clomiphene citrate (CC) priming in 8 endometriosis patients receiving GnRH agonist analog (Buserelin) therapy for 6 months. GnRH-analog treatment lowered the maximal PRL responses to TRH and MC stimulation in the luteal phase, compared to those of 8 normally menstruating control patients. The LH response to GnRH stimulation was also diminished, indicating pituitary desensitization, while the FSH response remained unchanged. Antiestrogen administration during GnRH-analog treatment further reduced the capacity of pituitary lactotropes to secrete PRL in TRH and MC tests, and it increased the LH response but not the FSH response to GnRH stimulation. These data suggest that CC affects the mechanisms controlling PRL and gonadotropin secretions in hypoestrogenic women after prolonged GnRH agonist analog treatment by different modes of action, the action on gonadotropes being stimulatory and that on lactotropes inhibitory.

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Condition tags

endometriosis

MeSH descriptors

Buserelin Clomiphene Pituitary Gland, Anterior Prolactin Adult Buserelin Clomiphene Estradiol Estradiol Female Follicle Stimulating Hormone Follicle Stimulating Hormone Humans Luteinizing Hormone Luteinizing Hormone Metoclopramide Metoclopramide Pituitary Gland, Anterior Prolactin

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