Normalization of serum luteinizing hormone levels in women with 46,XX spontaneous primary ovarian insufficiency.

OBJECTIVE: To determine the proportion of women with primary ovarian insufficiency who achieve normal serum LH levels on transdermal E(2) therapy.
DESIGN: Prospective.
SETTING: Clinical research center at a national US health research facility. PATIENT(S): Women with spontaneous primary ovarian insufficiency (n = 137) and 70 regularly menstruating control women (n = 70). INTERVENTION(S): Blood sampled from controls in the midfollicular phase and from patients while they were off E(2) for 2 weeks, then again 3 months later during the E(2)-only phase of hormone therapy (E(2) patch [100 microg/d] and oral medroxyprogesterone acetate [10 mg for 12 d/mo]). MAIN OUTCOME MEASURE(S): Serum LH. RESULT(S): While on transdermal E(2) therapy, significantly more women (51.1%, 70/137; 95% confidence interval, 42%, 60%) had serum LH levels in the normal range (5/137, 3.9% at baseline). Mean (SD) serum E(2) level significantly increased on therapy to 95.4 (84.9) pg/mL. CONCLUSION(S): A regimen of 100 microg/d of transdermal E(2) therapy achieves normal serum LH levels in approximately one half of women with spontaneous primary ovarian insufficiency. Theoretically, by avoiding inappropriate luteinization, physiologic E(2) therapy may improve follicle function in these women. Controlled studies to assess the effect of transdermal E(2) therapy on follicle function in these women are warranted.