The influence of severe illness on gonadotropin secretion in the postmenopausal female.

Severe weight loss in amenorrheic premenopausal women may significantly depress gonadotropin secretion. Gonadotropin leves were studied in 111 postmenopausal women to determine if weight loss and cachexia could similarly affect gonadotropin function. Thirty-three healthy ambulatory postmenopausal women and twenty-seven healthy hospitalized women admitted electively were found to have a wide range of elevated values, whose mean did not differ significantly. Mean levels for both LH and FSH were significantly suppressed (P less than .005) in severely ill postmenopausal women both with or without weight loss. (formula: see text) Recovety from illness in six patients was associated with a rapid rise in FSH levels while LH remained depressed. Two severely ill patients studied over a 6 h period revealed constant depression of both gonadotropins without the characteristic pulses seen in four normal control postmenopausal women. These results indicate that gonadotropin secretion may be suppressed in severely ill postmenopausal women whether weight loss is present of not, and the central nervous regulatory mechanism responsible for intermittant release of gonadotropins is impaired. The disparate FSH and LH recovery indicates that if separate gonadotrophs exist, the LH gonadotroph is more severely affected than the FSH gonadotroph and/or that the responsible regulatory mechanisms are different.