Circadian, ultradian, and episodic gonadotropin and prolactin secretion in human pseudocyesis

Abstract

Abstract. Six women with pseudocyesis were studied by 15-min blood sampling for 12 to 24 h to determine their gonadotropin and PRL secretory profiles aiming to clarify the endocrine alterations in this form of hypothalamic amenorrhea. Clinical and biochemical evidence of hyperandrogenism was found in 4 patients. Persistent hyperprolactinemia was present only in one patient. Significant circadian and ultradian periodicities were identified by time series analysis in the 12-24 h profiles of FSH, LH and PRL secretion. Pulse analysis by the Van Cauter (UL-TRA.JN) method revealed a 24-h mean LH interpulse interval of 91±21 min with a mean LH amplitude of 5.4±0.8 IU/l. There was a significantly lower pulse frequency at night than during the daytime. The mean 24-h PRL interpulse interval and pulse amplitude were 134±22 min and 9.2±1.8 IU/l, respectively. Both FSH and LH mean levels were higher during the daytime than at night, while the reverse was true for PRL values. Decreased LH pulse frequeny and amplitude emerged as the most distinctive findings. Antecedent hypothalamic-pituitary aberrations due to other endocrinopathies and the timing of the hormonal assessment (e.g. recovery phase) may explain, at least in part, the reported heterogeneity of neuroendocrinologic findings in pseudocyesis.

Evidence for a Coupled Oscillator Model of Endocrine Ultradian Rhythms

“…FSH exhibits low-amplitude URs that are often concomitant with LH (Booth et al, 1996; Genazzani et al, 1993; Joustra et al, 2016; Lockwood et al, 1998; Matsumoto and Bremner, 1984; Pincus et al, 1998; Stewart et al, 1994; Urban et al, 1988; Veldhuis et al, 1991; Yen et al, 1972), although pulsatile FSH is not always detectable in general circulation (Filicori et al, 1984; Ginther et al, 1998; McNeilly et al, 2003; Spratt et al, 1988; Yen et al, 1972). Gonadotropins are also coupled to gonadal hormone production on ultradian frequencies; LH peaks usually precede peaks in testosterone and progesterone by 10 to 40 min (Backstrom et al, 1982; Beaven et al, 2010; Bray et al, 1991; Filicori et al, 1984; Genazzani et al, 1991; Ginther et al, 1998; Lewis et al, 1995; Nakajima et al, 1990; Nóbrega et al, 2009; Rossmanith et al, 1990a; Sisk and Desjardins, 1986; Soules et al, 1989; Spratt et al, 1988; Urban et al, 1988; Veldhuis et al, 1988; Winters and Troen, 1986), and estrogen pulses occur either concomitant with or just after testosterone or progesterone in men (Winters and Troen, 1986) and women (Backstrom et al, 1982; Licinio et al, 1998a; Venturoli et al, 1988), respectively. Finally, inhibin (a hormone produced by the gonads that inhibits FSH) also shows weak URs at approximately circhoral frequencies (τ = 1-1.7 h) in antiphase with the gonadotropins (Lockwood et al, 1998; Nakajima et al, 1990).…”

Emotional Aspects of Hyperprolactinemia

“…3. There are, in the psychoanalytical literature, several the reference range they are close to the upper limit [15]. detailed descriptions of women who, in the context of actual or threatened separation, developed breast 5.…”

Pseudocyesis and its Modern Perspective

“…An androgenic pattern of hormone secretion, persistent corpus luteum and endogenous opioid peptides (6) have been postulated as of aetiological importance. Circadian and ultradian pattern of secretions of prolactin and gonadotrophins may partly account for the heterogeneity of neuroendocrine findings (7). Prolactin modulates maternal functions and reproductive behaviour.…”