Healthy Clinical Trial
Official title:
The Effect of Aging on the Isolated Pituitary Response to Gonadotropin Releasing Hormone at Baseline and With Low Dose Estrogen Administration
The purpose of this study is to study the effects of aging and estrogen on the brain. Specifically, this study will examine how the hypothalamus signals the pituitary gland to secrete reproductive hormones and how that changes with aging.
Although it is clear that loss of ovarian function plays a major role in the menopause in
women, there is evidence from animal studies that primary age-related hypothalamic and
pituitary changes may also contribute to reproductive aging. Complete cessation of ovarian
function results in the loss of negative feedback of ovarian steroids and inhibin on the
hypothalamic and pituitary components of the reproductive axis. An increase in serum levels
of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) occurs in postmenopausal
women with removal of negative ovarian feedback. However, levels of LH and FSH after
menopause decline steadily as a function of age in most though not all studies.
The current study is designed to determine: 1) whether negative feedback on LH and FSH
occurs at the pituitary; and 2) whether there is an effect of aging on estrogen negative
feedback at the pituitary. Younger and older postmenopausal women underwent a baseline study
and a second identical study after a month of low dose estrogen replacement. The study
protocol consisted of the following: 1) administration of a GnRH antagonist (Nal-Glu at 150
mg/kg that blocks endogenous GnRH so that the dose and interval of pituitary exposure to
GnRH are precisely controlled; 2) beginning 8 hours following GnRH antagonist administration
(at a time when LH had reached its nadir following GnRH receptor blockade), administration
of 4 graded doses of GnRH (25, 75, 250 and 750 ng/kg every 2 hours with 2 hours of blood
draws following each dose). Blood was sampled every 30 min for 4 hours before antagonist
administration, every 30 min for the following 7 hours and then every 10 min until the
completion of the study.
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