this prospective study was conducted in order to evaluate the effect of surgical menopause and exogenous estrogen administration on the short-term dynamic changes of pituitary gonadotropin and ovarian steriod hormone levels.
Serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were measured and analyzed preoperatively and the first, second, and fourth postoperative week following bilateral oophorectomy in seven
women
with
regular menstrual cycles. Estrogen replacement therapy(ERT) was started from the fourth postoperative week. ERT with conjugated estrogen(Srogen 1.25 mg) was then given orally for 4 weeks.
Same hormone profile were also measured in the first & fourth week of post ERT respectively.
The control serum FSH, LH & E2 levels prior to surgery were all within normal range for follicular and luteal phase gonadotropins & E2, respectively. But hypoestrogenic levels were noted in two patients even though normal pituitary gonadotropins
levels
& normal menstruation.
By the end of thefirst postoperative week after bilateraloophorectomy, the mean E2 level were markedly & significantly decreased. The mean serum E2 level in the second postoperative week was even lower than that of the first postoperative week,
which
was not statistically significant(P>0.05). This result suggested that the lowest serum E2 level was persisted at the end second postoperative week. But E2 levels gradually increased from the second to the fourth weeks after surgery(P<0.05). Serum
FSH
level increased promptly by the end of the first week after bilateral oophorectomy. By the end of the first postoperative week serum FSH levels reached above postmenopausal levels. But serum LH levels had reached just below the postmenopausal
levels. In
all patients, serum FSH levels increased rapidly land more higher than LH levels. The progressive elevation of serum gonadotropins was noted according to time elapsed.
During estrogen administration menopasual levels of gonadotropins were suppressed. FSH levels markedly declined but LH levels didn't decreased markedly. However, the concentrations of both gonadotropins were still markedly elevated compared with
those
in premenopausal women. ERT only with conjugated estrogen (Srogen 1.25mg) following bilateral oophorectomy seems not to be sufficient to maintain supression of gonadotropin levels typical of normally menstruating women.
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