Dynamics of Suppression and Recovery of Plasma FSH, LH, Androstenedione and Testosterone in Polycystic Ovarian Disease Using an Oral Contraceptive

Abstract

Four women with proven and 3 with probable polycystic ovaries (PCO) had plasma FSH, LH, androstenedione (A) and testosterone (T) measured by radioimmunoassay before and during the administration of norethindrone 2 mg–mestranol 0.1 mg (Ortho-Novum 2 mg) daily for 17–21 days to determine how long a progestin–estrogen preparation should be given to evaluate the degree of suppressibility of elevated peripheral plasma concentrations of A and T in women with PCO. The pattern of recovery of these hormones was also studied. Pretreatment means ± se were: FSH 6.4 ± 1.2 mIU/ml, LH 21 ± 3 mIU/ml, A 515 ± 24 ng/100 ml, T 93 ± 17 ng/100 ml. The mean of each hormone decreased progressively from days 5–8 to days 13–16 of treatment. The mean of each hormone at the 13–16-day treatment period was: FSH 2.7 ± 1.2 mIU/ml, LH 6.7 (5–8) mIU/ml, A 216 ± 21 ng/100 ml and T 33 ± 3 ng/100 ml. Suppression and recovery of A and T were significantly correlated with LH. FSH began recovery before LH, A or T and was not significantly correlated with LH during suppression or recovery. The data established the effectiveness of this pill in correcting the hyperandrogenism associated with PCO and indicate that a suppression test should consist of giving the pill for at least 3 weeks and measuring plasma A and T during the last week of drug administration.