HYPOTHALAMO‐PITUITARY OVARIAN FUNCTION IN THIRTY‐ONE WOMEN WITH CHRONIC ALCOHOLISM

Abstract

SUMMARY A study of hypothalamo‐pituitary function was carried out in chronic alcoholic women aged 29–66 years, with chronic pancreatitis or cirrhosis of the liver. Amenorrhoea was present in most of them (67%). The hormonal investigation included assessment of basal plasma steroids, gonadotrophin and prolactin values, followed by an anterior pituitary function test. Clomiphene stimulation and/or hCG tests were performed. The subjects were divided into four groups according to their oestrogen status on the one hand, and the baseline gonadotrophin concentration on the other. Results were compared with two control groups composed of twelve healthy post‐menopausal women and ten normal women of reproductive age. Five different patterns of hypothalamo‐pituitary ovarian activity could be distinguished: post‐menopausal women (eight), perimenopausal women (eight), hypothalamic amenorrhoea (five), anovulation (four) and inadequate luteal phase (six). A normal peri‐ or post‐menopausal hormonal profile was found in most (77%) chronic alcoholics of more than 45 years of age. In contrast, 84% of patients of reproductive age had functional hypothalamic disorders. These observations suggest that chronic alcoholism affects sexual function at the hypothalamo‐pituitary level chiefly during the reproductive period. The pathogenesis of these endocrine changes is not clear. The relative importance of ethanol consumption, liver damage and non‐specific factors such as nutritional status and chronic illness are discussed.