Abstract
Serial assays of urinary oestrogens, pregnanediol, follicle-stimulating hormone (FSH) and luteinising hormone (LH) have been performed in two women who developed amenorrhoea as a result of medication by oral contraceptives. Oestrogen levels were generally within the range normally found during the follicular phase of the menstrual cycle. However, in both subjects during part of the investigation there was a rise to midcycle levels; in the first woman this occurred spontaneously and in the second as a result of clomiphene treatment. Urinary LH activity was present in both patients throughout the study but in neither was a midcycle peak of LH output observed. The findings are compatible with the view that long term therapy by oral contraceptives may impair the cyclic release of gonadotrophins at the hypothalamic level thus resulting in amenorrhoea and anovulation.
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