GONADOTROPINS AND GONADOTROPIN RECEPTORS DURING THE PERIMENOPAUSE

Twenty-two perimenopausal patients (aged 47-56 years) admitted for ele ctive abdominal hysterectomy and salpingo-oophorectomy were selected t o understand better the clinical significance of increasing gonadotrop in levels as an indicator of target organ responsiveness. Prior to ane sthesia, blood was drawn from the patients for subsequent analyses of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and 17 beta-estradiol (E(2)) levels. Ovarian tissue was obtained during s urgery and frozen at -70 degrees C for subsequent analyses for FSH and LH receptor content. The phase of the menstrual cycle of the patients or postmenopause was determined by serum gonadotropin and E(2) levels and histological evaluation of the endometrium. Patients with no dete ctable FSH receptors showed significantly higher serum FSH and LH leve ls (4.7- and 4.3-fold, respectively) when compared to patients with de tectable FSH receptors: FSH receptors were present in 27% of the patie nts, LH receptors were present in 68% of the patients and a negative c orrelation was found between serum LH levels and ovarian LH receptors. In postmenopausal patients, neither FSH receptors nor LH receptors we re detectable. High serum gonadotropin levels in perimenopausal patien ts thus suggest the existence of low or undetectable ovarian gonadotro pin receptor levels.