THE HYPOTHALAMUS-PITUITARY-OVARY AND HYPOTHALAMUS-PITUITARY-THYROID AXES IN SPINAL CORD-INJURED WOMEN

Sixteen women with spinal cord injury (SCI) underwent studies of the h ypothalamus-pituitary-ovary (HPO) and hypothalamus-pituitary-thyroid ( HPT) axes with luteinizing hormone (LH) releasing hormone (LHRH) and t hyrotropin (TSH) releasing hormone (TRH) stimulation tests during the early follicular phase. The mean interval from injury to participation in this study was 7.5 years (range, 1.5 to 13.1). All subjects were m enstruating regularly. Five (35.7%) SCI subjects who were menstruating before injury had postinjury amenorrhea for 1 to 12 months, and the o ther nine (64.3%) SCI subjects had no interruption of menstruation aft er injury. Two SCI subjects whose injury occurred in preadolescence pr oceeded to menarche without any delay. The amount of menstrual flow wa s noted to be reduced in nine (64.3%) SCI subjects. Two and three SCI subjects had elevated follicle-stimulating hormone (FSH) and prolactin (PRL) levels, respectively. LH responses to LHRH were significantly h igher in the SCI group (P <.001). Ten (62.6%) SCI subjects had enhance d LH responses to LHRH. The mean TSH, PRL, and FSH responses to TRH an d LHRH of the SCI group were not significantly different from those of age-matched controls. However, five (31.2%), four (25.0%), and five ( 31.2%) SCI subjects had enhanced TSH, PRL, and FSH responses to TRH an d LHRH, respectively. Six (37.5%) SCI subjects had a delayed FSH respo nse to LHRH. In total, 13 (81.2%) SCI subjects had at least one axis a bnormality. These findings are consistent with the hypothesis that cha nges of central neurotransmitters may occur after SCI. Copyright (C) 1 996 by W.B. Saunders Company.