A brief review of the effects of chronic hydrocephalus on the gonadotropinreleasing hormone system: Implications for amenorrhea and precocious puberty

Precocious puberty and amenorrhea have been associated with hydrocephalus, but the pathogenesis has not been determined. Approximately 22 cases of ame norrhea, and a few cases of precocious puberty, have been reported in hydro cephalic patients. Shunt treatment leads to initiation and maintenance of n ormal reproductive cycles in most cases. An underlying mechanism responsibl e for reproductive dysfunction may involve the role of gonadotrophin releas ing hormone (GnRH). The exact pathway by which hydrocephalus disrupts the h ypothalamic GnRH system is unknown. However, compressive forces, ischemia, and impairment of neurotransmitter feedback loops are likely candidates.