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J Clin Endocrinol Metab. 2019 Jan 15. doi: 10.1210/jc.2018-02400. [Epub ahead of print]

The relationship between progesterone, sleep, and LH and FSH secretory dynamics in early post-menarchal girls.

Author information

1
Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
2
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH.
3
Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA.
4
Endocrine Sciences, Lab Corp, Calabasas Hills, CA.
5
ZRT Laboratory, Beaverton, OR.
6
Social & Scientific Systems, Inc., Durham, NC.
7
Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.

Abstract

Context:

During puberty, LH pulse frequency increases during sleep; in women, LH pulse frequency slows during sleep in the early/mid-follicular phase (FP) of the menstrual cycle. The origin and significance of this developmental transition are unknown.

Objective:

To determine the relationship between progesterone (P4) exposure, sleep-related slowing of LH pulses in the FP, and the inter-cycle FSH rise, which promotes folliculogenesis, in early post-menarchal girls.

Methods:

23 girls (gynecologic age 0.4-3.5 yrs) underwent hormone measurements and pelvic ultrasounds during two consecutive cycles and one frequent blood sampling study with concurrent polysomnography during the FP.

Results:

Subjects demonstrated one of four patterns during cycle 1 that represent a continuum of P4 exposure: ovulatory cycles with normal or short luteal phase lengths or anovulatory cycles ± follicle luteinization. Peak serum P4 and urine pregnanediol (Pd) in cycle 1 were inversely correlated with LH pulse frequency during sleep in the FP of cycle 2 (both r=-0.5 p=0.02). The inter-cycle FSH rise and folliculogenesis in cycle 2 were maintained following anovulatory cycles without P4/Pd exposure or nocturnal slowing of LH pulse frequency in the FP.

Conclusions:

During late puberty, rising P4 levels from follicle luteinization and ovulation may promote a slower LH pulse frequency during sleep in the FP. A normal FSH rise and follicle growth, however, can occur in the absence of P4-associated slowing. These studies therefore suggest that an immature LH secretory pattern during sleep is unlikely to contribute to menstrual irregularity in the early post-menarchal years.

PMID:
30649404
DOI:
10.1210/jc.2018-02400

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