Effects of estrogen/progestin therapy in women with ovarian insufficiency associated with weight loss

Abstract

Objective: To study the influence of estrogen/progestin therapy on the hypothalamic-hypophysial-ovarian system in patients with hypogonadotropic ovarian insufficiency associated with weight loss.

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Methods: We studied 38 women with menstrual disorders related with weight loss, aged 16-25, who had received estrogen/progestin therapy during 3-6 months. A basic examination and re-examination after the end of the treatment was carried out to determine clinical status, fat metabolism, FSH, LH, prolactin, estradiol and progesterone blood levels. Percent body fat was measured by dual energy X-ray absorptiometry. The test with exogenous estrogen's was performed before and on the 20-30 th day after the end of the therapy.

Results: 70% of patients gained weight during estrogen/progestin therapy. Body mass index and percent body fat increased at the end of the treatment (p<0.05). The resumption of menses happened in 50% patients. The restoration of positive feedback mechanism (PFBM) between the ovaries and hypophysis occurred in 39.5% patients. The frequency of menses and PFBM resumption positively correlated with weight gain (p<0.05). Menses and PFBM restored after patients had achieved approximately 90% of ideal body weight.

Conclusions: Estrogen/progestin therapy can increase body weight, fat mass and restore the positive feedback mechanism between the ovaries and hypophysis and menstrual cycle in some patients with hypogonadotropic ovarian insufficiency associated with weight loss.