Normalization of serum luteinizing hormone levels in women with 46,XX spontaneous primary ovarian insufficiency

ObjectiveTo determine the proportion of women with primary ovarian insufficiency who achieve normal serum LH levels on transdermal E2 therapy.DesignProspective.SettingClinical research center at a national US health research facility.Patient(s)Women with spontaneous primary ovarian insufficiency (n = 137) and 70 regularly menstruating control women (n = 70).Intervention(s)Blood sampled from controls in the midfollicular phase and from patients while they were off E2 for 2 weeks, then again 3 months later during the E2-only phase of hormone therapy (E2 patch [100 μg/d] and oral medroxyprogesterone acetate [10 mg for 12 d/mo]).Main Outcome Measure(s)Serum LH.Result(s)While on transdermal E2 therapy, significantly more women (51.1%, 70/137; 95% confidence interval, 42%, 60%) had serum LH levels in the normal range (5/137, 3.9% at baseline). Mean (SD) serum E2 level significantly increased on therapy to 95.4 (84.9) pg/mL.Conclusion(s)A regimen of 100 μg/d of transdermal E2 therapy achieves normal serum LH levels in approximately one half of women with spontaneous primary ovarian insufficiency. Theoretically, by avoiding inappropriate luteinization, physiologic E2 therapy may improve follicle function in these women. Controlled studies to assess the effect of transdermal E2 therapy on follicle function in these women are warranted.