eMedicine Specialties > Obstetrics and Gynecology > Reproductive Endocrinology and Infertility

Luteinizing Hormone Deficiency: Follow-up

Author: Nichole M Giannios, DO, Reproductive Endocrinology and Infertility Fellow, Department of Obstetrics and Gynecology, University Hospitals/Case Medical Center
Coauthor(s): Rebecca Flyckt, MD, Resident in Obstetrics and Gynecology, University Hospitals/Case Medical Center; Allen Donald Seftel, MD, Professor, Department of Urology, Case School of Medicine; William W Hurd, MD, MSc, Professor of Reproductive Biology, Case Western Reserve University School of Medicine; Lilian Hanna Baldwin Chair in Gynecology and Obstetrics, Director, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center
Contributor Information and Disclosures

Updated: Feb 12, 2008

Follow-up

Further Outpatient Care

  • Kallmann syndrome: Patients require lifelong hormonal therapy and specific treatment to achieve fertility.
  • Hypogonadotropic hypogonadism: Patients with stress-related hypothalamic dysfunction can often regain gonadal function after weight gain or stress reduction. Patients with genetic or idiopathic hypogonadotropic hypogonadism require lifelong hormonal therapy and specific treatment to achieve fertility.
  • Pituitary dysfunction: Pituitary microadenomas (≤1 cm) often resolve spontaneously. Pituitary macroadenomas (>1 cm) are usually persistent and require at least annual imaging to detect enlargement. Most causes of panhypopituitarism are irreversible and patients require lifelong hormonal therapy and specific treatment to achieve fertility.
  • Luteal phase deficiency: When pregnancy is desired, hormone therapy is required for ovulation induction or luteal support. No long-term health risks are associated with this condition.

Complications

LH deficiency results in infertility and decreased sex hormones if untreated. Complications associated with the secondary lack of estrogen or testosterone can be avoided by replacement hormone therapy. Hypothalamic and pituitary anomalies can result in other hormonal deficiencies (eg, thyroid, adrenal) that can adversely affect health.

Prognosis

Most causes of LH deficiency are irreversible. However, with appropriate hormone replacement therapy, fertility and a normal life expectancy can be anticipated.

Patient Education

Patients need to be educated about the incidence, pathophysiology, and treatment of their specific condition.

Miscellaneous

Medicolegal Pitfalls

Appropriate diagnostic tests and timely referral to specialists are essential for these patients.

 
Acknowledgments

MRI of pituitary adenoma courtesy of Kristine Blackham, MD, University Hospitals of Cleveland, Case Medical Center, Department of Radiology



More on Luteinizing Hormone Deficiency

Overview: Luteinizing Hormone Deficiency
Differential Diagnoses & Workup: Luteinizing Hormone Deficiency
Treatment & Medication: Luteinizing Hormone Deficiency
Follow-up: Luteinizing Hormone Deficiency
Multimedia: Luteinizing Hormone Deficiency
References
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References

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Further Reading

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Keywords

Kallmann syndrome, hypothalamic suppression, hypogonadotropic hypogonadism, pituitary dysfunction, hyperprolactinemia, luteal phase deficiency, luteinizing hormone deficiency, LH, follicle-stimulating hormone, FSH, thyroid-stimulating hormone, TSH, human chorionic gonadotropin, hCG, gonadotropin-releasing hormone, GnRH, hormone replacement therapy

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Contributor Information and Disclosures

Author

Nichole M Giannios, DO, Reproductive Endocrinology and Infertility Fellow, Department of Obstetrics and Gynecology, University Hospitals/Case Medical Center
Nichole M Giannios, DO is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, and American Osteopathic Association
Disclosure: Nothing to disclose.

Coauthor(s)

Rebecca Flyckt, MD, Resident in Obstetrics and Gynecology, University Hospitals/Case Medical Center
Disclosure: Nothing to disclose.

Allen Donald Seftel, MD, Professor, Department of Urology, Case School of Medicine
Allen Donald Seftel, MD is a member of the following medical societies: Ohio State Medical Association
Disclosure: lilly Consulting fee Consulting; sanofi-aventis Consulting fee Consulting; auxilium Consulting fee Consulting; solvay Consulting fee Consulting; plethora Grant/research funds clinical trial; indevus Consulting fee Consulting; nature publishing  journal editor

William W Hurd, MD, MSc, Professor of Reproductive Biology, Case Western Reserve University School of Medicine; Lilian Hanna Baldwin Chair in Gynecology and Obstetrics, Director, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center
William W Hurd, MD, MSc is a member of the following medical societies: Alpha Omega Alpha, American Association of Gynecologic Laparoscopists, American College of Obstetricians and Gynecologists, American College of Physician Executives, American College of Surgeons, American Gynecological and Obstetrical Society, American Medical Association, American Society for Reproductive Medicine, Society for Gynecologic Investigation, and Society of Reproductive Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Karen Loeb Lifford, MD, Director of General Gynecology, Associate Program Director, Department of Obstetrics and Gynecology, Instructor, Brigham and Women's Hospital, Harvard Medical School
Karen Loeb Lifford, MD is a member of the following medical societies: Association of Professors of Gynecology and Obstetrics, Massachusetts Medical Society, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Antonio V Sison, MD, Medical Director, Ob/Gyn Group, Robert Wood Johnson University Hospital at Hamilton
Antonio V Sison, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists and Association of Professors of Gynecology and Obstetrics
Disclosure: Nothing to disclose.

CME Editor

Frederick B Gaupp, MD, Consulting Staff, Department of Family Practice, Hancock Medical Center
Frederick B Gaupp, MD is a member of the following medical societies: American Academy of Family Physicians
Disclosure: Nothing to disclose.

Chief Editor

Bryan D Cowan, MD, Professor and Chairman, Department of Obstetrics and Gynecology, University of Mississippi College of Medicine; Consulting Staff, Department of Obstetrics and Gynecology, Veterans Affairs Medical Center; Medical Director, Wiser Hospital for Women, University of Mississippi Medical Center
Bryan D Cowan, MD is a member of the following medical societies: American Association of Gynecologic Laparoscopists, American College of Obstetricians and Gynecologists, American Gynecological and Obstetrical Society, American Medical Association, American Society for Reproductive Medicine, Association of Professors of Gynecology and Obstetrics, Central Association of Obstetricians and Gynecologists, Endocrine Society, Sigma Xi, Society for Assisted Reproductive Technologies, Society for Gynecologic Investigation, Society for the Study of Reproduction, and Society of Laparoendoscopic Surgeons
Disclosure: Wyeth None Speaking and teaching

 
 
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