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Luteinizing Hormone Deficiency Medication

  • Author: Nichole M Barker, DO; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
 
Updated: Oct 30, 2014
 

Medication Summary

Medical therapy for patients with luteinizing hormone deficiency varies with respect to cause and if pregnancy is desired.

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Androgen

Class Summary

Used in hypogonadism.

Testosterone (Androderm, Androgel, Testim)

 

Promotes and maintains secondary sex characteristics in males who are androgen deficient.

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Estrogen derivative

Class Summary

Used as estrogen replacement therapy.

Estradiol (Estraderm, Estrace, Vivelle, Noven, Climara, Vivelle-Dot, FemPatch)

 

Restores estrogen levels in girls with hypogonadotropism to concentrations that induce negative feedback at gonadotrophic regulatory centers, which in turn reduces release of gonadotropins from pituitary.

Multiple studies have shown it will prevent bone loss at the spine and hip when started within 10 y of menopause.

Used for the purpose of hormone replacement and induction of puberty. Acts by regulating transcription of a limited number of genes. Estrogens diffuse through cell membranes, distribute themselves throughout the cell, and bind to and activate the nuclear estrogen receptor, a DNA-binding protein found in estrogen-responsive tissues. The activated estrogen receptor binds to specific DNA sequences or hormone-response elements, which enhances transcription of adjacent genes and, in turn, leads to the observed effects.

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Ovulation induction agents

Class Summary

These agents induce ovulation.

Follitropin Alfa (Gona-f, Gona-f RFF)

 

Stimulate gonadal steroid production. Either recombinant or human purified hormone may be used.

Clomiphene citrate (Clomid, Serophene)

 

Oral agent for ovulation induction in patients with luteal phase deficiency

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Progestational agents

Class Summary

These agents may support the luteal phase of a female who is subfertile in whom inadequate intrinsic luteal phase progesterone is available.

Progesterone intravaginal gel (Progestasert, Crinone Vaginal Gel)

 

Can be administered PO, vaginally, or IM. All routes of administration are equally effective. Begin treatment 2-3 d after ovulation and continue until 10th wk of pregnancy.

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Contributor Information and Disclosures
Author

Nichole M Barker, DO Physician in Reproductive Endocrinology and Infertility, Seattle Reproductive Medicine

Nichole M Barker, DO is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Allen Donald Seftel, MD Professor of Urology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School; Head, Division of Urology, Director, Urology Residency Training Program, Cooper University Hospital

Allen Donald Seftel, MD is a member of the following medical societies: American Urological Association

Disclosure: Received consulting fee from lilly for consulting; Received consulting fee from abbott for consulting; Received consulting fee from auxilium for consulting; Received consulting fee from actient for consulting; Received honoraria from journal of urology for board membership; Received consulting fee from endo for consulting.

William W Hurd, MD, MSc, MPH Professor and Director, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Duke University Medical Center

William W Hurd, MD, MSc, MPH is a member of the following medical societies: American College of Surgeons, American Gynecological and Obstetrical Society, AAGL, Society of Reproductive Surgeons, Alpha Omega Alpha, American College of Obstetricians and Gynecologists, American Medical Association, American Society for Reproductive Medicine, Society for Reproductive Investigation

Disclosure: Nothing to disclose.

Rebecca Flyckt, MD Associate Staff, Reproductive Endocrinology and Infertility, Cleveland Clinic

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Richard Scott Lucidi, MD, FACOG Associate Professor of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine

Richard Scott Lucidi, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine

Disclosure: Nothing to disclose.

Acknowledgements

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

References
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