Luteinizing Hormone Deficiency Medication

  • Author: Nichole M Barker, DO; Chief Editor: Richard Scott Lucidi, MD   more...
 
Updated: Mar 23, 2012
 

Medication Summary

Therapies for patients with luteinizing hormone deficiency are synthetic progestational agents (progesterone) and ovulation induction agents (clomiphene citrate). No demonstrable differences between these 2 drug choices exist with respect to pregnancy rates.

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Androgen

Class Summary

Used in hypogonadism.

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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.

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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.

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

 

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

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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.

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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  Fellow in Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University Hospitals/Case Medical Center

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

Disclosure: Nothing to disclose.

Coauthor(s)

Rebecca Flyckt, MD  Fellow, Reproductive Endocrinology and Infertility

Disclosure: Nothing to disclose.

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 is a member of the following medical societies: American Urological 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; endo 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.

Specialty Editor Board

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.

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

Disclosure: Medscape Salary Employment

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

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

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

Disclosure: Nothing to disclose.

Additional Contributors

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

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