Medication Summary
Medical therapy for patients with luteinizing hormone deficiency varies with respect to cause and if pregnancy is desired.
Androgen
Class Summary
Used in hypogonadism.
Testosterone (Androderm, Androgel, Testim)
Promotes and maintains secondary sex characteristics in males who are androgen deficient.
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.
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.
Letrozole (Femara)
Oral agent for ovulation induction.
Clomiphene (Clomid, Serophene)
Oral agent for ovulation induction.
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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MRI of pituitary macroadenoma.
