Dysfunctions within the hypothalamic-pituitary-gonadal axis occur frequently among women with multiple sclerosis (MS) and may induce menstrual disturbances and subsequent infertility. We have measured serum concentrations of prolactin. gonadotropins and sex hormone binding globulin (SHBG) as well as free and bound oestrogen and androgen levels in 14 women of fertile age with MS. These women all displayed regular cycles without having experienced fertility problems. As controls 14 normal women with regular periods and ideal body weight of 91% (range 80-101) were included. Serum from both groups was sampled during the early follicular phase. The MS-patients had significantly (P less than 0.05) higher concentrations of prolactin, LH, FSH, total and free testosterone (P less than 0.01) and a significantly lower serum concentration of oestrone sulphate (P less than 0.01). The abnormal hormone concentrations were not related to clinical status of the disease. We propose that the increased androgen levels are of ovarian origin as adrenal androgens were normal. The reason for the slight increase of prolactin and the marked increase of gonadotropins in women with MS is speculative. As oestradiol levels, however, were within normal range, we assume that a peripheral resistance to gonadotropins combined with an abnormal central regulation causes the increased pituitary secretion.

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The aim of the study was to investigate whether the expulsion of the placenta was delayed among women who had previously undergone induced abortion by suction curettage. We studied the duration of the third stage of labor retrospectively by comparing the third stage of labor, recorded in minutes, between 76 second gravida women with previously induced abortions and 95 second para women with previously uncomplicated pregnancies. The duration of the third stage of labor was also compared among a group of primigravidas and a group of second gravidas with previously induced abortions. We excluded women with previous gynecological disorders (e.g. resulting in curettage of the uterine cavity). All patients included presented normal pregnancies and deliveries resulting in full term (greater than 37 weeks), liveborn infants. By the statistical analysis (analysis of variance and Duncan's test), it could be shown that the 3rd stage of labor lasted significantly longer among women with previously induced abortions (mean: 12 minutes), than among the other groups included in the study (mean: 9 minutes). This discrete difference in length of the third stage of labor need not indicate an altered routine for women, who give birth subsequent to an induced abortion.

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