Luteinizing hormone pulse characteristics in depressed women

Abstract

M ajor depression is a common disorder that will affect at least 10% of women (DSM-III-R, p. 229). It is associated with abnormal hypothalamic regulation of a variety of neuroendocrine systems. If this dysregulation affects the hypothalamic-pituitary-gonadal (HPG) axis, potential physiologic manifestations could include impaired fertility, a condition of increasing clinical and social relevance for which an estimated 3 million couples sought treatment in 1995 (1).Regulation of the HPG axis depends on hypothalamic control of gonadotropin-releasing hormone. The frequency, amplitude, and perhaps other characteristics of the pulsatile release of gonadotropin-releasing hormone must fall within certain limits for maintenance of normal HPG axis functioning (2). Peripheral plasma concentrations of gonadotropin-releasing hormone are too small to be accurately assayed. However, because of its high correlation with luteinizing hormone (LH) release, gonadotropin-releasing hormone can be indirectly assessed by characterization of LH secretory patterns (3, 4). In the current study, 8-hour LH pulse characteristics of depressed women and normal subjects were compared in order to determine whether depression alters HPG axis function. METHODTwenty-three women between the ages of 18 and 40 years were recruited. Ten were psychiatric outpatients who met the DSM-III-R criteria for current major depressive episode (eight had major depression, recurrent; two had bipolar disorder not otherwise specified and were currently depressed), and 13 were normal subjects without any current axis I diagnoses. The mean age of the depressed women was 30.7 years (SD=3.8, range=26-37). The mean age of the comparison women was 30.1 years (SD=6.3, range=20-39). The depressed patients were initially diagnosed in a clinical interview using DSM-III-R criteria. They also met the Research Diagnostic Criteria (eight had recurrent unipolar depression; two had bipolar disorder and were currently depressed) according to the Schedule for Affective Disorders and Schizophrenia (SADS) (5). The comparison subjects were screened with the nonpatient version of the SADS. A subject was excluded if she had a history of other axis I diagnoses, current major medical illness, current use of birth control pills, a history of endocrinopathy, oophorectomy, current hormone replacement, or current amenorrhea. Each subject was free of psychotropic medications and was tested during the first week of her menstrual cycle. After complete description of the study to the subjects, written informed consent was obtained.The subjects were admitted to the University of Minnesota General Clinical Research Center at 10:30 a.m. An accurate weight was obtained, and an intravenous line with 5% dextrose in water (to keep it open) was started. Beginning at 11:00 a.m., a 5-ml blood sample was collected every 10 minutes for 8 hours, the "intensive sampling method" (6). Blood was drawn into heparinized tubes, immediately placed on ice, and centrifuged within 1 hour. The plasma was then stored at -70°...

Depression and Its Effect on the Menstrual Cycle

“…A study in 1997 reported that depressed women had higher LH amplitudes. However, there was no significant difference in the number of LH pulses over an eight-hour period [25]. In the year 2000, Young et al conducted a similar study on reproductive-age women with major depressive disorder.…”

“…It is pertinent that these menopausal changes in women's life are associated with mood symptoms [16,41]. As discussed ahead, it is established that depression affects the reproductive hormone regulation in females [25,26,29]. Thus, it is significant to explore the association between depression and menopause.…”

Perinatal Mood and Anxiety Disorders in Women Undergoing Medically Assisted Reproduction

“…In another study, IVF women had lower depressive symptoms than spontaneous pregnancy women at the third trimester of pregnancy, but the difference disappeared three months postdelivery; furthermore, the former had higher anxiety scores than the latter at the third trimester and the difference was maintained three months postdelivery [40]. Proposed underlying mechanisms include hyperprolactinemia, alterations in the regulation of the hypothalamic-pituitary-adrenal (HPA) and gonadotropin-luteinizing hormone (GnRH-LH) axes, and hyper-or hypothyroidism [41,42]. Other stress-related factors, such as low socioeconomic status, living in the inner city or degraded neighborhoods, and alcohol habits, may trigger anxiety and depressive symptoms and in turn negatively affect libido, thus resulting in infertility [43].…”