Functional hypothalamic amenorrhea are very probably due to a decrease of the frequency of the secretory pulses of LH, ie of GnRH. This decrease could be the consequence of a chronic hypersecretion of the corticotropin releasing hormone (CRH). CRH seems to act on the hypotalamic pulse generator of GnRH through the effect of the endogenous opioid peptides of the central nervous system. Opioid receptor antagonists restore normal pulse frequency of LH in most cases. Research is being done to try to elucidate the cause of the failure to such treatment: dopamine in among other mechanisms, supposed to play an essential role.
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