[The role of pulsatile LHRH therapy in women: the treatment of delayed puberty and of hypothalamic amenorrhea].

The importance of gonadotropin pulsatility for normal hypothalamic-pituitary-gonadal axis function is well known. The most important aim of exogenous LHRH administration, given in females with delayed puberty or hypothalamic amenorrhea is to physiologically restore LH pulsatility to a more physiologic way as possible. In fact, a variable degree of LHRH endogenous defect is present in these conditions. Moreover, exogenous LHRH pulsatile administration is able to restore normal pubertal development until menarche appears and normal ovulatory cycles occur and pregnancy is induced. We reported our experience and review the literature regarding the importance and use of LHRH pulsatile therapy in delayed puberty and hypothalamic amenorrhea. We have also evaluated the data for various administration routes, the choice of patients, response to therapy and the possible diagnostic use of pulsatile LHRH with regard to the differential diagnosis of delayed puberty.