Interactions between psychosomatic conflicts and gonadotropin secretion.

This present paper represents an attempt to correlate hormonal patterns and psychoanalytical data in 30 patients with secondary amenorrhea. Based on psychoanalytical data and the maximal LH response to GnRH, which were obtained independently, the patients were divided into two groups presenting differing psychosomatic symptomatologies. Patients with severe psychosomatic disease (group A) complaining predominantly of somatic discomfort, exhibited a weak pituitary response to GnRH. Patients presenting mainly mental symptoms were found to be less affected by the psychosomatic disease (group B). The LH responses to GnRH were only moderately impaired in these patients. Seven patients of group A underwent psychotherapy, resulting in a resumption of regular menses in 4 patients. Eight untreated controls of this group who remained amenorrheic exhibited unaltered gonadotropin in levels. All patients of group B being treated by psychotherapy resumed regular menses, while 5 of 7 control patients developed spontaneous menstruation. The progress of sexual maturation in these patients is correlated with increasing pituitary LH response to GnRH. The present study provides evidence that the degree of a psychosomatic disturbance resulting in secondary amenorrhea is reflected by the pattern of plasma LH after GnRH stimulation.