Research Reports - Longitudinal sex and stress hormone profiles among reproductive age and post-menopausal women after severe TBI

Brain Inj. 2016 Mar 10:1-10. [Epub ahead of print]

Ranganathan P(1), Kumar RG(1), Davis K(1), McCullough EH(1), Berga SL(2), Wagner
AK(1,)(3,)(4).

PRIMARY OBJECTIVES: To describe hormone profiles for pre-/post-menopausal women,
to monitor time to resumption of menstruation among pre-menopausal women and to
describe cortisol associated LH suppression and phasic variation in other sex
hormones over timeMethods and procedures: This study determined amenorrhea
duration and characterized acute (days 0-7) and chronic (months 1-6)
gonadotropins [luteinizing hormone and follicle stimulating hormone (LH, FSH)],
sex hormones (progesterone, estradiol) and stress hormone (cortisol) profiles.
Women were pre-menopausal (n = 3) or post-menopausal (n = 3). Among
pre-menopausal women, menstrual cycle resolution and phase association
(luteal/follicular) was monitored using self-report monthly reproductive history
questionnaires. This study compared post-TBI hormone profiles, stratified by
menopausal status, to hormone levels from seven controls and described 6- and
12-month outcomes for these women.
MAIN OUTCOMES AND RESULTS: Consistent with functional hypothalamic amenorrhea
(FHA), menstruation resumption among pre-menopausal women occurred when serum
cortisol normalized to luteal phase control levels. For post-menopausal women,
serum cortisol reductions corresponded with resolution of suppressed LH levels.
CONCLUSIONS: The stress of TBI results in anovulation and central
hypothalamic-pituitary-ovarian (HPG) axis suppression. Future work will examine
acute/chronic consequences of post-TBI hypercortisolemia and associated HPG
suppression, the temporal association of HPG suppression with other
neuroendocrine adaptations and how HPG suppression impacts multidimensional
recovery for women with TBI. 

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