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    Treatment of female hypogonadism (f)

    The problem of hypogonadism and female infertility can be treated at all three levels of the hypothalamic-pituitary-testis axis depending on the localization of the disorder. The following hormone supplements are used:

    • GnRH agonists such as gonadorelin mimic the action of GnRH when administered in a pulsatile manner. These agents are used to treat hypogonadism with hypothalamic dysfunction.
    • Gonadotropins are used to treat secondary hypogonadism. Ovarian stimulation is achieved with follitropin (recombinant FSH) or hMG (menopause gonadotropin).HMG is prepared from urine of postmenopausal women and is a much cheaper option than recombinant FSH.Induction of ovulation is stimulated with lutropin (LH) or human chorionic gonadotropin (hCG). The structure of hCG is very similar to the structure of LH.
    • Estrogens in the micronised form are used in cases of primary hypogonadism and hypopituitarism. The micronised form is better water-soluble and thus better absorbed than the pure form (which is highly lipophilic).
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    A female with Turner’s syndrome (gonadal dysgenesis) requires:

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