The hypothalamic monoaminergic regulation of adrenocortical function in patients with hyperandrogenemia

Abstract

Since the majority of monoamines cannot penetrate through the hematoencephalic barrier, it is difficult to study their central metabolic disturbances. The ethymisole test was used to study the adrenocortical function in patients with hyperandrogenemia; ethymisole can penetrate through this barrier, it stimulates the brain structures that regulate adrenocortical function via endogenic monoamines activation. In 10 patients with the common form of ovarian polycystosis the ACTH and hydrocortisone response to ethymisole administration was virtually the same as in the reference group. This response was enhanced in 13 patients with ovarian polycystosis and adrenal hyperandrogenemia, and it could be arrested by ciproheptadin. This fact evidences, that the adrenal component of hyperandrogenemia is explained by hyperactivity of the hypothalamic serotoninergic systems, that regulate the secretion of corticotropin releasing factor. In 8 patients with ovarian polycystosis and functional hyperprolactinemia ACTH and hydrocortisone reaction to ethymisole administration was reduced; such type of response is observed in metoclopramide blocking of dopaminergic receptors. This fact points to the presence of hypothalamic dopaminergic insufficiency in the patients with ovarian polycystosis and hyperprolactinemia, this insufficiency involving not only the adrenocortical function regulating centers, but, possibly, the tuberoinfundibular system structures as well.