OBJECTIVES: I. Evaluate the sleep-entrained patterns of gonadotropin-releasing hormone
(GnRH) and sex steroid secretion in normal and hypogonadal children.
II. Examine the acute effects of sex steroids on the sleep-entrained patterns of GnRH
secretion in pubertal children and normal adults, either by stimulation of endogenous
production with pulsatile injection or by intravenous infusion of GnRH.
III. Examine the role of endogenous opioids by means of opioid receptor blockade in the sex
steroid regulation of GnRH secretion in pubertal children and normal adults.
PROTOCOL OUTLINE: This project involves several clinical protocols that study the regulation
and role of pulsatile gonadotropin-releasing hormone (GnRH) secretion.
Studies include dynamic and repeated stimulation tests of pulsatile GnRH; plasma luteinizing
hormone, follicular-stimulating hormone, testosterone (T), estradiol (E2), and GnRH
measurements at cyclic and episodic intervals; and evaluation of adrenal androgen patterns.
Circadian rhythms of GnRH secretion are monitored during sleep and awake hours. Growth
hormone secretory patterns and responses to provocative stimuli are studied as clinically
Selected participants undergo an assessment of pituitary responsiveness following T, E2,
and/or naloxone infusions. The suppressive effects of E2 are also studied during the early
follicular phase of the menstrual cycle.
Endocrinologically normal children and normal adult men and women are also studied.
PROTOCOL ENTRY CRITERIA:
- Suspected or proven hypothalamic-pituitary-gonadal dysfunction, i.e.: Significant
short stature and possible hypopituitarism Delayed adolescence Precocious puberty
Isolated growth hormone deficiency (IGHD)Primary hypogonadism
- Women are also studied, including those with the following disorders: Infertility
Oligo- or amenorrhea Hirsutism
- Age: 7 to 16 (18 to 35 for women and volunteers)
- Other: No pregnant or nursing women No prisoners Not in neuropsychiatric institute or
other facility for mental illness