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Effect of acute and chronic androgen suppression by glucocorticoids on gonadotropin levels in hirsute women.

Hirsute women may have increased serum LH levels and increased ratios of LH to FSH in serum as well as increased serum androgen levels. Glucocorticoid therapy lowers serum testosterone (T) levels in some hirsute women, but no significant effects on gonadotropin levels have been reported. Sixty hirsute women had serum T, LH, and FSH levels measured before and after acute and chronic glucocorticoid administration. Both acute and chronic treatment resulted in significant suppression of T levels. Serum LH levels significantly decreased after chronic therapy. Significant direct correlations were found between T and LH or T and the LH to FSH ratio, both before and after therapy. In 11 women with normal T levels, acute or chronic glucocorticoid treatment did not produce a significant change in LH levels or LH to FSH ratios. Women (n = 26) with elevated T levels that were suppressed more than 50% during treatment had significant decreases in their mean LH levels and LH to FSH ratios. No significant change in mean LH or LH to FSH ratio occurred in women (n = 23) with elevated T levels that were not suppressed by 50%. These results demonstrate that chronic, but not acute, glucocorticoid-induced suppression of T levels in hyperandrogenic hirsute women results in lowering of LH and LH to FSH ratios.