[Disorders of the hypothalamo-hypophyseal-ovarian axis in chronic alcoholic women]. / Troubles de l'axe hypothalamo-hypophyso-ovarien chez la femme alcoolique chronique.

This paper deals with the physiology of menstrual cycle disturbances in alcoholic women. Nineteen women, aged from 25 to 45 years, were investigated for the quality of their menstrual cycle (amenorrhoea in 6, spanomenorrhoea in 5, normal cycle in 8) and for their clinical, biochemical and, when possible, histological hepatic status. In all these women, hormone levels were measured (in the early follicular phase for those with normal menses), including E2, E1, LHRH test, T, delta 4A, SBG, T4L, T3L, cortisol and prolactin. According to their hormonal profile, these women were classified as hypothalamo-pituitary amenorrhoea (n = 4), premature menopause (n = 2), ovarian dystrophy (n = 1) and normal hormone levels (n = 12). Although our results are too few for statistic value, it appears that the amount of alcohol consumed, the degree of malnutrition and the hepatic abnormalities observed are more important in women with abnormal hormonal profile.

[Study of corticotropic function: respective values of short tests using metropirone and exogenous ACTH regardless of the hour administered]. / Exploration de la fonction corticotrope: valeurs respectives des tests courts à la métopirone et à l'ACTH exogène quelle que soit l'heure de sa réalisation.

Basal plasma cortisol levels and adrenal responses to stimulation by endogenous and exogenous ACTH were compared between a group of controls and a group of patients with corticotrophic insufficiency. In addition, the adrenal response to the administration of exogenous ACTH was compared in each of these groups in relation to the timing of the test. There was a clear parallel between respective adrenal responses to exogenous ACTH and endogenous ACTH. Adrenal stimulation by exogenous ACTH may be used to investigate the residual secretion of endogenous ACTH and in the diagnosis or corticotrophic insufficiency, when a lesion interrupting functional hypothalamo-pituitary connections has been excluded. In the opposing case, use of a short test with metopirone is essential in order to confirm corticotrophic insufficiency. This test is better tolerated than the classical test and is not subject to sources of error due to urine collections.