Response of serum levels of
gonadotropins and
prolactin to doses of
estrogen and
progesterone was measured in a patient with the complete form of
androgen insensitivity, ie,
testicular feminization. Before
gonadectomy a single 2.5-mg dose of
estradiol benzoate (E2B) produced a decrease in
gonadotropin levels.
Gonadectomy resulted in a rise of serum levels of
follicle-stimulating hormone (FSH) and
luteinizing hormone (LH) but had no effect on levels of
prolactin. The following results were obtained after
gonadectomy: During low-dosage
therapy with
ethinyl estradiol (EE) a single 2.5-mg dose of E2B produced a decrease in FSH and LH levels, no LH surge, and a small rise in
prolactin levels. With a tenfold higher EE priming, the same dose of E2B provoked an LH surge;
progesterone administration produced FSH, LH, and
prolactin release. However,
progesterone priming blocked the positive feedback of
estradiol and enhanced its negative feedback. Pituitary sensitivity ot nonandrogenic
steroids appears to be normal in cases of
testicular feminization. Under this condition, after
gonadectomy, the dynamics of
gonadotropins and
prolactin in response to
estrogens or
progesterone administration are similar to those in normal women and suggest that aromatization products of
testosterone do not produce any irreversible effects on neuroendocrine differentiation of
androgen-insensitive patients