Luteinizing hormone-releasing hormone (
LH-RH) secretion from the hypothalamus follows a rhythmic pattern, inducing pulsatile
luteinizing hormone (LH) and
follicle-stimulating hormone (FSH) secretion from the pituitary gland. Consideration of this physiologic principle led to the introduction of pulsatile
LH-RH therapy via
infusion pump for the treatment of different forms of
hypogonadotropic hypogonadism. We report on 10 male patients, 16 to 28 years of age, suffering from
idiopathic hypogonadotropic hypogonadism (IHH) including Kallman's syndrome (n = 2) and
delayed puberty (n = 2). All presented with complete
eunuchoidism and had undergone no treatment for their conditions during the previous 2 years.
LH-RH was administered in subcutaneous pulses of 4 to 16 micrograms, with a portable
infusion pump (ZYKLOMAT, Ferring Corp., Kiel, FRG); treatment periods ranged from 6 to 24 months. With
therapy, the subjects improved secretion of LH, FSH and
testosterone. Testicular volumes and penis size increased; all patients developed normal secondary sexual characteristics. Spermatogenesis was induced in all patients. The time to onset of spermatogenesis ranged from 3 to 15 months. No major side effects were observed, and no patient dropped out of the study. The results indicate that pulsatile
LH-RH therapy is an highly effective treatment for IHH and
delayed puberty.