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To examine the effect of night shift on the ovarian function, 122 teachers, 67 office workers, 377 nurses, 133 factory workers and 67 barmaids were surveyed. The incidence of irregular menstrual cycle was 13.1% in teachers, 14.9% in office workers, 24.9% in nurses, 36.8% in factory workers and 40.3% in barmaids. The incidence was significantly higher in women working at night than women working during the day. Plasma concentrations of melatonin, LH, FSH and prolactin were determined at 2200 h and 0200 h in 5 nurses working at night and in 6 nurses resting in their quarters. Plasma concentrations of melatonin and prolactin at 0200 h were significantly lower in nurses of the working group than others of the resting group, but plasma concentrations of LH and FSH did not differ between the two groups. These results indicate that night shift suppresses the ovarian function by affecting the circadian rhythm of melatonin and prolactin.

In order to study the changes in androgen levels in patients with polycystic ovary syndrome (PCOS), serum androgen levels (testosterone [T], free-testosterone [free-T] and sex-hormone-binding globulin [SHBG]) were measured and related to the incidence of menstrual abnormalities, obesity and hirsutism. Tests were made in 61 cases of PCOS identified by transvaginal ultrasound and in normal controls. The following results were obtained: 1) The PCOS group with menstrual irregularities had significantly higher levels of T and free-T than the control group, but SHBG levels were not significantly altered. 2) The obese group had significantly higher free-T levels than the non-obese group, and SHBG was significantly lowered. 3) There were significant correlations between the levels of obesity and free-T and SHBG. 4) T and free-T were moderately high in the hirsutism group and SHBG was moderately low, but not significantly so. These findings indicate that, in PCOS patients, serum androgen levels, especially free-T and SHBG, are closely related to menstrual irregularities and the level of obesity.

To study the effects of melatonin on the human hypophyseal ovarian axis, we measured the concentrations of melatonin in the plasma of women with a regular menstrual cycle and of women with an abnormal menstrual cycle, at days 5 through 10 after the onset of menstruation or withdrawal bleeding. In seven women with a regular menstrual cycle, there was a tendency for the plasma melatonin concentration to gradually decrease chronologically from 49.0 +/- 9.8pg/ml (M +/- S.E.) at 9:30 h to 19.0 +/- 4.0pg/ml at 12:00 h. On the other hand, the plasma melatonin concentration at 21:30 h was 50.3 +/- 7.4pg/ml which was almost the same as the level at 9:30 h, while the concentration during the night significantly increased chronologically to 106.3 +/- 28.6pg/ml at 24:00 h. By comparing the plasma melatonin concentration measured during the day with that measured during the night, a significant difference was discovered after 21:40 h (p less than 0.05). The plasma melatonin concentration at 10:00 h and 22:00 h in 20 women with a regular menstrual cycle was 28.1 +/- 3.4pg/ml and 72.2 +/- 9.9pg/ml, respectively, showing a diurnal rhythm with a significantly higher level during the night than during the day. On the other hand, the plasma melatonin concentration in most of the women with an anovulatory cycle or amenorrhea was within the range of the mean level of +/- 1.5 x the standard deviation obtained from the 20 women with a regular menstrual cycle. However, an increase in plasma melatonin during the night was not found in three of nine women with an anovulatory cycle and one of two women with second grade amenorrhea.(ABSTRACT TRUNCATED AT 250 WORDS)

To study the prognosis of adolescent ovulatory disturbance in patients with persistently elevated LH levels (greater than or equal to 25 mIU/ml), normal FSH levels and high LH/FSH (greater than 2.0), 17 patients aged 12-19 years were studied longitudinally for 4-9 years. These 17 patients consisted of 7 patients suffering from amenorrhea with estrogenic effect, 5 patients with functional bleeding, 3 patients with delayed menarche and 2 patients with oligomenorrhea. All of the patients showed exaggerated LH responses to 100 micrograms of LHRH administration while the FSH responses were not different from those obtained from normal women. Out of the 17 patients, 10 (58.8%) patients showed the values of testosterone and 7 (41.2%) androstenedione which were above the mean + 2SD of normal women. Consequently, the mean serum testosterone and androstenedione levels were significantly higher than those in normal women. The mean LH (36.6 +/- 8.3 mIU/ml), FSH (11.2 +/- 1.5 mIU/ml) and LH/FSH (3.3 +/- 0.8) at the age of 21.4 +/- 2.5 years were not different from the mean LH (39.9 +/- 13.3 mIU/ml), FSH (10.8 +/- 1.8 mIU/ml) and LH/FSH (3.8 +/- 1.5) at the age of 16.1 +/- 1.8 years, respectively. None of the 17 patients showed amelioration or deterioration of ovulatory disturbance during long-term observation. To further investigate the central dopamine activity, 10 mg of metoclopramide (MCP) was administered intravenously in these 17 patients. The LH and PRL responses to MCP were evaluated, and the results were compared to those obtained from 17 patients aged over 20 with PCO and from 17 normal women. The LH responses to MCP were positive in this juvenile patient group and the patients aged over 20 PCO group. However, the LH responses to MCP were negative in normal women in both the follicular and luteal phases. In contrast, the PRL responses to MCP were significantly attenuated in juvenile patients and in patients aged over 20 with PCO compared to those in normal women. Since the hormonal profiles in these 17 patients with anovulation or oligo-ovulation were very similar to those in the group aged over 20 with established PCO, it may be suggested that 1) at least part of the adult patients with PCO may have had PCO from late adolescence; 2) the majority of the patients with high LH and normal FSH levels in adolescence will suffer from ovulatory disturbance continuously; 3) in these patients, an aberration of central dopamine in control of LH and PRL may exist.