Analysis of the Positive Feedback Effect of Estrogen on the Release of Gonadotropin in Women

In order to elucidate the positive feedback mechanism of estrogen on gonadotropin release in women, the responses of plasma LH and FSH to the constant infusion of estradiol-17 beta for a prolonged period were studied. The infusion was initiated on various days of the follicular phase and maintained for 36-66 hr at a constant rate of 500 or 1,000 microgram/24 hr. When the stimulus of estradiol was sustained for more than 30 hr in the women of the middle or late follicular phase, a positive feedback effect to elicit gonadotropin surges was observed during the maintenance of the infusion. In contrast, the stimulus of estrogen was ineffective in the early follicular phase, even if sustained for a longer period up to 66 hr. Gonadotropin levels, also, increased after the end of infusion. The magnitude of the responses, however, was much smaller, as compared to spontaneous preovulatory gonadotropin surges. In all cases, the effect of estradiol was greater for LH than for FSH. It is suggested that: 1) Preovulatory gonadotropin surges are triggered by estrogen increments rather than the withdrawal of the negative feedback effect of estrogen. 2) Low levels of estrogen for a certain period of the early follicular phase may play an important role in priming the control system which responds to the positive feedback effect of estrogen.