Acetyl-L-carnitine (ALC) administration positively affects reproductive axis in hypogonadotropic women with functional hypothalamic amenorrhea

作者：Genazzani A D^*; Lanzoni C; Ricchieri F; Santagni S; Rattighieri E; Chierchia E; Monteleone P; Jasonni V M

来源：Journal of Endocrinological Investigation, 2011, 34(4): 287-291.

DOI：10.3275/6997

• Hypothalamic amenorrhea
• LH
• acetyl-L-carnitine
• opioids
• reproductive axis

Background: Hypothalamic amenorrhea (HA) is characterized by neuroendocrine impairment that, in turn, negatively modulates endocrine function, mainly within the reproductive axis. HA presents with hypo-LH, hypoestrogenism and, until now, a definite therapeutic strategy has not yet been found. The aim of the following study was to test the efficacy of acetyl-L-carnitine (ALC) administration in HA-affected subjects. Population: Twenty-four patients affected by stress-induced HA were divided into two groups according to LH plasma levels: group A, hypo-LH (LH <= 3 mlU/ml; no.=16), and group B, normo-LH (LH>3 mlU/ml; no.=8), were treated with ALC (1 g/day, per os) for 16 weeks. Design: Patients underwent baseline hormonal assessment, pulsatility test (for LH and FSH), naloxone test (for LH, FSH and cortisol) both before and after 16 weeks of treatment. Results: Under ALC administration hypo-LH patients showed a significant increase in LH plasma levels (from 1.4 +/- 0.3 to 3.1 +/- 0.5 mlU/ml, p<0.01) and in LH pulse amplitude (p<0.001). No changes were observed in the normo-LH group. LH response to naloxone was restored under ALC therapy. Maximal LH response and area under the curve under naloxone were significantly increased (p<0.05 and p<0.01, respectively). No changes were observed in the normo-LH patients. Conclusions: Our data support the hypothesis of a specific role of ALC on counteracting the stress-induced abnormalities in hypo-LH patients affected by hypothalamic amenorrhea. (J. Endocrinol. Invest.

• 出版日期2011-4