Gonadotropins, Estrogens, and Adrenal Steroids during the Menopausal Hot Flash*

Six postmenopausal women with frequent hot flashes underwent an 8-h recording of finger temperature as an objective marker of flushing. Serial measurements of serum LH, FSH, estrone, estradiol, dehydroepiandrosterone (DHEA), androstenedione (Δ), cortisol (F), and progesterone were also performed to identify any acute fluctuations in hormonal concentrations which were associated with the temperature changes. A significant increase (P < 0.001) in the level of LH was found, with a maximal percent change of 34 ± 4% during the 5- to 10- min segment after the onset of the finger temperature rises. This maximal LH increase coincided with a maximal finger temperature increase 7.2 ± 0.7 min after onset. Significant correlations were noted between LH measurements and finger temperature measured simultaneously and 5 and 10 min before the time of the sample, suggesting that the maximal LH increase occurs slightly after the maximal finger temperature elevation. Significant rises of DHEA (P < 0.02), A (P < 0.02), and F (P < 0.01) were also observed, with the maximal percent change being 56 ± 25%, 18 ± 7%, and 45 ± 16% for these respective hormones. A borderline significant change (P = 0.051) of progesterone was also noted(25 ± 17%). No acute changes of FSH, estrone, or estradiol could be related to the occurrence of hot flashes. The association of pulsatile LH release with the hot flash suggested that the factors concerned with the pulsatile release of LH maybe involved in the pathophysiology of these symptoms. The concomitant rises of DHEA, Δ, F, and progesterone suggested that increased adrenal activity may occur after the hot flash. The significance of this finding remains to beelucidated.