Gonadotropins

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Gonadotropins: Luteinizing and Follicle Stimulating Hormones

Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are called gonadotropins because
stimulate the gonads - in males, the testes, and in females, the ovaries. They are not necessary for life,
but are essential for reproduction. These two hormones are secreted from cells in the anterior pituitary
called gonadotrophs. Most gonadotrophs secrete only LH or FSH, but some appear to secrete both
hormones.

As described for thyroid-simulating hormone, LH and FSH are large glycoproteins composed of alpha and
beta subunits. The alpha subunit is identical in all three of these anterior pituitary hormones, while the
beta subunit is unique and endows each hormone with the ability to bind its own receptor.

Physiologic Effects of Gonadotropins

Physiologic effects of the gonadotrophins are known only in the ovaries and testes. Together, they
regulate many aspects of gonadal function in both males and females.

Luteinizing Hormone

In both sexes, LH stimulates secretion of sex steroids from the gonads. In the testes, LH binds to
receptors on Leydig cells, stimulating synthesis and secretion of testosterone. Theca cells in the ovary
respond to LH stimulation by secretion of testosterone, which is converted into estrogen by adjacent
granulosa cells.

In females, ovulation of mature follicles on the ovary is induced by a large burst of LH secretion known
as the preovulatory LH surge. Residual cells within ovulated follicles proliferate to form corpora lutea,
which secrete the steroid hormones progesterone and estradiol. Progesterone is necessary for
maintenance of pregnancy, and, in most mammals, LH is required for continued development and
function of corpora lutea. The name luteinizing hormone derives from this effect of inducing
luteinization of ovarian follicles.
Follicle-Stimulating Hormone

As its name implies, FSH stimulates the maturation of ovarian follicles. Administration of FSH to humans
and animals induces "superovulation", or development of more than the usual number of mature
follicles and hence, an increased number of mature gametes.

FSH is also critical for sperm production. It supports the function of Sertoli cells, which in turn support
many aspects of sperm cell maturation.

Control of Gonadotropin Secretion

The principle regulator of LH and FSH secretion is gonadotropin-releasing hormone (GnRH, also known
as LH-releasing hormone). GnRH is a ten amino acid peptide that is synthesized and secreted from
hypothalamic neurons and binds to receptors on gonadotrophs.

As depicted in the figure to the right, GnRH stimultes secretion of LH, which in turn stimulates gonadal
secretion of the sex steroids testosterone, estrogen and progesterone. In a classical negative feedback
loop, sex steroids inhibit secretion of GnRH and also appear to have direct negative effects on
gonadotrophs.

This regulatory loop leads to pulsatile secretion of LH and, to a much lesser extent, FSH. The number of
pulses of GnRH and LH varies from a few per day to one or more per hour. In females, pulse frequency is
clearly related to stage of the cycle.

Numerous hormones influence GnRH secretion, and positive and negative control over GnRH and
gonadotropin secretion is actually considerably more complex than depicted in the figure. For example,
the gonads secrete at least two additional hormones - inhibin and activin - which selectively inhibit and
activate FSH secretion from the pituitary.
Disease States

Diminished secretion of LH or FSH can result in failure of gonadal function (hypogonadism). This
condition is typically manifest in males as failure in production of normal numbers of sperm. In females,
cessation of reproductive cycles is commonly observed.

Elevated blood levels of gonadotropins usually reflect lack of steroid negative feedback. Removal of the
gonads from either males or females, as is commonly done to animals, leads to persistent elevation in
LH and FSH. In humans, excessive secretion of FSH and/or LH most commonly the result of gonadal
failure or pituitary tumors. In general, elevated levels of gonadotropins per se have no biological effect.

Pharmacologic Manipulation of Gonadotropin Secretion

Normal patterns of gonadotropin secretion are absolutely required for reproduction, and interfering
particularly with LH secretion is a widely-used strategy for contraception. Oral contraceptive pills
contain a progestin (progesterone-mimicking compound), usually combined with an estrogen. As
discussed above, progesterone and estrogen inhibit LH secretion, and oral contraceptives are effective
because they inhibit the LH surge that induces ovulation.

Another route to suppressing gonadotropin secretion is to block the GnRH receptor. GnRH receptor
antagonists have potent contraceptive effects in both males and females, but have not been widely
deployed for that purpose.

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