Central hypogonadism in women is a condition, the basis of which is hypoestrogenemia against the background of normal or low levels of gonadotropins.

OBJECTIVE

To study the ultrasound characteristics of internal genital organs in patients with central hypogonadism of different genesis and to evaluate the dynamics of these parameters against the background of hormone replacement therapy.

MATERIAL AND METHODS

The data of ultrasound examination of internal genital organs of 138 women were analyzed: 91 patients with central hypogonadism (32 women with central hypogonadism as a manifestation of hypopituitarism and 59 women with isolated central hypogonadism) and 47 healthy women (control group).

RESULTS

In all women with central hypogonadism the volumes of uterus and ovaries were statistically significantly smaller than in the group of healthy women (p<0.001). The patient groups did not differ in uterine (p=0.7315) and ovarian (p=0.4327) sizes between cohorts. In primary amenorrhea, patients with hypopituitarism had smaller ovarian volumes compared to those of women in the same group with secondary amenorrhea (p<0.0001). In the group of isolated central hypogonadism, patients with primary amenorrhea were characterized by smaller volumes of both uterus and ovaries compared to patients with secondary amenorrhea (p<0.0001). No correlation between the size of the internal genitalia and the duration of the disease was revealed. No statistically significant dynamics of uterine (p=0.1907) and ovarian (p=0.6236) sizes was observed in patients with hypopituitarism (n=20) on the background of estrogen-gestagen substitution therapy with duration of 1—5 (Me 2 [1; 3]) years; in patients with isolated central hypogonadism (n=19) ovarian volume also did not change (p=0.8206), uterine volume statistically significantly increased (p=0.0013), but did not reach the values of the control group.

CONCLUSION

The volumes of internal genital organs in women with central hypogonadism are statistically significantly smaller than in healthy women, and on the background of hormone replacement therapy do not reach the values characteristic of healthy women. This fact may be an additional obstacle in the realization of reproductive plans in such patients.