Which medication is used to stimulate GnRH secretion in hypothalamic amenorrhea?

Which medication is used to stimulate GnRH secretion in hypothalamic amenorrhea?

• A. Clomiphene
• B. Letrozole
• C. Metformin
• D. Prednisone

Answer: (A)

Stimulating GnRH release by removing inhibitory signals allows the hypothalamus to drive the pituitary’s production of FSH and LH, which promotes ovulation in hypothalamic amenorrhea. Clomiphene achieves this by blocking estrogen receptors in the hypothalamus, which reduces the negative feedback from estrogen. That disinhibits GnRH secretion, increasing pulse frequency and amplitude, and subsequently raises FSH/LH to stimulate ovulation. The other options don’t act by directly boosting GnRH release. Letrozole lowers estrogen production and reduces feedback indirectly, which can encourage ovulation but isn’t a direct GnRH stimulant. Metformin helps with insulin resistance and ovulation in some PCOS patients, not by increasing GnRH pulses. Prednisone doesn’t promote GnRH secretion and isn’t used for this purpose.

Stimulating GnRH release by removing inhibitory signals allows the hypothalamus to drive the pituitary’s production of FSH and LH, which promotes ovulation in hypothalamic amenorrhea. Clomiphene achieves this by blocking estrogen receptors in the hypothalamus, which reduces the negative feedback from estrogen. That disinhibits GnRH secretion, increasing pulse frequency and amplitude, and subsequently raises FSH/LH to stimulate ovulation.

The other options don’t act by directly boosting GnRH release. Letrozole lowers estrogen production and reduces feedback indirectly, which can encourage ovulation but isn’t a direct GnRH stimulant. Metformin helps with insulin resistance and ovulation in some PCOS patients, not by increasing GnRH pulses. Prednisone doesn’t promote GnRH secretion and isn’t used for this purpose.