醫學六：80題 ( 包括麻醉科,眼科,耳鼻喉科,婦產科,復健科等科目及其及相關臨床實例與醫學倫理 )題庫下載題庫

由於hypogonadotropic hypogonadism 是本身無法分泌FSH與LH，因此抑制雌激素的副回饋仍然無法解決問題。須解決其根本因素，如： brain or pituitary tumors, pituitary apoplexy, head trauma, ingestion of certain drugs, and certain systemic diseases and syndromes.

Mechanism of Action  (clomiphene)

Clomiphene is a racemic mixture consisting of zuclomiphene (~38%) and enclomiphene (~62%), each with distinct pharmacologic properties. Clomiphene acts at the level of the hypothalamus, occupying cell surface and intracellular estrogen receptors (ERs) for longer durations than estrogen. This interferes with rece...

由於hypogonadotropic hypogonadism 是本身無法分泌FSH與LH，因此抑制雌激素的副回饋仍然無法解決問題。須解決其根本因素，如： brain or pituitary tumors, pituitary apoplexy, head trauma, ingestion of certain drugs, and certain systemic diseases and syndromes.

Mechanism of Action  (clomiphene)

Clomiphene is a racemic mixture consisting of zuclomiphene (~38%) and enclomiphene (~62%), each with distinct pharmacologic properties. Clomiphene acts at the level of the hypothalamus, occupying cell surface and intracellular estrogen receptors (ERs) for longer durations than estrogen. This interferes with receptor recycling, effectively depleting hypothalamic ERs and inhibiting normal estrogenic negative feedback. Impairment of the feedback signal results in increased pulsatile GnRH secretion from the hypothalamus and subsequent pituitary gonadotropin (FSH, LH) release, causing growth of the ovarian follicle, followed by follicular rupture (ASRM 2013; Dickey 1996).

Use 

Treatment of ovulatory dysfunction: Treatment of ovulatory dysfunction in women desiring pregnancy

Hypogonadotropic hypogonadism (HH), also known as secondary or central hypogonadism, as well as gonadotropin-releasing hormone deficiency or gonadotropin deficiency (GD), is a condition which is characterized by hypogonadismdue to an impaired secretion of gonadotropins, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH), by the pituitary gland in the brain, and in turn decreased gonadotropin levels and a resultant lack of sex steroid production.