Suppression of Daytime and Nighttime Luteinizing Hormone Frequency by Progesterone in Early Pubertal Girls With and Without Hyperandrogenemia
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Purpose
During childhood, the levels of the hormones GnRH (Gonadotropin-releasing hormone), LH (luteinizing hormone), FSH (follicle stimulating hormone), estrogen, and progesterone are very low. However, when puberty starts, GnRH and LH pulses begin to increase, but they initially do so at night only. It is unknown why GnRH and LH pulses increase at night and then decrease during the day (instead of being increased all the time).The purpose of this study is to see how quickly progesterone reduces LH pulses. The study is also meant to find out whether too much testosterone (also a hormone) in the blood causes problems with the ability of progesterone to reduce LH pulses. In this study, the investigators aim to discover whether or not giving 3 small doses of progesterone to pubertal girls will prevent the nighttime increase of LH pulses. From the information gathered in this study, the investigators may be able to learn more about how menstrual cycles are normally established in girls during puberty. Ultimately, if the investigators understand these normal processes, the investigators may be able to better understand abnormalities of puberty.
| Condition | Intervention |
|---|---|
|
Polycystic Ovary Syndrome Hyperandrogenism |
Drug: Progesterone Drug: Placebo |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Single Group Assignment Masking: Single Blind (Subject) Primary Purpose: Basic Science |
| Official Title: | Suppression of Daytime and Nighttime LH Frequency by Progesterone in Early Pubertal Girls With and Without Hyperandrogenemia (JCM024) |
- Average Leuteinizing hormone (LH) interpulse interval and the total number of LH pulses [ Time Frame: 1100hr to 0700 hr ] [ Designated as safety issue: No ]
- Hourly hormone measurements during sampling period. [ Time Frame: 1100hr to 0700 hr ] [ Designated as safety issue: No ]The hourly measurements of Progesterone, FSH, Estrogen, and Testosterone will be analyzed in a similar manner as the LH interpulse interval data.
| Estimated Enrollment: | 40 |
| Study Start Date: | May 2008 |
| Estimated Study Completion Date: | April 2015 |
| Estimated Primary Completion Date: | April 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Progesterone
Subjects will take 5-25 mg oral micronized P (based on body weight, to achieve mean plasma P 1-2 ng/ml)
|
Drug: Progesterone
Subjects will take 5-25 mg oral micronized P (based on body weight, to achieve mean plasma P 1-2 ng/ml) or placebo at 1100, 1500, and 1900 h.
|
|
Placebo Comparator: placebo
placebo at 1100, 1500, and 1900 h.
|
Drug: Placebo
Placebo
|
Eligibility| Ages Eligible for Study: | 9 Years to 14 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Female volunteers in early to midpuberty (i.e., late Tanner I [estradiol level > 20 pg/mL], Tanner II, or Tanner III)
- Premenarcheal
Exclusion Criteria:
- Pregnancy
- Inability to comprehend what will be done during the study or why it will be done
- Hemoglobin less than 12 g/dl and hematocrit less than 36%
- Persistently abnormal sodium, potassium, or bicarbonate (i.e., confirmed on repeat)
- Persistently elevated creatinine, hepatic transaminases, or alkaline phosphatase (i.e., confirmed on repeat)
- Total bilirubin > 1.5 times upper limit of normal (i.e., confirmed on repeat)
- Significant history of cardiac or pulmonary dysfunction (e.g., known or suspected congestive heart failure; asthma requiring intermittent systemic corticosteroids; etc.)
- Untreated hypo- or hyperthyroidism (reflected by persistently abnormal TSH values)
- Total testosterone > 200 ng/dl
- Basal (follicular) 17-OHP > 200 ng/ml (in girls without a previous diagnosis of congenital adrenal hyperplasia)
- DHEA-S > 800 mcg/dl
- Elevation of prolactin > 2 times upper limit of normal
- Weight less than 26 kg.
Contacts and Locations| Contact: Michelle Y. Abshire, PhD | 434-243-6911 | pcos@virginia.edu |
| Contact: John C. Marshall, MD, PhD | 434-243-6911 | pcos@virginia.edu |
| United States, Virginia | |
| Center for Research in Reproduction, University of Virginia | Recruiting |
| Charlottesville, Virginia, United States, 22908 | |
| Contact: Michelle Y. Abshire, PhD 434-243-6911 pcos@virginia.edu | |
| Principal Investigator: John C. Marshall, MD, PhD | |
| Principal Investigator: | John C. Marshall, MD, PhD | University of Virginia |
More Information
No publications provided
| Responsible Party: | John Marshall, Director, Center for Research in Reproduction, University of Virginia |
| ClinicalTrials.gov Identifier: | NCT01428089 History of Changes |
| Other Study ID Numbers: | 13660, U54HD028934-18 |
| Study First Received: | August 30, 2011 |
| Last Updated: | June 12, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Virginia:
|
hyperandrogenemia |
Additional relevant MeSH terms:
|
Polycystic Ovary Syndrome Hyperandrogenism Ovarian Cysts Cysts Neoplasms Ovarian Diseases Adnexal Diseases Genital Diseases, Female Gonadal Disorders Endocrine System Diseases 46, XX Disorders of Sex Development |
Disorders of Sex Development Urogenital Abnormalities Adrenogenital Syndrome Congenital Abnormalities Progesterone Progestins Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 18, 2013