Oestrogene im biphasischen und im gestörten menstruellen Cyclus

  • J. Hammerstein
Part of the Oestrogene Hypophysentumoren book series (ENDOKRINOLOGIE, volume 15)

Estrogens in the Biphasic and Disturbed Menstral Cycle


This review on estrogens in the ovulatory cycle and in anovulatory disorders is mainly based on long-term estrogen excretion studies as performed by the author in more than 45 cases during the last 12 years. This sort of investigations still today appears to be the only feasable approach for studying the dynamics of the endogenous estrogen production in this field. Its advantages and limitations are briefly referred to.

The well established urinary excretion pattern of estrogens in the course of the ovulatory cycle is discussed with regard to its physiological range of variation and to its correlation to other events and parameters of the cycle such as colpocytology, histology, urinary and plasma levels of gonadotropins and urinary pregnanediol. Special attention is paid to the time relationship between the first estrogen excretion peak, the ripening of the follicle and ovulation. The increase of the urinary estrogen output during the second half of the cycle is interpreted as being due to the activity of the corpus luteum.

On the basis of estrogen excretion curves, at least three types of anovulatory cycles may be distinguished. Most frequently pseudomenstruation are preceeded by remarkably elevated estrogen values in the urine. In rare cases a sharp midcycle peak occurs just as in ovulatory cycles, but no evidence of corpus luteum function is seen afterwards. In the third type, estrogen excretion is fairly constant at low or moderate levels throughout the whole anovulatory cycle.

Functional as well as dysfunctional uterine bleedings are generally thought to be triggered either by hormonal deprivation or — in the case of break-through bleedings — by a relative hormonal deficiency which is know to develope at constant estrogen levels in the course of time. This concept, however, does not appear to be attributable to all kinds of dysfunctional bleedings. Thus, recurrent dyshormonal uterine hemorrhages do not only start in the presence of decreasing or steady but also of sharply increasing urinary estrogen excretion values. Furthermore, endometria sometimes fail to respond with bleeding to adequate estrogen deprivation. Factors are quoted which may modify the responsiveness of the target organ in such instances.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Allende, I. L. C., de: Obstet, gynee. Surv. 13, 753 (1958).CrossRefGoogle Scholar
  2. Allende, I. L. C., and O. Orías: Cytology of the human vagina. New York: P. Hoeber 1950.Google Scholar
  3. Barlow, J. J., and C. M. Logan: Steroids 7, 309 (1966).PubMedCrossRefGoogle Scholar
  4. Brown, J. B.: Biochem. J. 60, 185 (1955).PubMedGoogle Scholar
  5. Brown, J. B.: J. Endoer. 16, 202 (1957).CrossRefGoogle Scholar
  6. Brown, J. B.: J. Obstet. Gynaee. Brit. Emp. 66, 795 (1959).CrossRefGoogle Scholar
  7. Brown, J. B., R. D. Bulbroek, and P. C. Greenwood: J. Endoer. 16, 49 (1957).CrossRefGoogle Scholar
  8. Brown, J. B., R. Kellar, and G. D. Matthew: J. Obstet. Gynaee. Brit. Emp. 66, 177 (1959).CrossRefGoogle Scholar
  9. Brown, J. B.: A. Klopper, and J. A. Loraine: J. Endoer. 17, 401 (1958).CrossRefGoogle Scholar
  10. Brown, J. B., and G. D. Matthew: Recent Progr. Hormone Res. 18, 337 (1962).Google Scholar
  11. Burger, H. G., K. J. Catt, and J. B. Brown: J. clin. Endocr. 28, 1508 (1968).PubMedCrossRefGoogle Scholar
  12. Buschbeck, H.: Acta endocr. (Kbh.) 17, 31 (1954).Google Scholar
  13. Corner, G. W.: Brit. med. J. 1952 II, 403.CrossRefGoogle Scholar
  14. Corner, G. W., E. J. Farris, and G. W. Corner: Amer. J. Obstet. Gynec. 59, 514 (1950).PubMedGoogle Scholar
  15. Diezfalusy, E., u. C. Lauritzen: Oestrogene beim Menschen. Berlin-Göttingen-Heidelberg: Springer 1961.CrossRefGoogle Scholar
  16. Eren, S., G. H. Reynolds, M. E. Turner, F. H. Schmidt, J. H. Mackay, C. M. Howard, and J. R. K. Preedy: J. clin. Endocr. 27, 1451 (1967).PubMedCrossRefGoogle Scholar
  17. Frank, R. T.: Surg. Gynec. Obstet. 42, 572 (1926).Google Scholar
  18. Goering, R. W., S. Matsuda, and W. L. Herrman: Amer. J. Obstet. Gynec. 92, 441 (1965).PubMedGoogle Scholar
  19. Gruner, W.: Arch. Gynäk. 172, 465 (1942).CrossRefGoogle Scholar
  20. Hammerstein, J.: Z. Geburtsh. Gynäk. 152, 24 (1959).Google Scholar
  21. Hammerstein, J.: Habilitationsschrift, Berlin 1960.Google Scholar
  22. Hammerstein, J.: Arch. Gynäk. 196, 504 (1962a).CrossRefGoogle Scholar
  23. Gewebs- und Neurohormone — Physiologie des Melanophorenhormons, S. 241. Berlin-Göttingen-Heidelberg: Springer 1962 (b).Google Scholar
  24. Hammerstein, J.: Arch. Gynäk. 200, 638 (1965).CrossRefGoogle Scholar
  25. Hammerstein, J.: Verhandlungsberichte. Tagung dtsch. Ges. f. Gynäk. — Arch. Gynäk. 207, 48, (1969) (ausführliche Publikation in Vorbereitung).Google Scholar
  26. Hammerstein, J.: Der Gynäkologe 1, 112 (1969).Google Scholar
  27. Hammerstein, J., and E. Boquoi: Acta cytol. (Philad.) (im Druck).Google Scholar
  28. Hammerstein, J., u. J. Nevinny-Stickel: Arch. Gynäk. (in Vorbereitung).Google Scholar
  29. Hammerstein, J., B. F. Rice, and K. Savard: J. clin. Endocr. 24, 597 (1964).PubMedCrossRefGoogle Scholar
  30. Hoffmann, I., K. G. Ober u. A. Schmitt: Geburtsh. u. Frauenheilk. 13, 81 (1953).Google Scholar
  31. Loewe, S., u. F. Lange: Klin. Wschr. 5, 1038 (1926).CrossRefGoogle Scholar
  32. Loraine, J., and E. T. Bell: Lancet 1963 I, 1340.CrossRefGoogle Scholar
  33. Kaiser, R., B. Mackert u. W. Keyl: Arch. Gynäk. 199, 414 (1964).CrossRefGoogle Scholar
  34. Mikhail, G.: Clin. Obstet. Gynec. 10, 29 (1967).PubMedCrossRefGoogle Scholar
  35. Ober, K. G.: Dtsch. med. Wschr. 80, 532 (1955).CrossRefGoogle Scholar
  36. Pundel, J. P.: Précis de Colpocytologie hormonale. Paris: Masson & Cie 1966.Google Scholar
  37. Puttarajurs, B. V., and W. Taylor: J. Endocr. 18, 67 (1959).PubMedCrossRefGoogle Scholar
  38. Shearman, R. P.: Lancet 1964 II, 557.CrossRefGoogle Scholar
  39. Smith, O. W., G. V. Smith, and N. G. Gavian: Amer. J. Obstet. Gynec. 78, 1028 (1959).PubMedGoogle Scholar
  40. Stieve, H.: Der Einfluß des Nervensystems auf Bau und Tätigkeit der Geschlechtsorgane des Menschen. Stuttgart: Thieme 1952.Google Scholar
  41. Zander, J., E. Brendle, A.-M. v. Münstermann, E. Diczfalusy, B. Martinsen, and K.-G. Tillinger: Acta obstet, gynec. scand. 38, 724 (1959).CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1969

Authors and Affiliations

  • J. Hammerstein
    • 1
  1. 1.Abteilung für Gynäkologische Endokrinologie der Frauenklinik im Klinikum SteglitzFreien Universität BerlinDeutschland

Personalised recommendations