Opiate antagonist treatment of ovarian failure

Abstract

One-hundred-and-thirty-eight women suffering from hypothalamicor hyperandrogenic ovarian failure were treatedwith daily doses of 25-150 mg of the opiate antagonist naltrexone for 4-100 weeks.In patients with hypothalamicovarian failure, treatment with naltrexone alone was followedby an increase of gonadotrophins and by normalization ofthe menstrual cycle in 70% of patients.Eight of 10 patientswho did not respond to naltrexone and had not previouslyovulated in response to clomiphene administration exhibitedovulatory cycles when both compounds were administered.Twenty-four pregnancies were achieved in 22 women, corresponding to an overall pregnancy rate of 26% with acumulative pregnancy rate closely resembling that of a normalpopulation.In contrast, in hyperandrogenic insulin-resistantpatients, the pattern of gonadotrophin secretion did not seemto change dramatically during naltrexone treatment.However, the rise of insulin in plasma following an oral load of glucose(oGTT)was blunted cons