Gonadotrophin deficiency also occurs early in progressive hypopituitarism. Thus, patients with gonadal dysfunction should be investigated to avoid delayed diagnosis of a pituitary or parapituitary lesion. In women, gonadotrophin deficiency leads to inadequate oestrogen secretion, which may result in amenorrhoea and infertility (Fig. 2.12). Oestrogen deficiency also causes dyspareunia and atrophy of the breasts.
