Kisspeptin-10 Dosing for Female Patients
The recommended intravenous dosage of kisspeptin-10 for female patients is 10 nmol/kg as a single bolus during the preovulatory phase of the menstrual cycle, as this is the only time in the female cycle when kisspeptin-10 consistently stimulates gonadotropin release. 1
Critical Timing Considerations
The effectiveness of kisspeptin-10 in women exhibits profound menstrual cycle-dependent variation that is essential for clinical application:
During the follicular phase: Kisspeptin-10 fails to stimulate LH or FSH release even at maximal doses of 10 nmol/kg IV bolus, 32 nmol/kg subcutaneous bolus, or 720 pmol/kg/min IV infusion 1
During the preovulatory phase: Kisspeptin-10 at 10 nmol/kg IV bolus successfully elevates both serum LH and FSH 1
In postmenopausal women (sex steroid-deficient state): Kisspeptin-10 at 0.3 µg/kg (approximately 0.3 nmol/kg) produces robust gonadotropin responses with significantly larger LH (ΔAUC 5.3 ± 0.9 IU/l·h) and FSH responses compared to premenopausal women 2
Dosing Regimens by Clinical Context
Standard Dosing for Reproductive-Age Women
- Preovulatory phase administration: 10 nmol/kg as IV bolus 1
- Alternative lower dose: 0.3 µg/kg (approximately 0.3 nmol/kg) IV bolus, which produces measurable LH responses (ΔAUC 2.3 ± 0.8 IU/l·h) in early follicular phase women 2
Postmenopausal Women
- Recommended dose: 0.3 µg/kg IV bolus, which produces enhanced gonadotropin responses due to absence of sex steroid negative feedback 2
Route of Administration
Intravenous bolus is the most effective route for kisspeptin-10 in women, as subcutaneous administration (even at doses up to 32 nmol/kg) failed to stimulate gonadotropin release during the follicular phase 1
Critical Clinical Caveats
Sex Steroid Feedback Modulation
The gonadotropin response to kisspeptin-10 is profoundly influenced by sex steroid milieu:
Combined oral contraceptive users: Kisspeptin-10 (0.3 µg/kg) produces minimal LH response (ΔAUC 0.9 ± 0.4 IU/l·h, not statistically significant), indicating suppression by pharmacological estrogen/progestogen 2
Progestogen-only contraceptive users: Partial preservation of LH response (ΔAUC 2.6 ± 0.8 IU/l·h) despite suppressed baseline LH 2
Sexual Dimorphism in Response
Men respond to kisspeptin-10 at substantially lower doses than women, with robust LH and FSH elevation occurring at doses as low as 0.3 nmol/kg and 1.0 nmol/kg respectively 1. This represents a critical difference when translating dosing between sexes.
Comparison with Alternative Kisspeptin Isoforms
While kisspeptin-54 produces slightly greater magnitude and duration of LH responses compared to kisspeptin-10 in male studies 3, no direct comparative data exists for women. Both isoforms appear similarly effective in men when administered intravenously 3.
Practical Administration Considerations
- Timing of blood sampling: LH response peaks approximately 30 minutes after IV bolus administration 4
- Duration of effect: Single bolus produces acute gonadotropin elevation lasting approximately 60 minutes 2
- Repeated dosing: In male studies, repeated kisspeptin-10 boluses at 75-minute intervals maintained consistent LH responses without tachyphylaxis 5, though this has not been validated in women