GONADOTROPIC RESPONSIVENESS TO CLOMIPHENE, LRH, ESTRADIOL, AND BROMOCRIPTINE IN GALACTORRHEIC WOMEN

  • 1 January 1977
    • journal article
    • research article
    • Vol. 50  (2) , 139-144
Abstract
Hyperprolactinemic patients (20) with galactorrhea were studied to determine their gonadotropic responses to various stimuli. Women (5) lacked response to gonadotropin following the administration of clomiphene citrate. Patients (10) who had luteinizing hormone releasing hormone (LRH) tests before and during bromocriptine administration exhibited varied FSH [follicle stimulating hormone] and LH [luteinizing hormone] responses that apparently were unaffected by bromocriptine therapy. A loss of the normal positive feedback of estrogens at the level of the hypothalamus was demonstrated in most patients before and during bromocriptine therapy. Long-term treatment with bromocriptine in 11 women decreased serum prolactin, cessation of lactation in all and pregnancy in 8. The failure of normal secretion of gonadotropins in hyperprolactinemic women may result from inadequate release of endogenous LRH and loss of the positive feedback of estrogens as a result of the same hypothalamic disturbance that provokes the hyperprolactinemia. The elevated prolactin levels may exert a short-loop negative feedback of the hypothalamic level, inhibiting cyclic gonadotropin release.