CLINICAL AND ENDOCRINE FEATURES OF HYPERPROLACTINAEMIC AMENORRHOEA

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Abstract
The clinical radiological and endocrine findings in 35 women with hyperprolactinemia and amenorrhea are described. Twelve patients had radiological evidence of a pituitary tumor, and 6 were tested after pituitary ablation. Patients (17) with hyperprolactinemia and normal pituitary X-rays were also studied. None was on any drug known to increase prolactin secretion, and all patients were euthyroid when tested. Basal serum prolactin concentrations were high in the group with untreated pituitary tumors and in those with normal X-rays. The levels were variable in the post-ablation cases. The increase of prolactin after TRH [thyrotropin-releasing hormone] was subnormal in all of the groups. Serum estradiol concentrations were low in most patients, and 19 of 21 patients tested had no withdrawal bleeding after treatment with a progestogen. Mean serum gonadotropin concentrations (basal and after LHRH [luteinizing hormone-releasing hormone]) were normal in 29 patients but subnormal in 4 post-ablative cases. Anovulatory responses to clomiphene were obtained in 19 of 20 patients tested. Patients (15) were treated with bromocriptine; 12 ovulated and 8 became pregnant; 2 not responding had impaired LH [luteinizing hormone] and FSH [follicle-stimulating hormone] production. Hyperprolactinemic amenorrhea is a common disorder with characteristic endocrine features. Galactorrhea is unusual (30%). Treatment with bromocriptine lowers prolactin concentrations and rapidly repairs the reproductive defect.