Serum adrenal androgens in hyperprolactinaemic women prior to, during, and after chronic treatment with bromocriptine

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Abstract
Conflicting data exist in the literature regarding serum adrenal androgen concentrations in hyperprolactinemic states and the influence or lack thereof of dopaminergic drugs on the androgens. A prospective study was performed on 7 hyperprolactinemic women, none of whom had clinical features commonly associated with elevated androgens. Serum levels of prolactin (Prl), cortisol, androstenedione, dehydroepiandrosterone (DHA) and dehydroepiandrosterone sulfate (DHAS) were measured basally, at 3, 6 and 12 mo. during chronic bromocriptine therapy, and 2 mo. following withdrawal of the drug. Prior to bromocriptine therapy, and despite a mean serum Prl of 178 ng/ml, all values of cortisol, androstenedione and DHA were normal as were 6 of 7 DHAS values. During treatment with bromocriptine for 12 mo., the mean Prl level dropped into the normal range, but levels of cortisol, androstenedione and DHA remained unchanged. DHAS was significantly lower at 12 mo. when compared to initial levels but was not significantly different at 3 and 6 mo. No significant differences were observed in cortisol or androgens 2 mo. after termination of the bromocriptine compared to basal levels. A significant correlation was observed between cortisol and both androstenedione (P = 0.0042) and DHA (P = 0.0002) but not with DHAS. A significant correlation existed between Prl and DHAS. (P < 0.0001) but not with androstenedione or DHA. Normal levels of serum adrenal androgens were found in 6 of 7 hyperprolactinemic women, none of whom demonstrated clinical features of the polycystic ovary syndrome. Apparently increased basal adrenal androgens in hyperprolactinemia may not be as common as previously reported; androstenedione and DHA do not correlate with Prl; and DHAS is correlated with Prl. Although it appears that DHAS and prolactin concentrations are related, the mechanism underlying this relationship remains uncertain.

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