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Results for “hyperprolactinemia”

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PubMed2004

Hyperprolactinemia after low dose of amisulpride.

OBJECTIVES: Amisulpride in antipsychotic doses can induce hyperprolactinemia. The aim of this study was to prove whether the same is true for low doses of amisulpride. METHODOLOGY: Plasma prolactin levels were measured in 5 males and 5 females with depressive symptoms who were treated with 50 mg of amisulpride per day as an augmentation to antidepressants (n=5), benzodiazepine anxiolytics (n=8) or in monotherapy (n=1). Six of these patients were assessed prior to onset of amisulpride treatment and after 10 days of amisulpride use. Four patients had been using amisulpride for more than a month. RESULTS: There was a significant increase of prolactin levels from mean 16+/-6 ng/ml to 113+/-65 ng/ml (median 14.5 ng/ml to median 92 ng/ml; Wilcoxon matched pair test, p=0.027). All patients had hyperprolactinemia (30-200 ng/ml). The prolactinemia was significantly higher in females (mean 160+/-50 ng/ml; median 198 ng/ml) than in males (mean 48+/-12 ng/ml; median 48 ng/ml; Mann-Whitney U test, p=0.041). CONCLUSION: Even low doses of amisulpride used as an augmentation to antidepressant treatment, benzodiazepines or in monotherapy seem to be associated with hyperprolactinemia. The co-medication of antidepressants and benzodiazepines can potentially increase intensity of prolactinemia.

Adult↗

PubMed2005

[Hyperprolactinemia: etiology, clinical symptoms, and therapy].

Hyperprolactinemia is one of the most common endocrinological disorders. The main clinical symptoms are limited to hypogonadism, which manifests as fertility disturbances, oligo- or amenorrhea in women, and libido loss, impotence, and fertility disturbances in men, as well as bone density disturbances (osteopenia, osteoporosis) and alactorrhea. Hyperprolactinemia is caused in most cases by drugs or it has an organic etiology (pituitary tumor:--prolactinoma). Differentiation between these two causes is very important for both therapeutic decisions and prognosis. In the medical treatment of a hyperprolactinemic condition dopamine receptors type D2 agonists are used. Such drugs have well-established high therapeutic efficiency (in the vast majority of patients they cause normalization of PRL serum level, tumor shrinkage, and withdrawal of the hyperprolactinemia-related symptoms and tumor mass). This is why they are the first line treatment for prolactinoma. In cases of a lack of pharmacological effect, drug intolerance or resistance, large tumors with accompanying compression symptoms' (tumor mass effect), dynamic tumor enlargement, or if a macroprolactinoma-affected woman desires pregnancy neurosurgery should be considered. Radiotherapy is used mainly as a supplement to surgical treatment.

Adult↗

PubMed2004

[The effect of hyperprolactinemia on morphology and function of androgen receptor expressing cells in rat testis, epididymis and prostate].

UNLABELLED: The effects of hyperprolactinemia on the testis, epididymis and prostate are not fully understood. The aim of this study was to determine the influence of hyperprolactinemia induced with metoclopramide (MCP) on expression of the androgen receptor (AR) in the testis, epididymis and the lateral and dorsal lobes of the prostate in rats. Male, sexually mature, inbred Wistar rats were divided into two groups of ten rats each. Hyperprolactynemia was induced in the study group with metoclopramide intraperitoneally at 2.2 mg/kg b. w. for 14 days. Rats of the control group were given saline. Prolactin (PRL) levels in serum were measured with an enzyme immunoassay. Serum levels of testosterone (T) were measured with a radioimmunoassay. The testis, epididymis and lateral and dorsal lobes of the prostate were obtained for light and electron microscopy. The immunohistochemical reaction to AR was assessed by optical density measurements with a computer image analyzer. Ultrastructural studies of androgen receptor expressing cells were carried out with transmission and scanning electron microscopes. RESULTS: PRL concentrations in MCP rats were increased by more than twice, while T concentrations were reduced by half. The intensity of the immunohistochemical reaction to AR in the testis, epididymis and lateral and dorsal lobes of the prostate differed significantly in the study and control groups. Hyperprolactinemia produced structural changes in cells expressing the androgen receptor in the testis, epididymis and the lateral and dorsal lobes of prostate.

Animals↗

PubMed2006

[Comparative study of overactive bladder prevalence in patients younger than 50 years with and without hyperprolactinemia].

OBJECTIVE: To determine if the hyperprolactinemia is associated with idiopathic overactive bladder. PATIENTS AND METHODS: We performed a transversal and analytic two groups study. We included all the patients whom plasma levels of prolactin were measured in the National Institute of Perinatology from March 1st to May 31, 2005 and fulfilled the selection criteria. To all these patients we applied a questionnaire of eight questions for the overactive bladder diagnostic. We used chi square statistical technique to establish if hyperprolactinemia is associated with the overactive bladder. RESULTS: One hundred sixty years patients were studied, establishing a relative prevalence of 2.82 (IC 95%: 1.45-3.17), determining association between the variables. CONCLUSIONS: hyperprolactinemia is associated with overactive bladder.

Adult↗

PubMed2006

Low-dose risperidone augmentation of antidepressants or anxiolytics is associated with hyperprolactinemia.

OBJECTIVE: Risperidone in antipsychotic doses induces hyperprolactinemia. The aim of this study was to verify whether the same is true for low doses of risperidone (0.5-2 mg per day) added to antidepressants or anxiolytics. METHODS: Prolactin levels were measured in 4 men (mean age 49.5+/-19.1 years) and 8 women (mean age 31.3+/-8.2 years) inpatients with depressive and anxiety disorders who were treated with risperidone (median doses per day 1.25 mg) for median 15.5 days as an augmentation treatment to antidepressants (n=8), anxiolytics (n=6) and mood stabilizers (n=2). RESULTS: 11 of 12 patients had hyperprolactinemia. Median plasma prolactin level was 1598 mIU/ml, 95% CI 1 040-2 661 mIU/ml. Significant correlation between risperidone daily dose and plasma prolactin level (Spearman's R=0.655, p=0.02) was detected. Two women suffered from galactorrhea and one from amenorrhea. CONCLUSIONS: Even low doses of risperidone used as an augmentation to antidepressants or benzodiazepines are associated with hyperprolactinemia and can induce endocrinological side effects. The co-medication of antidepressants and benzodiazepines can potentially increase intensity of prolactinemia.

Adult↗

PubMed1991

[Disorders of the hypothalamo-hypophyseal system as a cause of infertility in hyperprolactinemia].

The purpose of the study was to describe hypothalamopituitary functional status of females with infertility in combination with hyperprolactinemia. To this end, changes in prolactin, LH, FSH and TSH in response to the administration of releasing hormones (Gn--RH and TRH) and the dopamine antagonist metoclopramide were assessed in 28 patients with hyperprolactinemic amenorrhea and 5 normal cycling women. Lactotrophs were found to be resistant to functional tests, the resistance increasing as the prolactin level went up. Gonadotrophic and thyrotrophic response to functional tests, on the contrary, increased with the progress of hyperprolactinemia. A conclusion is drawn that stable hyperprolactinemia is a result of disturbance in lactotrophic receptor apparatus, for which reason lactotrophs are no longer sensitive to dophamine inhibiting effect on prolactin secretion.

Adult↗

PubMed1991

Transient hyperprolactinemia in infertile women with luteal phase deficiency.

This study was conducted to evaluate the prevalence of transient hyperprolactinemia in infertile women with luteal phase deficiency. One hundred fifty-one luteal phase deficiency patients and 11 controls had serum prolactin (PRL) measured daily for 3-4 days near ovulation. Thirty-three subjects (21.9%) had transient hyperprolactinemia, with PRL above 20 ng/mL for 1 or 2 days, and were studied further. The blood samples of these 33 subjects and of the controls were also analyzed for LH and FSH. Plasma progesterone was measured on the fourth, seventh, and tenth days after ovulation in both groups. The mean (+/- SD) of the mid-cycle integrated LH surge (125.0 +/- 23.0 mIU/mL; N = 26) and the sum of three plasma progesterone levels (23.8 +/- 4.5 ng/mL; N = 21) in the luteal phase deficiency women were significantly (P less than .001) lower than those of the controls (LH 158.7 +/- 13.8 mIU/mL; progesterone 33.8 +/- 6.5 ng/mL). All 33 luteal phase deficiency subjects with transient hyperprolactinemia were treated with bromocriptine at a dose ranging from 1.25-5 mg/day to maintain mid-cycle PRL levels between 5-15 ng/mL. Both the integrated LH surge and the sum of three progesterone levels increased significantly (P less than .05) during bromocriptine treatment, to 142.6 +/- 22.4 mIU/mL (N = 20) and 28.2 +/- 6.2 ng/mL (N = 18), respectively. Fourteen of the 33 patients conceived. The cumulative probability of conception was 31% for six cycles and 45% for 12 cycles of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

[Adult T cell leukemia/lymphoma with hyperprolactinemia: successful treatment by OK432 and PSK].

A 48-year-old woman was admitted in September 1987, because of lumbago and galactorrhea. Peripheral blood analysis showed neutrophilia and eosinophilia without abnormal lymphocytes. The antibody to adult T-cell leukemia (ATL) virus-associated antigen was detected and a hyperprolactinemia was observed. The blastogenic responses to PHA, ConA and PWM were lowered. Brain CT and MRI scannings showed no abnormalities in the hypophysis and hypothalamus, but abdomen CT revealed markedly enlarged abdominal lymph nodes. Two months after the administration of OK432 and PSK, the lymph node swellings disappeared and the responses to PHA, ConA and PWM were normalized, but hyperprolactinemia and galactorrhea persisted. After four months of the remission period, the patient developed lymph node swellings again, and was diagnosed from the biopsy specimen of the retroperitoneal lymph node as having malignant lymphoma of diffuse mixed cell type. Southern blot analysis showed a monoclonal integration of HTLV-I proviral DNA. Despite repeated combination chemotherapies, she died of pneumonia in February 1989. Autopsy revealed marked infiltrations of lymphoma cells in the liver, spleen and lungs, but no abnormality accounting for hyperprolactinemia was detected in the suprasellar regions. This case was of interest in that immunotherapy was effective in achieving a remission and in normalizing immuno-parameters in ATLL.

Adjuvants, Immunologic↗

PubMedDate not supplied

[Levels of estradiol, progesterone and testosterone in hyperprolactinemia].

In 69 patients with hyperprolactinemia the concentrations of FSH (foliculostimulating) hormone, LH (luteinization) hormone, PRL (prolactin), PRG (progesterone), T (testosterone) and E2 (estradiol) were determined by the RIA method on the 7th, 14th, and 21st day following the beginning of spontaneous or induced uterine bleeding. According to the recorded E2 and PRG concentrations, all the patients were divided into three groups: one group with the E2 and PRG concentrations within normal ovulation cycle values (N = 31); the second group with the E2 concentrations within normal values and the PRG values characteristic of the 21st day (N = 18), and the third group with the E2 concentrations below the lower normal values on the 7th and the 14th day and the PRG anovulation concentrations on the 21st day (N = 20). The mean values of the E2 concentrations in the hyperprolactinemic patients were significantly lower in all the three control groups (P less than 0.01; 0.05; 0.01) on the 7th day and (P less than 0.01; 0.05; 0.001) on the 14th day, which suggests the impairment of the follicular phase of the cycle. In the second and third groups there was no significant difference between the E2 concentrations on the 7th and the 14th day, while the PRG concentrations on the 21st day remained on the level of the anovulation values. Unlike the control group, the patients with hyperprolactinemia showed no significant increase of the Lh concentration on the 14th day. The effect of hyperprolactinemia on the impairment of the ovarian function is discussed.

Adult↗

PubMed1990

[Correlation of serum prolactin, sperm count and motility. Prevalence of hyperprolactinemia in the infertile male].

Serum prolactin (PRL) levels were measured in 147 males. All patients had no known tumor, endocrine disorder, or symptoms or signs of hyperprolactinemia. All patients denied taking any medication or agents that could alter PRL levels. Semen analyses revealed 34 patients were normospermic, 69 were oligospermic, 26 were azoospermic, and 18 were purely astenzoospermic. PRL levels for the patient groups were not statistically significantly different. PRL values were higher than the normal ranges in 12.2% of the overall study population. A lower incidence (6.19%) was observed for hyperprolactinemia in the normospermics. These findings are comparable to those described elsewhere. Serum testosterone did not drop significantly in the hyperprolactinemics. Similarly, the FSH and LH values did not change significantly. The possible role of PRL in male infertility and the effect of hyperprolactinemia of varying degrees and etiology on sperm count and motility are discussed.

Humans↗

PubMed1990

[Hyperprolactinemia syndrome in men].

A total of 122 male subjects suffering from secretory infertility were examined. In 25 of them (20 percent) blood prolactin levels were above the norm. Measurements of basal prolactin levels and of its secretion in metoclopramide test helped distinguish two types of hyperprolactinemia syndrome, differing in the pattern of spermatogenesis disorders. Possible pathogenesis of individual types of hyperprolactinemia in men is discussed. Therapy with dopamine agonists (lisenyl, parlodel) was found most effective in Type I hyperprolactinemia syndrome, associated with essential prolactin hypersecretion and oligospermia.

Adult↗

PubMed1989

[Correlations between hyperprolactinemia and galactorrhea].

In a prospective study performed between January, 1989 to August, 1988, we evaluated the association between hyperprolactinemia and its clinical features. Of the 58 subjects included: 23 had hyperprolactinemia and 35 were controls. The most frequent clinical manifestations in hyperprolactinemic patients were galactorrhea (43.4%) and amenorrhea (17.3%) amenorrhea-galactorrhea syndrome was found in only 8.6% cases with hyperprolactinemia. We found a statistically significant correlation (R = 0.66, p less than 0.01) between serum prolactin levels and clinical symptoms in hyperprolactinemic patients.

Adult↗

PubMed1989

Hyperprolactinemia in clinically asymptomatic, fertile men: report of two cases.

Although the role of prolactin (PRL) in men is undefined, hyperprolactinemia has been associated with decreased reproductive potential. Two healthy, fertile, asymptomatic men with hyperprolactinemia are reported. Both men had normal puberty. Both were euthyroid and had normal gonadotropin levels and androgen profiles. Semen analyses were normal and both had fathered children. The serum PRL level (mean +/- standard error of the mean) (N = 5) of subject 1 was 48 +/- 12 ng/mL, and of subject 2 was 214 +/- 5 ng/mL. Sella turcica computed tomography scans with contrast were normal. The two subjects underwent a thyrotropin-releasing hormone stimulation test. Serum PRL and TSH were measured by radioimmunoassay. At time 0 and at 15 minutes, PRL bioactivity was measured in the Nb2 node rat lymphoma assay. Both subjects showed a normal TSH response to thyrotropin-releasing hormone. Subject 1 had baseline PRL immunoactivity and bioactivity measuring 41 and 50 ng/mL, respectively, peaking at 76 and 70 ng/mL 15 minutes after infusion of thyrotropin-releasing hormone. Subject 2 had baseline PRL immunoactivity of 200 ng/mL and bioactivity of 67 ng/mL, neither of which were altered by infusion of thyrotropin-releasing hormone. Administration of L-dopa decreased the serum PRL of subject 1 from 33 to 7 ng/mL, but had no clinically significant effect in subject 2. Prolactin and gonadotropin secretion may be dissociated in men so that hyperprolactinemia may not always manifest as reproductive dysfunction.

Adult↗

PubMedDate not supplied

[Functional interrelations of monoamines, thyrotropic hormone and thyroid hormones in hyperprolactinemia].

Functional interrelationships of serotonin, dopamine, prolactin, TRH and thyroid hormones in patients with hyperprolactinemia were studied. Altogether 26 patients with amenorrhea in hyperprolactinemia without clinical signs of disorder of thyroid function were examined. The levels of serotonin and dopamine were determined by spectrofluorimetry, the level of hormones was determined by a radioimmunoassay. An increase in the level of serotonin and a decrease in the level of dopamine in all the patients, a decrease in TRH and T4, and an increase in T3 were noted. The levels of monoamines, TRH and thyroid hormones showed correlation. It has been concluded that disorder of the monoaminergic mechanisms of regulation creates conditions for the rearrangement of hormonal interrelationships in the neuroendocrine functional system and determines the involvement of the hypophyseothyroid system in the pathological process. Therefore patients with hyperprolactinemia are at risk of developing thyroid functional disorders.

Adult↗

PubMed1988

Does hyperprolactinemia affect hepatic regeneration independent of sex steroids?

Prolactin, administered exogenously, has been shown to be trophic to the liver, causing increases in the liver weight-to-body weight ratio. In ornithine decarboxylase activity, and in thymidine kinase activity. To investigate the effect of endogenous hyperprolactinemia on hepatic regeneration, pituitary isografts were placed beneath the renal capsule in rats 2 weeks before the rats underwent a two-thirds partial hepatectomy. Prolactin levels 2 weeks after the transplant were greater in the animals with the pituitary isografts compared with levels in controls. The increase in the liver weight-to-body weight ratio after hepatectomy was similar in the rats with pituitary transplant and the controls. However, chronic hyperprolactinemia was associated with increased basal levels of ornithine decarboxylase activity and thymidine kinase activity. Both ornithine decarboxylase activity and thymidine kinase activity increased after partial hepatectomy, and the magnitude of the changes was similar for both groups of animals. The levels of estrogen receptor activity before the partial hepatectomy and the reduction in receptor activity that follows partial hepatectomy were similar in the two groups of animals. Moreover, the levels of androgen receptor activity within the liver before partial hepatectomy and the increase in receptor activity after hepatectomy were similar in the two groups of animals. Thus, chronic sustained hyperprolactinemia has no beneficial effect on the hepatic regenerative response, despite induction of both basal ornithine decarboxylase and thymidine kinase activities.

Animals↗

PubMed1988

Hyperprolactinemia, infertility, and hypothyroidism. A case report and literature review.

A 30-year-old woman presented with infertility, hyperprolactinemia, and pituitary enlargement. Although relatively asymptomatic, she was found to have primary hypothyroidism. She became pregnant within a month following institution of levothyroxine replacement, and the pituitary enlargement resolved within one year. We discuss the relationship between hypothyroidism, hyperprolactinemia, and pituitary enlargement. This case emphasizes the need for thyroidal status evaluation in patients with presumptive prolactin-producing pituitary tumors before initiation of therapy for the hyperprolactinemia.

Adenoma↗

PubMed1986

Headache, hyperprolactinemia, and prolactinomas.

The present study was undertaken to investigate whether headache in women with nonpuerperal hyperprolactinemia was related to elevated serum prolactin (PRL) levels or the presence of a PRL-secreting pituitary adenoma. The subjects were 469 women seen initially during the period of 1973 to 1979 at four clinical centers with the complaints of secondary amenorrhea and/or galactorrhea, 212 of whom were subsequently diagnosed as having a prolactinoma. Headaches were four times more frequent (relative odds = 3.92; 95% confidence interval = 1.54 to 9.97) in the presence of an adenoma than in its absence. This effect was not altered by adjustment for PRL level or study center, nor could it be explained by confounding due to age, occupation, level of education, use of oral contraceptives, cigarette smoking, ethnic group, or history of head injury. Hyperprolactinemia was associated with headache only if a prolactinoma was present (chi 2 = 9.524; P = .002) and not in the absence of a prolactinoma (chi 2 = 1.547; P = .214). These findings suggest that the space-occupying mass effect of a prolactinoma is responsible for headache in women with nonpuerperal hyperprolactinemia. Despite its nonspecific nature, headache may be a useful indicator of the presence of an occult prolactinoma in women with secondary amenorrhea and/or galactorrhea.

Adenoma↗

PubMedDate not supplied

Hyperprolactinemia in oligospermic Nigerian males: effect of bromocriptine treatment.

OBJECTIVE: To assess the possible etiological role of hyperprolactinemia in oligospermic African males. DESIGN: Prospective. SETTING: University teaching hospital. PATIENTS AND METHODS: Of the 52 infertile males studied, 23 had oligospermia, 11 were hyperprolactinemic, while 7 had both oligospermia and hyperprolactinemia. Mean serum testosterone concentration was lower in oligospermic than normospermic patients (3.6 +/- 1.9 ng/mL vs. 6.3 +/- 2.8 ng/mL; P < .05), and in hyperprolactinemic than normoprolactinemic patients (2.8 +/- 1.5 ng/mL vs. 5.7 +/- 2.8 ng/mL; P < .05). The patients with both oligospermia and hyperprolactinemia had the lowest mean serum testosterone (2.2 +/- 0.7 ng/mL) concentration. Oral bromocriptine was given to the seven hyperprolactinemic, oligospermic patients for 9-12 weeks. RESULTS: Serum prolactin was reduced to normal in all and increased sperm count to normal in 4/7. The wives of two of the responders became pregnant. CONCLUSIONS: The serum concentration of prolactin should be estimated in all oligospermic patients who exhibit no obvious cause of the oligospermia. Those found to be hyperprolactinemic should be given bromocriptine.

Adult↗