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Results for “hyperprolactinemia”

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PubMed1998

[The method of treatment of functional evident hyperprolactinemia in sterile women].

OBJECTIVES AND DESIGN: The aim of study was evaluation of three methods of treatment of functional, evident hyperprolactinemia in women with primary or secondary sterility by use of Bromoergocriptine, Dopergin or Norprolac. MATERIALS AND METHODS: Our study contained 65 patients divided into three groups treated by use three methods. We used RIA-method for evaluation serum concentrations of h-PRL. Authors estimated the impact of dopaminergic receptors D2 agonist on the serum concentrations of h-PRL before, in 2nd and 6th month of observation. RESULTS: Authors obtained decrease serum concentrations of h-PRL in the three groups of patients during therapy and observation. CONCLUSION: Norprolac characterized well efficiency, safety and low count of side effects during treatment of hyperprolactinemia.

Adult↗

PubMed1998

Advances in TCM treatment of hyperprolactinemia.

In recent years, rapid progress has been seen in the treatment of hyperprolactinemia with TCM and materia medica. The old pattern of simply using bromocryptine to treat the disease has been changed. Most of the cases reported in this paper were primary hyperprolactinemia, with other primary diseases excluded. As TCM treatment produces definite therapeutic effects with few side-effects, the methods above reported are worth recommending.

Animals↗

PubMedDate not supplied

[Hyperprolactinemia and disorders of the menstrual cycle].

INTRODUCTION: The authors presented physiological conditions associated with increased prolactin values (sleep, stress, hypoglycemia, nipples stimulation, pregnancy and lactation) as well as the causes of pathological hyperprolactinemia. MATERIAL AND METHODS: The results of radioimmunoassay study have been analyzed in concern to the values of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) obtained from the serum of 100 women with increased PRL levels. The "HOECHT" sets were used for the analysis, whereas the values up to 20.9 microgrammes per litre were rated normal. The patients were distributed into 4 groups in concern to the level of PRL increase: 1st group--twenty (n = 20) patients with PRL values from 21-29.9 micrograms/l, 90 blood samples analyzed; 2nd group-forty (n = 40) patients with PRL values f; 30-49.9 micrograms/l, 183 blood samples analyzed; 3rd group--twenty (n = 20) patients with PRL values from 50-99.9 micrograms/l, 83 blood samples analyzed; 4th group--twenty patients (n = 20) with PRL values more than 100 micrograms/l, 78 blood samples analyzed. The values of FSH and LH recorded in the women with hyperprolactinemia were compared with mean values of the same hormones presented in IU/l from the follicular phase of the cycle in the control group which comprised 50 women of reproductive age having normal ovulatory menstrual cycle. RESULTS: The mean values of FSH and LH in the 1st group have not presented with statistically significant difference in relation to the control group. Prevalence of menstrual disorders was 30%, which was statistically significantly higher than in general population. FSH values in the 2nd group were almost the same as in the control group whereas the values of LH were significantly higher. The rate of polycistic ovary syndrome (PCOS) in this group has been significant, also the increased rate of anovulatory cycles from 30 to 67.5%. A mild increase of menstrual cycle rhythm disorders, from 35 to 40% has been recorded. The values of FSH and LH in the 3rd group were significantly lower than in the control group. The significance level was higher for FSH (p < 0.01) then LH (p < 0.05). There was a sudden increase of the cycle rhythm disorders in this group reaching 90%. The 4th group presented with significantly lower values of FSH and LH in relation to the control group, whereas the cycle rhythm disorders occurred in all patients. DISCUSSION: The obtained results were compared with the literature data and some explanations given. CONCLUSIONS: The values of FSH an LH were statistically significantly lower in the 3rd and 4th group. The 2nd group was characteristic for the sudden increase of the number of anovulatory cycles from 30 to 67.5%, whereas the 3rd group presented with the abrupt increase of menstrual cycle rhythm disorders, from 40 to 90%.

Anovulation↗

PubMed1999

Diagnostic evaluation of hyperprolactinemia.

A serum prolactin (PRL) level is obtained in response to a specific clinical presentation, including symptoms of hyperprolactinemia (such as amenorrhea and galactorrhea); serum PRL measurement may also be performed as part of an infertility evaluation. An initial level above the normal range should be followed by a repeat level from a blood sample drawn in the morning with the patient in a fasting state. The medical history and a few laboratory tests can eliminate the most common physiologic and pharmacologic causes of hyperprolactinemia, including pregnancy, primary hypothyroidism and treatment with drugs (such as neuroleptics) that reduce dopaminergic effects on the pituitary. In the absence of such causes, radiologic imaging of the sella turcica is necessary to establish whether a PRL-secreting pituitary adenoma or other lesion is present. The vast majority of patients are treated medically, with dopamine agonist drugs. Surgery is reserved for the patient with the uncommon tumor that does not respond to medical therapy or has a large cystic component or for the occasional patient who cannot tolerate dopamine agonists or who experiences pituitary apoplexy.

Amenorrhea↗

PubMed1999

Following patients under treatment for hyperprolactinemia.

Management of patients receiving treatment for hyperprolactinemia depends on a few specific parameters: whether the patient has no pituitary lesion, a pituitary microadenoma or a pituitary macroadenoma. In each of these categories, management will differ depending on whether the patient desires to become pregnant. Some patients with hyperprolactinemia who are asymptomatic may be managed expectantly, with periodic measurement of serum prolactin levels and careful monitoring for emergence of symptoms. In the vast majority of cases, treatment with a dopamine agonist is appropriate and effective. If pregnancy is desired, efforts should be made to time it carefully and to discontinue the drug as soon as a pregnancy test is positive. Only patients with macroadenomas who do not respond adequately to medical therapy and show signs of a cranial mass effect from the lesion should be referred for neurosurgical evaluation.

Adult↗

PubMed1998

[Domperidone and hyperprolactinemia].

Nine patients with hyperprolactinemia and one patient with pituitary microadenona were observed for 6 years. They were induced by administration of domperidone. The clinical characteristic of the 9 patients was summarized and analysed. The results suggest that prescribe domperidone for fertile women should pay more attention to its adverse effect on inducing hyperprolactinemia and even pituitary microadenona.

Adult↗

PubMed1998

[Diagnosis of hyperprolactinemia: determination of prolactin level at rest].

We present 3 women who were referred for evaluation of stress-related mild-to-moderate hyperprolactinemia. This frequent finding may mistakenly be considered a clinical problem, and lead to inappropriate investigation and therapy. We emphasize the importance of serial blood sampling for prolactin determination. We collected blood samples repeatedly under resting conditions from an indwelling venous brachial catheter, every 30 minutes for a total of 6 samples. All 3 patients had normal prolactin levels 30-60 minutes after starting the test. Neither further investigation nor medical therapy were needed and these anxious patients were reassured that their hyperprolactinemia was factitious.

Adult↗

PubMed2000

[Hyperprolactinemia is a frequent finding in HIV infection but does not correlate with viral burden].

Although many authors have reported the finding of hyperprolactinemia during the course of HIV infection, the circumstances determining the rise of prolactin (PRL) concentrations in serum are poorly understood. To analyze the relationships between serum PRL and other clinical variables in HIV-infected patients, 46 HIV-infected patients and 17 seronegative controls were studied. Serum PRL concentrations were significantly higher in the HIV-infected group (p = 0.022). Furthermore, Serum PRL and serum IgG correlated positively (Rs = 0.42; p = 0.05, Spearman-Rank). On the contrary, serum PRL concentrations did not correlate with the plasmic viral burden (Rs 0.039; p = 0.841), Our data confirm that hyperprolactinemia is a frequent finding during the course of HIV infection, and that serum PRL are independent of viral replication kinetics. Considering that a positive correlation was found between serum PRL and immunoglobulins, it is possible that serum PRL might increase in response to non specific immunological activation, or even in response to immunological activation at the onset of infections.

Adult↗

PubMed2001

Effects of hyperprolactinemia on osteoporotic fracture risk in premenopausal women.

The aim of the study was to evaluate the osteoporotic fracture risk in premenopausal women with hyperprolactinemia due to prolactinoma. Bone mineral density (BMD) was measured in 20 white, premenopausal women with prolactinoma and in 60 healthy control white women, using quantitative ultrasound (QUS) at the os calcis, with an Achilles Lunar Plus device. We measured all three parameters of QUS: broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness. BMD results were expressed also as T- and Z-scores. Age and body mass index (BMI) were not statistically significantly different between the two groups. Comparative analysis showed reduced values of QUS parameters in women with prolactinoma versus controls. Only the difference in SOS parameter was statistically significant between the two studied groups (p = 0.0001). The Z-score was significant lower in women with prolactinoma than in healthy women. These data reveal a significant bone loss in women with prolactinoma compared to controls. The SOS parameter showed a good negative correlation with age, and all the QUS parameters were positively correlated with BMI. The relative risk for developing osteoporosis in women with prolactinoma was found to be 4.5, indicating that hyperprolactinemia in women is a major risk factor for osteoporosis.

Adolescent↗

PubMed2002

Germ cells with nuclear DNA fragmentation related to apoptotic cells in rat testis in experimental hyperprolactinemia induced by metoclopramide.

The cells with nuclear DNA fragmentation related to apoptosis were detected by TUNEL technique in the seminiferous epithelium of control rats and of rats with experimental hyperprolactinemia induced by metoclopramide. The percentage of convoluted tubules with apoptotic cells and the number of apoptotic cells (predominantly spermatogonia and spermatocytes) was increased in the experimental group. The results indicated stage-specific germ cell apoptosis. In the experimental group, apoptotic cells were most evident at early (I-IV), middle (VII-VIII) and late (XII-XIV) stages of the seminiferous epithelium cycle, as revealed by light and electron microscopy. We suggest that a decreased concentration of testosterone and an increased concentration of prolactin could disturb spermatogenesis and contribute to the intensive apoptosis of germ cells in rats with hyperprolactinemia. Sertoli cells which have receptors for testosterone and prolactin and play an important role in spermatogenesis and in the initiation of apoptosis in seminiferous epithelium, could mediate such an influence of both hormones.

Animals↗

PubMed2002

Hyperprolactinemia does not influence hypothalamic-pituitary-adrenocortical function during hypoglycemia in women.

Elevated plasma prolactin and mild hypocortisolemia have been observed in patients with rheumatic disorders. This study was designed to assess the potential inhibitory effect of hyperprolactinemia on hypothalamic-pituitary-adrenocortical function. Hypoglycemia was induced by intravenous insulin injection (0.1 IU/kg) in 10 female volunteers of fertile age during their follicular phase twice: 60 min after either domperidone (10 mg orally) or placebo administration. Blood samples were collected from an indwelling catheter inserted into the cubital vein at -60, 0, 30, 45, 60 and 90 min. The concentrations of prolactin, adrenocorticotropic hormone (ACTH), cortisol, epinephrine, norepinephrine and glucose were measured in plasma. Domperidone administration significantly increased plasma prolactin concentrations (71 +/- 11 ng/ml vs. 14 +/- 6 ng/ml; p <0.001), while basal plasma concentrations of ACTH, cortisol, norepinephrine and epinephrine were unaffected. Insulin-induced hypoglycemia resulted in a significant rise in the mean plasma ACTH levels from 10 +/- 1 pg/ml (domperidone) and 11 +/- 1 pg/ml (controls) to 148 +/- 19 pg/ml (domperidone) and 139 +/- 12 pg/ml (controls) at 45 min (p < 0.001), in plasma cortisol from 407 +/- 62 nmol/l (domperidone) and 391 +/- 42 nmol/l (controls) to 925 +/- 60 nmol/l (domperidone) and 810 +/- 52 nmol/l (controls) at 60 min (p < 0.001), and in plasma epinephrine from 40 +/- 26 pg/ml (domperidone) and 16 +/- 3 pg/ml (controls) to 274 +/- 55 pg/ml (domperidone) and 352 +/- 61 pg/ml (controls) at 30 min; (p < 0.001). The significant increase in ACTH, cortisol and epinephrine responses to hypoglycemia was similar in both groups. We observed mild norepinephrine response to hypoglycemia but this was irrespective of the medication. In conclusion, pharmacologically-induced hyperprolactinemia did not induce significant changes of hypothalamic-pituitary-adrenocortical function and did not influence sympathoadrenal activity in healthy young women.

Adrenal Cortex↗

PubMedDate not supplied

[Hyperprolactinemia and pregnancy].

Prolactin is a polipeptidic hormone secreted by the anterior pituitary gland, whose main role consists in the stimulation of lactation in the postpartum period. The increasing of prolactin secretion can be physiological (pregnancy and lactation) or pathological (hypothalamic and pituitary diseases, iatrogenic, etc.). The suppression of the hypothalamic-pituitary-gonadal axis and the resistivity of the ovary and gonadotropin action are induced in hyperprolactinemia, the amenorrhea and lack of ovulation being the result. Infertility associated with hyperprolactinemia is reversible with treatment, irrespectively to the type of treatment (radical or medical). Lowering of prolactin levels to normal or near normal is often necessary to permit ovulation. Dopamine-like drogs, as bromocriptine, appear to be safe for the developing fetus, at lest when the treatment is interrupted in the first trimester of pregnancy.

Bromocriptine↗

PubMed1992

[Pituitary tumor syndrome and hyperprolactinemia in peripheral hypothyroidism].

We studied 7 women with primary hypothyroidism who were suspected to harbor a prolactinoma on the basis of a pituitary gland enlargement associated with hyperprolactinemia. The diagnosis of prolactinoma was confirmed in 1 case only, which was treated surgically. In the remaining 6 patients the serum prolactin levels fell to normal on thyroxine replacement therapy and reduction in size of the pituitary gland was demonstrated by neuroradiological imaging in the 3 documented cases. This study underlines the fact that hyperprolactinemia associated with pituitary hyperplasia is secondary to hypothyroidism and that thyroid function tests should be obtained in all hyperprolactinemic patients even those with pituitary enlargement.

Adult↗

PubMed1992

New long-acting bromocriptine (Parlodel MR and Parlodel LAR) in the treatment of pituitary tumours with hyperprolactinemia.

In order to assess the efficacy and tolerability of new long acting bromocriptine: Parlodel MR (oral form) and Parlodel LAR (injectable form suitable for repeatable administration) 40 patients (29 women and 11 men) with pituitary tumours with hyperprolactinemia (PRL 70 micrograms/l) were investigated in a double blind study. Patients were divided into 2 groups of 20. In the first group Parlodel R or Parlodel MR in equivalent doses was given, the other group was administered Parlodel R or Parlodel LAR. During the next 6 months 20 patients were treated with Parlodel MR and the other 20 with Parlodel LAR. In all patients pituitary and peripheral hormones, CT scan and visual fields were examined before and after 28 days of bromocriptine treatment. During the next six months 20 patients were treated with Parlodel MR while the other 20 with Parlodel LAR. Serum PRL fell in all patients and values in the normal range were obtained in 36 patients. In 30 out of 35 patients with signs of pituitary tumour in CT scan, a significant tumour shrinkage was observed. Most patients achieved considerable clinical improvement: disappearance of galactorrhoea, resumed menses in women, increased potency in men. There were no difference in efficacy in Parlodel R, Parlodel MR and Parlodel LAR, but in the case of Parlodel LAR the least number of side effects was found. Treatment with long acting bromocriptine-Parlodel MR and LAR of patients with pituitary tumours with hyperprolactinemia is an efficacious, safe and better tolerated method than Parlodel R treatment.

Adult↗

PubMed1992

Pathologic hyperprolactinemia.

Unlike other pituitary hormones, PRL is under tonic inhibition by the hypothalamus by way of the PRL inhibitory factor, dopamine. GAP and GABA may also be inhibitory. PRL-releasing factors include TRH and VIP and possibly others. Circulating PRL is predominantly monomeric, although some patients with hyperprolactinemia appear to have increased quantities of the less biologically active polymeric forms. PRL is secreted episodically, with an increase in the amplitude of the secretory pulses with sleep. A transitory increase also occurs in response to the protein component of meals. Basal PRL levels increase in response to the hormonal milieu of pregnancy, and suckling postpartum triggers PRL release. Pathologic increases of PRL owing to hypothalamic dysregulation occur with a variety of medications, including the neuroleptics, metoclopramide, antidepressants, methyldopa, reserpine and verapamil, abuse of opiates and cocaine, renal insufficiency, cirrhosis, hypothyroidism, adrenal insufficiency, neurogenic stimulation, and idiopathically. Hyperprolactinemia also may occur from structural lesions of the stalk and hypothalamus, which cause disinhibition with or without maintenance of PRF activity, ectopic neoplasm production, and, most commonly, from prolactinomas. Diagnostic testing consists of routine chemistry and thyroid testing and imaging with MRI or CT. Dopamine agonists are the treatment of choice of prolactinomas of all sizes. Transsphenoidal surgery is an alternative for the patient who does not respond to medical therapy or who wishes definitive tumor removal, realizing that long-term cure is achieved in only 50% to 60% of patients with microadenomas and a much lower number in those with macroadenomas. Radiotherapy is reserved for patients who do respond to either medical or surgical treatment. Patients wishing to become pregnant usually are treated with bromocriptine, although prepregnancy surgical debulking may be advisable for those with large macroadenomas to reduce problems with tumor enlargement.

Bromocriptine↗

PubMed1992

[Experiences with bromocriptine treatment of female infertility due to hyperprolactinemia].

From July 1981 to September 1988, 106 infertile patients with hyperprolactinemia treated with bromocriptine were reviewed retrospectively with special attention to the dosage of bromocriptine and the evaluation of infertility before treatment 84 patients (79.2%) became pregnant. The patients were divided into 3 groups according to the following doses of bromocriptine: 7.5, 5.0, and less than 5.0 mg/day. The pregnancy rate was 90.7%, 84.6%, and 66.7% respectively with the highest at 7.5mg/day, which was significantly higher than that at less than 5.0mg/day (P less than 0.02). The average duration from treatment to pregnancy was 3.6, 3.4, and 7.4 months respectively. The duration in the less than 5mg/day group was twice that in the other two groups. 84.5% of the pregnancies occurred within 6 months of treatment. Pretreatment of organic lesions and additional therapy for induction of ovulation were given to 29.8% of patients who later became pregnant. Systematic evaluation of the causes of infertility other than hyperprolactinemia before the use of bromocriptine and an optimal dose of 5-7.5mg/day will give the best results.

Adult↗

PubMed2004

[Paraparesis, hyperprolactinemia and adynamic ileus in Guillain-Barré syndrome].

A case of Guillain-Barré with unusual autonomic dysfunction at its onset, that consisted of constipation and hypertension, followed by adynamic ileus and flaccid paraparesis with areflexia limited to the lower limbs, is presented. Inappropriate secretion of antidiuretic hormone and hyperprolactinemia were demonstrated, which resolved spontaneously afterwards. The adynamic ileus resolved and the paraparesis improved with gastric aspiration and intravenous immunoglobulin administration, only to worsen eighty days later. Paraparesis worsened, accompanied by hypertension, an abnormal hypotensive response to captopril and limb pain. The whole clinical picture resolved after a second course of intravenous immunoglobulin. Unusual clinical aspects of Guillain-Barré syndrome found in this case are reviewed, such as paraparesis, prolonged adynamic ileus and endocrine abnormalities, comparing them with available data from the neurological literature. Differential diagnosis with myelopathy, metabolic and paraneoplasic neuropathies, POEMS syndrome, chronic inflammatory demyelinating polyneuropathy and recurrent Guillain-Barré syndrome are commented on. Hyperprolactinemia is proposed as a marker, either of adenopituitary denervation or of the autoimmune response, in the course of this disease.

Aged↗

PubMed2004

Melatonin circadian rhythm in women with idiopathic hyperprolactinemia.

OBJECTIVES: Relationship between melatonin and prolactin has been suggested on the basis of both experimental and clinical studies. However, there are scarce and controversial data concerning melatonin concentrations in hyperprolactinemic patients. Therefore, the aim of the present study was to evaluate the circadian rhythm of melatonin in female patients suffering from hyperprolactinemia. MATERIAL AND METHODS: The study was performed on 28 women aged 17-58 years (mean+/-SEM: 30.5+/-1.8 years) suffering from idiopathic hyperprolactinemia and 14 healthy volunteers aged 20-50 years (mean+/-SEM: 36.4+/-3.0 years) with normal prolactin levels. Blood samples for measurements of serum melatonin and prolactin concentrations were collected at 08:00, 12:00, 16:00, 20:00, 24:00, 02:00, 04:00, 06:00, and 08:00 h. Melatonin and prolactin concentrations were measured by enzyme immunoassay. RESULTS: Significant increase in melatonin serum concentrations was also observed in hyperprolactinemic patients in comparison with healthy volunteers during the night. Similar increase was also observed in the area under curve of melatonin concentrations. However, no correlation was found between prolactin and melatonin concentrations in any examined time points. CONCLUSION: The results of the present study confirm suggestions of the presence of the relationship between melatonin and prolactin secretion.

Adolescent↗