Hypothalamic-pituitary evaluation in patients with galactorrhea-amenorrhea and hyperprolactinemia

Obstet Gynecol. 1980 Jan;55(1):1-7.

Abstract

Twenty-two women with galactorrhea and/or amenorrhea were evaluated. Thyroxine (T4), thyroid-stimulating hormone (TSH), and visual fields were normal. Hyperprolactinemia (22 to 440 ng/ml) was present in 19 patients. Evidence of tumor was found in 73.7% of the woemn, whereas 26.3% were classified as functional. Three patients with empty sella syndrome showed normal prolactin levels (12.2 to 18.5 ng/ml). There was a significant negative correlation between prolactin levels and follicle-stimulating hormone (FSH) (P less than 0.05), but not between prolactin and luteinizing hormone (LH) levels. Hypocyloidal polytomography was better than plain x-ray films in detecting early prolactin-secreting pituitary tumors (14 patients). Pituitary testing using an insulin tolerance test showed a statistically significant difference in human growth hormone (hGH) reserve between tumor and functional groups (P less than 0.0005), and none for the cortisol response. The 17-hydroxycorticoid response to metyrapone was impaired in the tumor patients (group 1). Serum prolactin levels showed various degrees of suppression with L-dopa (9.3 to 98.8%), with no significant difference between the various groups.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adrenocorticotropic Hormone / metabolism
  • Amenorrhea / etiology
  • Amenorrhea / physiopathology*
  • Empty Sella Syndrome / blood
  • Empty Sella Syndrome / complications
  • Empty Sella Syndrome / diagnosis
  • Female
  • Follicle Stimulating Hormone / blood
  • Galactorrhea / etiology
  • Galactorrhea / physiopathology*
  • Growth Hormone / metabolism
  • Humans
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Lactation Disorders / physiopathology*
  • Levodopa
  • Luteinizing Hormone / blood
  • Pituitary Neoplasms / blood
  • Pituitary Neoplasms / complications
  • Pregnancy
  • Prolactin / blood*

Substances

  • Levodopa
  • Adrenocorticotropic Hormone
  • Prolactin
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • Growth Hormone