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Minerva Med. 1997 Nov;88(11):479-87.

Prolactin response to thyrotropin-releasing hormone as a guideline for cyclical mastalgia treatment.

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Institute of General Surgery, Medical and Surgical School, 2nd University of Naples.



We studied a group of 36 fertile women affected with moderate-to-severe cyclical mastalgia (mean age: 26.0 years) showing a normal menstrual history and normal basal levels of circulating hormones, including prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), progesterone (P), testosterone (T), dehydroepiandrosterone sulphate (delta HEAs), androstenedione (A). Using serial measurements of PRL plasma levels after an intravenous injection of thyrotropin-releasing hormone (TRH), (TRH test), patients were divided in two groups: 19 patients with abnormal PRL response to TRH and the remaining 17 with normal response.


Bromocriptine treatment, 2.5 mg b.i.d. for 3-6 months, was effective in 73.6% of patients with abnormal TRH test and in 23.5% of patients with normal TRH test: the difference was statistically significant. On the other hand, 76.9% of patients with either normal TRH test or resistant to bromocriptine therapy had a favourable response to percutaneous progesterone and systemic non-steroidal antiinflammatory drugs (NSAIDs).


These results seem to confirm the hypothesis that PRL response to TRH could be used to identify patients affected with cyclical mastalgia that are likely to benefit by bromocriptine treatment.

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