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Pituitary function testing in amenorrhea-galactorrhea-hyperprolactinemia.

C W Simpson, E R Plunkett

    Fertility and Sterility
    |November 1, 1979
    PubMed
    Summary
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    This study evaluated pituitary function in patients with amenorrhea-galactorrhea-hyperprolactinemia. Hormone level testing showed limited clinical value but may help predict ovulatory response to bromocriptine therapy.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine

    Background:

    • Hyperprolactinemia, characterized by amenorrhea and galactorrhea, affects women of reproductive age.
    • Assessing pituitary function is crucial for understanding the underlying causes and guiding treatment.

    Observation:

    • Fifteen patients (age 16-55) with amenorrhea-galactorrhea-hyperprolactinemia underwent pituitary function tests.
    • Tests included insulin, luteinizing hormone-releasing hormone (LHRH), and thyrotropin-releasing hormone (TRH) stimulation.
    • Measurements included growth hormone (GH), thyroid-stimulating hormone (TSH), cortisol (F), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin.

    Findings:

    • Most patients exhibited normal GH, TSH, and cortisol responses.
    • Decreased LH responses correlated with abnormal sellar tomography (P < 0.025).

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  • Elevated prolactin levels were associated with a trend of decreased FSH.
  • Absent prolactin responses were noted in 5 of 7 evaluable cases.
  • Implications:

    • Pituitary function testing has limited individualized clinical utility in hyperprolactinemia.
    • Gonadotropin response may offer prognostic value for bromocriptine-induced ovulation.
    • Further research may refine the role of dynamic pituitary testing in managing hyperprolactinemia.