Treatment of amenorrhoea, galactorrhoea and hypogonadism with bromocriptine

The effect of bromocriptine administration was studied in 34 patients, whose presenting symptoms included amenorrhoea, galactorrhoea, infertility, dyspareunia, delayed puberty, and impotence. Two patients were found to have raised plasma prolactin values during investigation for acromegaly. With the exception of three individuals all patients had hyperprolactinaemia. Pituitary fossa enlargement or asymmetry was reported in 16 patients and one patient had primary hypothyroidism. Virtually all patients complained of side effects when first starting bromocriptine but only two patients were unable to tolerate prolonged therapy with doses which ranged from 5--40 mg daily. A single oral dose of 2.5 mg resulted in a greater than 50% reduction in plasma prolactin within five hours in 22 of 26 patients. Over the course of one month, five patients with significant pituitary fossa enlargement appeared to show less rapid suppression of plasma prolactin than five patients without fossa enlargement. At two months this trend was still evident but eventually all patients showed acceptable control of plasma prolactin, with the exception of one patient who required pituitary surgery. Galactorrhoea ceased in 13 of 15 patients, menstrual periods resumed in ten of 13 patients, two patients becoming pregnant first. Potency returned and puberty proceeded in two hypogonadal males. Six of the nine patients requesting treatment for infertility became pregnant. It is concluded that bromocriptine provides effective treatment for galactorrhoea, amenorrhoea or gonadal disorders when there is associated hyperprolactinaemia.