[Relation between hyperprolactinemia and polycystic ovary syndrome]

The authors compared 12 hyperprolactinemic patients with polycystic ovary (PCO) syndrome to 12 patients with galactorrhea-amenorrhea (GA) syndrome. Luteinizing hormone-releasing hormone (LH-RH) and thyreotropin-releasing hormone (TRH) tests were performed at the same time in every case to determine the reactivity of the pituitary gland. The distinctive features of the PCO syndrome were beyond the clinical symptoms the characteristic ovarian structure verified by ultrasound examination, as well as the elevated serum LH, testosterone levels and the estradiol concentration at the normal upper limit. The basal prolactin value was higher at the GA patients than at the PCO ones. The patients with PCO syndrome demonstrated significantly greater LH and prolactin elevation to the combined LH-RH + TRH test than the patients with GA syndrome. On the basis of basal prolactin, estradiol and stimulated prolactin values it is likely, that the hyperprolactinemia in the two groups developed through different pathomechanisms. The persistent anovulation and the abnormal hormonal milieu in PCO syndrome cause the increased secretion of the pituitary lactotrophs supported by the TRH test, whereas the central dopamine decrease is the most likely explanation in the non-tumourous GA cases.