Hyperprolactinemia as a cause of delayed puberty: successful treatment with bromocriptine

An 18-year-old male patient was referred because of galactorrhea and delayed puberty. There was no gynecomastia, but a white milky secretion could easily be expressed from each breast. The chest and skull X-rays were normal. The plasma prolactin was increased to 58 ng/ml and rose to 97 ng/ml after 200 microgram TRF iv. The patient was treated for one year with testosterone; his voice deepened, body hair developed, libido and sexual function became overt, and bone age advanced from 14 1/2 to 17 years, but the galactorrhea increased. After a satisfactory stage of pubertal development was reached, the testosterone was stopped. tthe galactorrhea then decreased to its pretreatment intensity; however, sexual potency diminished, sexual hair growth decreased, and the plasma prolactin levels rose to 246 ng/ml. After a 5-month interval without treatment, bromocriptine was given and brought about an impressive improvement. Virilization and general well being were superior to that during testosterone treatment, the galactorrhea vanished, plasma prolactin decreased, testosterone rose to normal values, and a normal semen analysis was recorded.