Hyperprolactinaemic amenorrhoea in Hong Kong

Area of Science:

• Reproductive Endocrinology
• Clinical Medicine
• Endocrinology

Background:

• Hyperprolactinemia, characterized by elevated serum prolactin (PRL) levels, is associated with various menstrual disorders.
• Understanding the prevalence and causes of hyperprolactinemia in patients with menstrual irregularities is crucial for effective management.

Purpose of the Study:

• To investigate the prevalence of hyperprolactinemia in patients presenting with menstrual disorders.
• To identify the underlying causes of hyperprolactinemia in this cohort.
• To evaluate the efficacy of bromocriptine treatment in managing menstrual disorders associated with hyperprolactinemia.

Main Methods:

• Retrospective analysis of 595 patients attending a Menstrual Disorder Clinic.
• Measurement of serum prolactin (PRL) levels on multiple occasions.
• Categorization of hyperprolactinemia causes including idiopathic, drug-induced, hypothyroidism, and suspected pituitary microadenoma.
• Treatment with bromocriptine for selected patients and assessment of treatment outcomes.

Main Results:

• 15.5% of patients exhibited elevated serum PRL levels (mean 67.1 ng/ml).
• Secondary amenorrhea (66.3%) and irregular menstruation (32.6%) were common presentations.
• Idiopathic hyperprolactinemia (46.7%) and suspected pituitary microadenoma (19.5%) were frequent diagnoses.
• Bromocriptine treatment in 38 patients led to normalization of PRL levels, restoration of menstruation, and cessation of galactorrhea within 1-3 months.
• 13 patients successfully conceived and delivered healthy babies following bromocriptine treatment.

Conclusions:

• Hyperprolactinemia is a significant finding in women with menstrual disorders.
• Bromocriptine is an effective treatment for hyperprolactinemia-associated menstrual irregularities, leading to improved reproductive outcomes.
• Further investigation into pituitary imaging and underlying causes is warranted for comprehensive patient management.