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Prolactin pulsatility in patients with gonadal dysfunction

P J Moult, J E Dacie, L H Rees

    Clinical Endocrinology
    |April 1, 1981
    PubMed
    Summary
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    Measuring serum prolactin levels frequently over two hours did not provide additional diagnostic information for hyperprolactinemic gonadal dysfunction. Two or three random prolactin measurements are sufficient for clinical assessment.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine
    • Clinical Diagnostics

    Background:

    • Hyperprolactinemia, indicated by elevated serum prolactin, can cause gonadal dysfunction.
    • Accurate diagnosis is crucial for effective treatment, often involving bromocriptine therapy.
    • The utility of serial prolactin sampling versus random measurements requires clarification.

    Purpose of the Study:

    • To evaluate the diagnostic value of frequent, serial serum prolactin measurements.
    • To determine if intensive sampling offers predictive information beyond random levels.
    • To correlate prolactin fluctuation patterns with clinical presentation and treatment response.

    Main Methods:

    • Serum prolactin concentrations were measured every 15 minutes for 2 hours in 227 patients.

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  • Patients presented with symptoms suggestive of hyperprolactinemic gonadal dysfunction.
  • Prolactin levels were compared with clinical data, pituitary imaging, and bromocriptine response.

    • Main Results:

    • 138 out of 227 patients had at least one elevated random prolactin level.
    • 22% of patients showed no significant prolactin fluctuation; 38% had progressively falling levels.
    • Frequent sampling yielded basal prolactin levels 27% lower than random levels but offered no additional predictive information.

    Conclusions:

    • Serial prolactin sampling provides no significant diagnostic advantage over two or three random measurements.
    • Clinical data and random prolactin levels are sufficient for diagnosing hyperprolactinemic gonadal dysfunction.
    • The diagnostic yield of intensive prolactin monitoring is limited in this patient cohort.