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Management of hyperprolactinaemic amenorrhoea
British Journal of Obstetrics and Gynaecology
|April 1, 1977
Summary
Treatment for hyperprolactinemia-induced amenorrhea effectively restored menstrual cycles in most patients. Surgery, radiation, and bromocriptine were used, with bromocriptine often being the primary treatment for those without pituitary tumors.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Neurosurgery
Background:
- Hyperprolactinemia is a common cause of amenorrhea.
- Pituitary tumors are a frequent cause of hyperprolactinemia.
- Effective treatment strategies are crucial for restoring fertility.
Purpose of the Study:
- To present treatment outcomes for 52 patients with amenorrhea and hyperprolactinemia.
- To evaluate the efficacy of surgery, radiation, and bromocriptine.
- To outline a treatment policy based on radiological findings.
Main Methods:
- Radiological examination of the pituitary fossa (tomography, air encephalography).
- Treatment modalities included surgery (transsphenoidal/transfrontal), external irradiation, and bromocriptine.
- Patients were categorized based on pituitary tumor presence and prior treatment.
Main Results:
- Ovulatory menstrual cycles were restored in 42 patients (81%).
- 19 pregnancies occurred.
- Treatment failure occurred in 10 patients due to inadequate prolactin reduction or gonadotropin deficiency.
Conclusions:
- Amenorrhea associated with hyperprolactinemia is treatable with various modalities.
- Bromocriptine is effective, especially for patients with normal pituitary radiology.
- A tailored treatment approach considering tumor status and patient goals is recommended.