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Hyperprolactinemia in postmenopausal women

Y Maor1, M Berezin

  • 1Department of Internal Medicine 'A', Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.

Fertility and Sterility
|April 1, 1997
PubMed
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Hyperprolactinemia in postmenopausal women is often caused by pituitary macroadenomas. This condition may represent a prolonged disease, with microadenomas potentially enlarging over time.

Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Oncology

Background:

  • Hyperprolactinemia, characterized by elevated prolactin (PRL) levels, can manifest in postmenopausal women.
  • The causes and clinical course of hyperprolactinemia in this demographic are not fully elucidated.

Purpose of the Study:

  • To investigate the clinical etiology and progression of hyperprolactinemia in postmenopausal women.
  • To differentiate the common causes of hyperprolactinemia in postmenopausal versus younger women.

Main Methods:

  • A retrospective case-note study was conducted at a tertiary care hospital.
  • Six postmenopausal women with hyperprolactinemia were analyzed, including clinical history, physical examination, and serum hormone levels (PRL, LH, FSH).
  • Pituitary imaging (CT) and response to bromocriptine treatment were assessed.

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Main Results:

  • The mean age of patients was 57.5 years, with a mean PRL level of 1,427 ng/mL.
  • All patients experienced secondary amenorrhea, and five had a history of galactorrhea.
  • Pituitary macroadenomas were identified in five of six patients, contrasting with the more common microadenomas in younger women.

Conclusions:

  • Pituitary macroadenomas are the predominant cause of hyperprolactinemia in postmenopausal women.
  • The clinical presentation suggests a long-standing, previously undetected disease, possibly involving the enlargement of microadenomas to macroadenomas over time.
  • Bromocriptine effectively normalized PRL levels, though five patients developed hot flushes post-treatment.