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Clinical Implication of Hyperprolactinemias, Especially with Prolactinoma and Luteal Insufficiency
Author(s) -
Tamaya Teruhiko,
Murakami Toshiki,
Ohno Yousuke,
Wada Keisuke,
Higashiyama Shusei,
Mizukawa Norio,
Okada Hiroji
Publication year - 1983
Publication title -
asia‐oceania journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 0389-2328
DOI - 10.1111/j.1447-0756.1983.tb00606.x
Subject(s) - prolactinoma , medicine , anovulation , endocrinology , luteal phase , ovulation , bromocriptine , trh stimulation test , basal (medicine) , galactorrhea , prolactin , gonadotropin , hyperprolactinaemia , hormone , thyrotropin releasing hormone , insulin resistance , polycystic ovary , insulin
The incidence of prolactinoma was 23 out of 64 hyperprolactinemic anovulatory patients (35.9%). The basal plasma prolactin (PRL) level showed a positive correlation to prolactinoma size. The turn of height in the increment ratio of PRL in the TRH test was prolactinomatous < hyperprolactinemic (except prolactinoma) < normoprolactinemic in anovulatory patients. This progression had statistical significance. The TSH release in the TRH test seemed to decrease with increase in tumor size. Gonadotropin secretion and the gonadotropin release in the LHRH test were independent of tumor size. ΔLH in the LHRH test in the patients with prolactinomas was significantly lower than ΔLH in the other anovulatory patients. The basal FSH level in hyperprolactinemic patients with or without prolactinomas tended to be lower than that in normoprolactinemic patients. The hyperprolactinemia associated with luteal insufficiency was 9.3 per cent in the incidence. In 9 out of 15 confirmed luteal hyperprolactinemic patients (60%), the endometrium appeared out‐of‐phase without any difference of basal gonadotropin level. Bromocriptine therapy of women with hyperprolactinemia, irrespective of the etiology, lead easily to restoration of ovulation, sometimes with clomiphene citrate. Clomiphene citrate induced ovulation in 4 out of 10 cases of prolactinoma (40%) and in 11 out of 16 cases of idiopathic hyperprolactinemia (68.8%). hMG‐hCG induced ovulation in 10 out of 10 cases in both groups (100%).