Transient hyperprolactinemia in infertile women with luteal phase deficiency

Article Abstract:

Luteal phase deficiency, a cause of infertility, is an abnormality of the latter part of the menstrual cycle; while its cause is not known, it is associated with several hormonal abnormalities, including hyperprolactinemia (increased blood levels of prolactin, a sex hormone). To learn more about the incidence and effects of elevated prolactin (PRL) levels in infertile women, 151 infertile subjects with luteal phase deficiency (diagnosed by evaluating biopsies of the uterine lining) and 11 healthy women were studied. The women kept records of their basal body temperatures (BBTs) and blood was sampled for several days around midcycle to determine levels of PRL and other hormones. When transient hyperprolactinemia (serum PRL levels above 20 nanograms per milliliter in two or fewer of three or four samples) was identified, treatment was started with bromocriptine (a drug that lowers PRL levels) and hormonal levels were again measured. Results showed that 33 of the subjects had transient hyperprolactinemia, although the average peak PRL level was not different for the luteal phase-deficient and normal groups. After bromocriptine treatment, 32 of these women had decreased midcycle PRL levels. The magnitude of their LH surges (a sudden increase in luteinizing hormone that precedes ovulation) and progesterone levels increased. Fourteen of the 33 patients conceived and 12 delivered healthy infants; two miscarriages occurred. Bromocriptine treatment also caused endometrial dating to normalize in 21 patients; this means that the thickness of the uterine lining was in phase with the woman's hormonal profile. The results indicate that transient hyperprolactinemia could be one cause of the complex infertility problems associated with luteal phase deficiency. The recommendation is made that PRL be measured in the late follicular phase of the cycle (which precedes the luteal phase) and that treatment with bromocriptine be instituted for women with this problem. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Drug therapy, Infertility, Female, Female infertility, Luteal phase defects, Bromocriptine

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Ectopic hyperprolactinemia resulting from an ovarian teratoma

Article Abstract:

Prolactin, a hormone secreted by the pituitary gland, is associated with lactation, or the secretion of breast milk. Normally, elevated levels of prolactin in nonpregnant female patients indicate a malfunction of the pituitary gland. However, a case history is presented in which, after treatment to relieve symptoms of secondary amenorrhea (absence of menstruation) and galactorrhea (spontaneous flow of breast milk) caused by elevated prolactin (hyperprolactinemia), the condition returned. The patient, a 25-year-old women, was initially diagnosed with a pituitary tumor and treated surgically. The procedure was not entirely successful and was followed-up with drug therapy. After apparent relief of symptoms for about two years, prolactin levels were again found to be elevated and galactorrhea returned. An ovarian teratoma (tumor) was noted during routine examination. When the tumor was removed, tissue examination revealed the presence of prolactin. After removal of the tumor, the patient's prolactin level returned to normal. The authors are not aware of any other documented cases of hyperprolactinemia associated with teratoma. It was believed that this patient's pituitary function was not the cause of the initial prolactin irregularity, although it is possible that pituitary irregularity was a contributing factor. A variety of suggestions which outline possible courses that this patient's condition actually followed are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Teratoma, Ovarian tumors, Lactation disorders

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Hyperprolactinemia and nonpuerperal mastitis (duct ectasia)

Article Abstract:

Mammary duct ectasia (inflammation) and excessive secretion of prolactin, the hormone involved with milk production (hyperprolactinemia), occurring in a period other than after childbirth (nonpuerperal), were evaluated in 108 patients. The data on mastitis is of practical interest in the diagnosis of breast cancer. Inflammatory breast disease often causes transient hyperprolactinemia. Mastitis may also be a symptom of hyperprolactinemia due to a tumor of the pituitary gland. Researchers suggest that there is a causal relationship, based on the increased secretion of the mammary gland. In patients with nonpuerperal mastitis, prolactin levels in the blood should be measured after the inflammatory process has disappeared. If levels remain high, an investigation should be conducted to search for abnormalities of the hypothalamic-pituitary region.

Inflammation, Breast, column

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