Hypogonadism, galactorrhoea and hyper-prolactinaemia: Evaluation of pituitary gonadotrophins reserve before and under bromocriptine

Asfour, M.; L'Hermite, M.; Hedouin-Quincampoix, M.; Fossati, P.

Acta Endocrinologica 84(4): 738-749


ISSN/ISBN: 0001-5598
PMID: 322432
DOI: 10.1530/acta.0.0840738
Accession: 068526249

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Gonadotropin levels in basal conditions and after gonadotropin-releasing hormone (Gn-RH) stimulation in 20 patients with hypogonadism, galactorrhea, and hyperprolactinemia are reported and, in some cases, results after treatment with bromocriptine are included. The radiological study of the sella turcica allowed classification of the patients in 3 groups: 1) grossly enlarged sella turcica, 2) localized alterations indicating the probable existence of a prolactin-secreting microadenoma, and 3) no radiological abnormality. All the Group 1 patients had low basal luteinizing hormone (LH) levels and a blunted response to Gn-RH. Basal LH and the response to Gn-RH were normal in most of Group 2 and in all of Group 3. An exaggerated follicle stimulating hormone (FSH) response to Gn-RH was observed in 6 of 12 patients in Group 2 but not in the other groups. It is suggested that the Gn-RH test might contribute to the assessment of the hypothalamo-pituitary axis of patients with hyperprolactinemia. 6 patients teated for 4 months with bromocriptine experienced restoration of menses or regained potency. These results are compatible with the hypothesis that hyperprolactinemia per se could interfere with the endogenous secretion of Gn-RH at the hypothalamic level.