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PubMed1980

Prolactin-secreting pituitary adenomas. III. Frequency and diagnosis in amenorrhea-galactorrhea.

Hypocycloidal tomograms of the sella turcica and serum prolactin concentrations were obtained in 146 women with amenorrhea, galactorrhea, or both to diagnose prolactin-secreting pituitary adenomas. Findings suggesting an adenoma, ie, abnormal tomogram and elevated serum prolactin concentration, were found in 24.6% (16/65) of previously unscreened patients and 59.2% (48/81) of prescreened patients. The combination of an abnormal tomogram and elevated prolactin level was relatively specific for an adenoma, as 91% (42/46) of women with these findings who underwent surgery had histologically confirmed tumors. Tumors occurred in women from 15 to 45 years of age, with amenorrhea or galactorrhea ranging from less than six months to more than 20 years in duration. Some women in this series also had obesity, rapid weight loss, polycystic ovarian syndrome, amenorrhea following discontinuance of oral contraceptive use, or emotional stress.

Adenoma↗
PubMed1980

Prolactin-secreting pituitary oncocytoma with galactorrhea--amenorrhea syndrome: a histologic, ultrastructural, and immunocytochemical study.

A case is reported of a 24-year-old woman with amenorrhea and galactorrhea and markedly elevated serum prolactin levels who underwent operative resection of a pituitary adenoma. Ultrastructural examination revealed the classic features of an oncocytoma. Immunocytochemical staining was positive for prolactin. Following excision of the tumor, serum prolactin levels returned to normal and the galactorrhea became minimal. This is the first case of a pituitary oncocytoma in which secretion of prolactin was both clinically and immunocytochemically documented.

Adenoma↗
PubMed2001

Treatments for breast engorgement during lactation.

BACKGROUND: National surveys have shown that painful breasts are the second most common reason for giving up breastfeeding in the first two weeks after birth in the UK. One factor contributing to such pain can be breast engorgement. Views differ as to how engorgement arises, although restrictive feeding patterns in hospital are likely to have contributed in the past. These differing views are reflected in the range of solutions offered to treat engorgement in breastfeeding mothers and these treatments are assessed in this review. OBJECTIVES: To determine the effects of any proposed intervention to relieve symptoms of breast engorgement among breastfeeding women. SEARCH STRATEGY: The register of clinical trials maintained and updated by the Cochrane Pregnancy and Childbirth Group. CINAHL and MEDLINE were also searched. Date of last search: December 2000. SELECTION CRITERIA: All randomised and 'quasi-randomised' controlled trials, with or without blinding, that assess the effectiveness of treatments for the alleviation of symptoms in breastfeeding women experiencing engorgement. DATA COLLECTION AND ANALYSIS: Data were extracted by one reviewer and verified by a second reviewer. MAIN RESULTS: Eight trials, involving 424 women, were included. Three different studies were identified which used cabbage leaves or cabbage leaf extracts;. no overall benefit was found. Ultrasound treatment and placebo were equally effective. Use of Danzen (an anti-inflammatory agent) significantly improved the total symptoms of engorgement when compared to placebo (odds ratio (OR) 3.6, 95% confidence interval (CI) 1.3 - 10.3) as did bromelain/trypsin complex (OR 8.02, 95% CI 2.8-23.3). Oxytocin and cold packs had no demonstrable effect on engorgement symptoms. REVIEWER'S CONCLUSIONS: Cabbage leaves and gel packs were equally effective in the treatment of engorgement. Since both cabbage extract and placebo cream were equally effective, the alleviation in symptoms may be brought about by other factors, such as breast massage. Ultrasound treatment is equally effective with or without the ultra-wave emitting crystal, therefore its effectiveness is more likely to be due to the effect of radiant heat or massage. Pharmacologically, oxytocin was not an effective engorgement treatment while Danzen and bromelain/trypsin complex significantly improved the symptoms of engorgement. Initial prevention of breast engorgement should remain the key priority.

Breast Diseases↗
PubMed2000

Oxytocin for promoting successful lactation.

BACKGROUND: A rise in the concentration of oxytocin causes contraction of cells around the alveoli and milk ducts, in preparation for suckling. Lactation failure may result from insufficient oxytocin. OBJECTIVES: The objective of this review was to assess the effects of using oral or nasal oxytocin on lactation. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA: Randomised and quasi-randomised trials of variable doses of oxytocin and different methods of administration versus placebo in breastfeeding women using oxytocin to augment lactation. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted by two reviewers. MAIN RESULTS: Four trials of 639 women were included. There was potential for significant bias in these trials. Restricted breastfeeding schedules may have contributed to inadequate production of milk by the participants. Sublingual and buccal preparations of oxytocin were associated with an increase in milk production. Oxytocin did not appear to increase the incidence of breast pain and 100 international units of oxytocin appeared to be slightly more beneficial than 10 international units. REVIEWER'S CONCLUSIONS: An appropriate dose of sublingual or buccal oxytocin may help augment lactation where necessary. However if women are encouraged and supported with unrestricted breastfeeding, the need for oxytocin would probably be diminished.

Female↗
PubMed1983

Study of nucleolar organizer in women with galactorrhea, or polycystic ovaries, or using oral contraceptive.

In this paper we report on changes of the Ag-stained NOR (Ag-NOR) and Ag-stained acrocentric association (Ag-AA) frequencies in lymphocytes of women with polycystic ovaries, galactorrhea, or taking oral contraceptives. The results showed that Ag-AA frequencies were increased significantly in all three study groups while the Ag-NOR frequencies apparently did not increase. We assume that a difference in average Ag-NOR frequency between the two groups may be a measure of the change in the number of active rRNA genes, and that differences of Ag-AA frequency among populations reflect the change in transcriptional rate of the active rRNA genes.

Adult↗
PubMed1977

Clinical and hormonal response of patients with galactorrhea syndrome treated with bromergocryptine.

Tne patients with galactorrhea syndrome were treated with two different daily dosages (5 mg and 7.5 mg) of Bromergocryptine. The 5 mg daily dosage often did not produce the desired hormonal and clinical response. Five patients were treated with this regimen for 38 to 90 days, with treatment extending over more than one menstrual cycle. However, the 7.5 mg daily dosage resulted in complete cessation of galactorrhea in all patients, restoration of menstrual cycles in five patients, and pregnancies in four patients. Disappearance of lactation proved to be a very good indicator of the general responsiveness of patients. Nausea, vomiting, and occasional dizziness were side effects of the drug. The case histories and hormonal findings of four typical patients are reported.

Bromocriptine↗
PubMedDate not supplied

Galactorrhea and the defective luteal phase of the menstrual cycle.

Twelve patients with primary infertility due to a defective luteal phase associated with hyperprolactinemia and galactorrhea are reported. All were treated with 2-bromoergocryptine. During the first cycle of therapy, the serum prolactin level decreased in all cases, and galactorrhea disappeared during the second cycle of therapy. Seven women responded to 2-bromoergocryptine, as was reflected in their endometrial biopsies. The remaining five were given clomiphene citrate on the second and sixth days of the next 2-bromoergocryptine cycle. Three of these patients responded favorably to this combined therapy. Six pregnancies were reported during therapy. The results of follow-up after labor or abortion suggested that these cases represent a latent stage of the amenorrhea-galactorrhea syndrome.

Adult↗
PubMed2002

Sonographic appearances of galactoceles.

PURPOSE: The aim of this study was to investigate and summarize the sonographic appearances of galactoceles. METHODS: We retrospectively reviewed the sonograms and clinical records of 10 patients with galactoceles who had been examined over a 5-year period to evaluate breast lumps that had occurred during lactation or the puerperium. RESULTS: Sonograms from all patients showed well-defined lesions with thin, echogenic walls. The internal appearances of the lesions included homogeneous contents with medium-level echoes in 6 patients and heterogeneous contents with fluid clefts and anechoic rims in 4 patients. Focal echogenic areas with distal shadowing were seen in 2 patients. Most of the lesions showed some distal acoustic enhancement, depending on the internal contents. The diagnosis of a galactocele was established by needle aspiration in 9 patients and by excision biopsy in 1 patient. Needle aspiration alone was therapeutic in 8 patients. CONCLUSIONS: Galactoceles can have a wide range of sonographic appearances and can mimic other lesions of the breast, both benign and malignant. The clues to the diagnosis are recent childbirth and lactation and the presence of a well-defined lesion with some distal acoustic enhancement. Needle aspiration of the lesion is both a diagnostic tool and an effective treatment in most patients with galactoceles.

Adult↗
PubMed1991

Potential indicators of insufficient milk supply syndrome.

Insufficient milk supply syndrome is a complex phenomenon that has not been adequately investigated. Insufficient milk supply (IMS) is a major reason reported by mothers for early termination of breast-feeding in both developed and developing countries. Using the IMS conceptual framework by Hill and Humenick (1989), a survey was conducted to determine which set of predictors distinguished between mothers who reported an inadequate supply of breast milk (n = 100) from those who reported an adequate supply of milk (n = 284) during the first 8 weeks postpartum. Factor analysis suggested that Potential Determinant factors Maternal Confidence, Paternal Support, Maternal Health, Mother-in-Law Disapproval, and Infant Birthweight accounted for 56.7% of the variance while Potential Indicator factors Baby Behavior, Solid Foods, and Formula accounted for 70.4% of the variance. Using discriminant analysis, factors Maternal Confidence, Maternal Health, Mother-in-Law Disapproval, Baby Behavior, Solid Foods, and Formula predicted 78.04% of the cases accurately. The Potential Indicator factors alone predicted 76.58% of the cases accurately. These findings suggest that the IMS model is valid but additional variables may need to be considered.

Adult↗