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At least 577 records · Page 32Linked to original sources
PubMed1976

Galactorrhea-amenorrhea: psychological interaction with neuroendocrine function.

Further substantiation of the interaction between psychological disease and the onset of galactorrhea-amenorrhea is presented in women who underwent intensive psychometric and neuroendocrine evaluation prior to the use of the dopamine against 2-Br-alpha-ergocryptine (CB-154). Normalization of a previously distorted psychometric test profile in each woman was accompanied by a profound decline in prolactin and an unexpected alteration in the peripheral concentrations of norepinephrine and dopamine-beta-hydroxylase. Cesation of galactorrhea and resumption of menses were observed in each instance.

Adult↗
PubMed1977

Effects of alpha- and beta-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea.

The effects of alpha- and beta-adrenergic blocking agents on the serum prolactin levels of six women with hyperprolactinemia and galactorrhea were investigated. There was no indication that pituitary adenomas were etiologic agents for the hyperprolactinemia. Serum prolactin could be lowered with oral L-dopa. When intravenous phentolamine (an alpha-adrenergic blocking agent) or intravenous propranolol (a beta-adrenergic blocking agent) were administered for 1 hour, there was no significant change in serum prolactin levels.

Adenoma↗
PubMed1977

Bromocryptine therapy in cases of amenorrhea-galactorrhea.

Of 28 patients presenting with amenorrhea-galactorrhea, pituitary tumors were confirmed in eight. Six patients had occult hypothyroidism and the rest had an endocrine profile suggestive of pituitary tumor or of an idiopathic etiology. Treatment with bromocryptine resulted in suppression of the inappropriate lactation and restoration of regular menstrual function. In five cases, however, the galactorrhea was only diminished and in four of these cases, normal ovarian function did not return. Of the 19 patients that were seeking fertility and continued the medication for at least 20 days, nine pregnancies resulted. A similar response to bromocryptine was observed regardless of the underlying cause of the amenorrhea-galactorrhea.

Adult↗
PubMed1978

Tomographic diagnosis of pituitary microadenomas in Forbes-Albright syndrome (amenorrhea-galactorrhea).

The present study documents a characteristic tomographic sellar abnormality in five patients with Forbes-Albright syndrome (ammenorrhea-galactorrhea) and surgically proved pituitary microadenomas. This abnormality, noted in patients with normal-sized sellae, consists of asymmetric erosion of the anterior inferior wall of the sella turcica. Utilizing the twin criteria of an elevated serum prolactin and characteristic sella abnormality, herein described, previously unrecognized patients with pituitary microadenomas can be diagnosed and treated effectively.

Adenoma↗
PubMed1978

The significance of galactorrhea in patients with normal menses, oligomenorrhea, and secondary amenorrhea.

Thyroid-stimulating hormone and prolactin (PRL) were measured in a group of 149 women with galactorrhea. Three of these patients were found to have primary hypothyroidism. In the remaining 146 patients, the PRL assay was correlated with the menstrual history and the results of hypocycloidal polytomography. Sixty-two per cent of these patients had hyperprolactinemia and 35 per cent had abnormal tomograms. Nine patients with abnormal x-rays had normal prolactin levels. None of the patients with normal menses and normal PRL was found to have an abnormal x-ray. Fourteen of the 15 patients with PRL levels greater than 200 ng. per milliliter had abnormal tomograms. Almost 70 per cent of patients with secondary amenorrhea and low estrogen status had abnormal x-rays. In patients with oligomenorrhea and secondary amenorrhea with normal estrogen status, it was not possible to differentiate between patients with normal or abnormal tomograms based on the level of serum PRL. Polytomography remains the single most important diagnostic test in establishing the presence of a pituitary tumor.

Adolescent↗
PubMed1979

Comparison of serum prolactin, plain radiography, and hypocycloidal tomography of the sella turcica in patients with galactorrhea.

Hypocycloidal tomography of the sella turcica is being used with increasing frequency in patients with galactorrhea in order to establish the diagnosis of pituitary adenoma. In 201 patients with galactorrhea, serum prolactin (PRL) levels were correlated with anteroposterior (AP)--lateral plain radiographs and hypocycloidal tomography of the sella turcica. Plain films were normal in 167 and abnormal in 34 patients. Of the 167 patients with normal AP-lateral plain films, 80 had normal tomograms and normal serum prolactin levels while 80 patients had normal tomograms and elevated serum PRL levels (21 to 256 ng/ml). The remaining seven of the 167 patients had normal plain films with abnormal tomograms and elevated serum PRL levels (28 to 176 ng/ml). All patients with abnormal plain radiographs had abnormal tomograms and had either elevated or normal serum PRL levels. In view of these findings, sella tomography is only necessary in patients with normal plain radiographs and elevated serum PRL levels.

Adenoma↗
PubMed1979

Galactorrhea and pituitary tumors in postpill and non-postpill secondary amenorrhea.

One hundred sixty-seven women with secondary amenorrhea were observed from six months to four years. In 66 patients, the amenorrhea followed the discontinuation of oral contraceptives (postpill) while in the remaining 101 the amenorrhea was not temporally pill related (non-postpill). Galactorrhea was present in 43 (65%) of those with postpill amenorrhea and in 32 (32%) of those with non-postpill amenorrhea (p less than 0.001). Tomography of the sella turcica was performed in the 75 women with galactorrhea and in the 35 without galactorrhea who did not have withdrawal uterine bleeding following progesterone administration and who had low or normal serum follicle-stimulating hormone levels (hypothalamic-pituitary failure). Forty of the 75 patients with amenorrhea and galactorrhea had radiographic evidence of a pituitary tumor whereas only eight of 35 patients with hypothalamic-pituitary failure without galactorrhea had an abnormal sella turcica (p less than 0.01). The incidence of radiographic abnormalities in those with galactorrhea was similar in both the postpill and non-postpill groups.

Adolescent↗
PubMed1979

A practical approach for the evaluation of women with abnormal polytomography or elevated prolactin levels.

Based upon the experience gained in the evaluation of 60 patients with abnormal polytomography and/or elevated prolactin levels, the following observations can be made: Patients with amenorrhea, amenorrhea and galactorrhea, galactorrhea alone, or anovulatory cycles and infertility may or may not have pituitary tumors. Clinical symptoms do not always correlate with the prolactin level, and patients with normal prolactins may have pituitary tumors. The incidence of empty sella is significant (15.8% in this series). Visual field examination is not a useful screening procedure, but evaluation of thyroid function is important to detect the occasional patient with hypothyroidism (3.5% in this series). The insulin tolerance test is not helpful in detecting the presence of pituitary tumors or in guiding management decisions, and the CT scan contributes little and should be omitted from the evaluation process. A straightforward, economical, and efficient approach to this clinical problem is presented.

Adenoma↗
PubMed1980

The use of thyrotropin-releasing hormone in distinguishing prolactin-secreting pituitary adenoma.

In order to differentiate between a prolactin-secreting adenoma and a nonneoplastic etiology for galactorrhea, a single stimulatory dose of 500 microgram of thyrotropin-releasing hormone (TRH) was employed to assess the prolactin (PRL) response of 50 women. The results were compared to those obtained in 19 control subjects (10 with subsequent surgical removal of a PRL-secreting those obtained in 19 control subjects (10 with subsequent surgical removal of a PRL-secreting adeonoma and nine women stimulated in the early follicular phase). All patients were grouped according to normal or elevated serum PRL, and normal, equivocal, or abnormal findings by tomography of the sella turcica. Patients with a normal baseline PRL had a normal PRL response to TRH of at least 200% above baseline. This normal response was independent of findings by tomography of the sella turcica. A highly significant difference in response (p < 0.001) was illustrated by all patients with elevated PRL and abnormal tomograms, and in some patients with elevated PRL and normal or equivocal tomograms. These responses were identical to those of the control patients who had histologic evidence of a PRL-secreting adenoma. The findings indicate that a PRL-secreting adenoma in patients with galactorrhea can be identified on the basis of the PRL response to TRH stimulation.

Adenoma↗
PubMed1980

Prolactin modulation of dehydroepiandrosterone sulfate secretion.

To clarify the controversy about the effect of prolactin (PRL) on dehydroepiandrosterone sulfate (DHEA-S), this study was undertaken to investigate the effects of alterations in plasma PRL on plasma DHEA-S concentrations in hyperprolactinemic women, as well as in normal male subjects. DHEA-S was measured in a group of 21 women with hyperprolactinemia, galactorrhea, and amenorrhea (PRL:257 +/- 89 ng/ml; mean +/- SEM). In these women, mean plasma concentrations of DHEA-S (2.54 +/- 0.2 microgram/ml) were significantly higher (p < 0.005) than those in 41 normal control women (1.78 z microgram/ml) and those in a group of 11 amenorrheic patients (1.77 +/- 0.2 microgram/ml). Eight women with hyperprolactinemia were given 5 mg of bromocriptine each day for 4 consecutive weeks. Within 1 week of medication, PRL levels fell by 60% (p < 0.05). To test whether lowering normal plasma levels of PRL would affect plasma concentrations of DHEA-S, five normal male subjects received a 48-hour infusion of dopamine at an average rate of 6 microgram/kg/min. Plasma levels of PRL fell by 60% (p < 0.01) after 8 hours of infusion, and DHEA-S decreased by 27% by 16 hours (p < 0.05). These data suggest that PRL modulates the secretion of DHEA-S: an increase in plasma levels of PRL is correlated with elevated concentrations of DHEA-S, whereas a decrease in PRL is followed by a fall in DHEA-S.

Adult↗
PubMed1980

Predicted ovulatory response to 2-brom-alpha-ergocryptine (CB-154) in amenorrhea-galactorrhea syndromes.

Adenohypophyseal function was evaluated in 20 consecutive patients with hyperprolactinemic amenorrhea-galactorrhea in an attempt to predict ovulatory response with 2-brom-alpha-ergocryptine (CB-154) therapy. Pituitary fossa tomography and response to insulin, thyrotropin-releasing hormone, and luteinizing hormone--releasing hormone were correlated with the return of ovulatory cycles. Fourteen of 15 patients demonstrating normal pretreatment sellar volume ovulated, compared with 0 of 5 showing increased volume. Thirteen of 14 with adequate adenophypophyseal reserve of growth hormone and luteinizing hormone ovulated, compared with 0 of 6 and 1 of 6, respectively, with inadequate reserve. Serum prolactin suppression to normal occurred in 19 of 20 patients but could not predict response. Only 2 of 10 patients receiving clomiphene citrate ovulated and neither conceived, while 8 of the 10 ovulated with CB-154 and 6 of 7 desiring pregnancy conceived. CB-154 is an effective "fertility drug" and response to therapy can usually be predicted.

Adult↗