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Effect of sulpiride on poor puerperal lactation.

Forty-two primiparous and 54 multiparous women with total yields of milk not exceeding 50 ml for the first 3 postpartum days were treated with 100 mg of oral sulpiride or placebo for 4 days from the third postpartum day. In the primiparous mothers, the mean daily yield of milk in the sulpiride group increased significantly (p less than 0.01) over that in the control group after the fourth postpartum day. Mean (+/- SE) total volumes of milk for the third to fifth postpartum days were 661.5 +/- 64.4 and 441.2 +/- 51.2 ml in the sulpiride and the control groups, respectively. However, in the multiparous mothers, no significant difference between the control and the sulpiride group was noted in total yield of milk, since a good increase in the secretion of milk was obtained without medication in these mothers. Determinations of daily serum levels of prolactin in 20 primiparous women revealed significantly higher concentrations in the sulpiride group. The ratio of primiparous mothers with complete breast-feeding 1 month after delivery was higher in the sulpiride group (55%) than in the control group (30%), whereas there was no difference between the control group and the sulpiride group of multiparous women. These data indicate that poor initiation of puerperal lactation in primiparous mothers can be effectively treated with oral sulpiride.

Adult↗

Variation of serum prolactin-releasing activity in women with the galactorrhea-amenorrhea syndrome after bromocriptine treatment.

Serum methanol extracts were obtained from nine women with the galactorrhea-amenorrhea syndrome, 24 pregnant women in the third trimester, and 18 normal men and women. The serum extract released prolactin (PRL) in significant amounts from rat anterior pituitary in vitro. The extracts from patients with galactorrhea-amenorrhea released PRL in large quantities. A significant positive correlation was observed between the PRL-releasing activity and serum PRL levels in individual samples from the pregnant women and normal subjects but not from the patients with galactorrhea-amenorrhea. Bromocriptine therapy suppressed serum PRL levels of five patients without tumors but increased the PRL-releasing activity in three out of five patients after treatment for 1 or 2 months. Apparently hypothalamic regulation of PRL secretion was disrupted in these three patients after bromocriptine therapy.

Adult↗

Lactation as a complication of aesthetic breast surgery successfully treated with bromocriptine.

A case is presented of lactation occurring ten days after mastopexy with augmentation mammaplasty. Milk-draining sinuses involving the operative incisions necessitated prompt diagnosis and treatment to avoid breast implant loss. Bromocriptine, an ergot derivative, was used to suppress a pathologically elevated prolactin level and successfully effect a rapid resolution of lactation.

Adult↗

Endocrinologic and psychologic aspects of galactorrhea associated with normal menstrual cycles.

Twelve cases of galactorrhea in women with normal menstrual cycles who were radiologically free of any pituitary adenomas were investigated. Determinations were made for serum thyroid-stimulating hormone (TSH), T3 resin uptake (T3RU), total thyroxine by radioimmunoassay (T4), free thyroxine index (FT4I), norepinephrine, epinephrine, prolactin and urinary luteinizing hormone, total estrogens, pregnanediol and total catecholamines. Psychologic evaluation and assessment were also done using the Middlesex Hospital Questionnaire and the Eysenk, manual dexterity, Bender Gestalt and trial-making scales. Hypothyroidism associated with moderate hyperprolactinemia and anovulation were the main features in eight cases. Associated psychologic disturbances were reported. The other four cases showed significant elevations in serum epinephrine, norepinephrine and urinary total catecholamines with concomitant pathologic scales of anxiety and neuroticism. Thyroxine replacement and psychotherapy are recommended in the treatment of such cases.

Adult↗

Menstrual pattern and ovarian function in women with hyperprolactinemia.

Prolactin (PRL) and progesterone were systematically measured in all women presenting with amenorrhea, oligomenorrhea or galactorrhea at the Infertility Clinic of the Department of Obstetrics and Gynecology, State University of Campinas, Brazil, during a period of 34 months. The same hormonal assays were done to all infertile patients presenting for the first time during the last 6 months of the same period, for a total of 190 subjects. Fifty-five patients with amenorrhea, 38 with oligomenorrhea and 97 with normal cycles, 20 of whom had galactorrhea, were included in the study. Fifty-five percent of amenorrheic patients, 37% of oligomenorrheic and 9% of those with normal menses had elevated PRL. The mean PRL was higher the greater the menstrual disturbance but was not influenced by presence or absence of galactorrhea. Short luteal phase was the ovarian function condition most frequently associated with high PRL among women with normal menses.

Female↗

The use of bromocriptine in hyperprolactinemia and galactorrhea in Singapore.

Ninety-four women and seven men were treated with low dose bromocriptine for (a) hyperprolactinemia or (b) normoprolactinemia but with galactorrhea and a pituitary adenoma. All the pituitary adenomas became smaller or remained the same. Prolactin levels decreased with treatment and inappropriate galactorrhea improved in the 53 patients except for 7 where there was no change. Of the 41 women with premenstrual mastalgia 78% improved with treatment. Of the 74 women with ovulatory problems, a biphasic pattern was restored in 65 patients. Thirty-two patients out of the 92 trying to conceive achieved a pregnancy with an abortion rate of 12.5% and non-lethal congenital abnormality of 9.8% (2.1% in Singapore population). Fertility was restored in 3 hyperprolactinemic oligospermic males and improved libido was professed by most of the treated men. Side effects were present but were on the whole tolerable. Pregnancy rate was better in those with high levels of prolactin (greater than 1000 miU/l) than in those with hyperprolactinemia of between 500 and 1000 miU/l although this was not statistically significant chi 2 = 0.69. In the lower hyperprolactinemic range there was noticeable number of patients with endometriosis and increased luteinizing hormone (LH) levels.

Adenoma↗