BROMOCRIPTINE TREATMENT OF SEVEN WOMEN WITH PRIMARY AMENORRHOEA AND PROLACTIN-SECRETING PITUITARY TUMOURS

Abstract

Seven women with primary amenorrhea and hyperprolactinemia were treated with bromocriptine. All the women had started to develop secondary sex characteristics at normal age but pubertal development stopped and menarche did not occur. Radiological signs of a pituitary tumor were found in all the women. Before the pituitary tumor was diagnosed, 4 women had been given long-term cyclical estrogen replacement therapy. Three women had received primary tumor therapy with surgery and/or irradiation but had persistent hyperprolactinemia. The basal luteinizing hormone (LH) levels were low in 4 of the women while all the women had normal basal levels of follicle-stimulating hormone (FSH) and normal or exaggerated gonadotropin responses to luteinizing hormone-releasing hormone (LHRH). None of the women had evidence of endogenous estrogen production before treatment. Bromocriptine treatment normalized the raised serum prolactin levels (46-2900 .mu.g/l) in all but 1 woman, in whom the prolactin level decreased from 160 to 38 .mu.g/l. Regular ovulatory menstrual cycles appeared in 4 women, one of whom had previously been treated by transsphenoidal adenomectomy followed by external irradiation. Two other women with persistent hyperprolactinemia after previous surgical and/or irradiation treatment of large pituitary tumors did not menstruate after more than 1 yr of treatment with bromocriptine. One infertile patient with a microadenoma conceived at the 1st ovulation on therapy and developed symptoms and signs of tumor growth during pregnancy.