HYPERPROLACTINAEMIA AND LONG-TERM LACTATIONAL AMENORRHOEA

Abstract

Clinical details of lactational and menstrual history post-partum were correlated with measurements of serum prolactin [PRL], luteinizing hormone [lutropin], follicle-stimulating hormone [follitropin], estradiol and progesterone [PG] in Transkei women to study the role of PRL in the maintenance of post-partum lactational amenorrhea. Of 74 breast-feeding mothers studied, 66 had elevated serum PRL levels. Forty-four women were amenorrheic with minimal or absent endocrine evidence of ovarian activity. Of the 27 lactating women who reported menstruation, 12 had high levels of PRL and no apparent ovarian activity, 11 had lower PRL levels and increased estradiol levels suggesting ovarian follicular development, while only 4 women had increased PG levels indicating definite luteal activity. Three lactating women were pregnant. The results apparently support previous reports that lactational amenorrhea is associated with hyperprolactinemia. A possible sequence of endocrine events resulting in the return of post-partum fertility is proposed.