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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventy tests of stimulation with hypothalamic thyreotrophic hormone liberation factor, and 35 bromocriptine inhibition tests were carried out on a routine basis in patients with latent or frank hyperprolactinaemia. Pathological hyperprolactinaemia does not have a single clinical pattern: frank, it takes the form either of an exteriorised pituitary adenoma (14 cases), or of an amenorrhoea-galactorrhoea syndrome with or without micro-adenoma (12 cases); latent, it takes the form either of isolated amenorrhoea (17 cases) or of dysovulatory sterility (16 cases). Amongst the dynamic tests available, it is worthwhile to make a choice, and in the case of frank hyperprolactinaemia, the authors propose use of the bromocriptine inhibition test in the first instance. The TRH test is reserved for verification of the results of neurosurgery. As far as latent hyperprolactinaemia is concerned, it may be identify only by the TRH test, with the resultant possibility of specific treatment.
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PMID:[Diagnosis of hyperprolactinaemias: respective value of response to THR and to bromocriptine (author's transl)]. 9 29

The degree of autonomy in prolactin secreting pituitary adenomas and also prolactin secretory reserve in cases with suspected functional galactorrhea syndrome was evaluated with the use of metoclopramide, TRH and L-DOPA. It was found that in patients with pituitary adenoma the basal prolactin (PRL) level often exceeded 150 micrograms/l and the response to stimulation with TRH and/or metoclopramide was markedly diminished or even nonexistent, while the response to L-DOPA was usually retained. In patients with galactorrhoea and/or amenorrhoea, with normal skull X-ray the basal PRL level was either normal or moderately raised but the response to stimulation was various; mostly it was excessive, it was sometimes normal, but in some other cases it was markedly diminished as in patients with adenoma. In the author's opinion the so-called "functional disorder" of prolactin secretion is mainly hyperresponsiveness to stimulation, whereas the basal PRL level in those cases is usually normal or only intermittently raised. In the cases with a moderate hyperprolactinaemia, especially if it appears to be constant, and the response to stimulation is diminished or none at all, we suspect a pituitary microadenoma. Finally, there are rare cases of galactorrhoea with normal basal PRL and normal response to stimulation, in which the sensitivity of the mammary PRL receptor is probably increased. We suggest therefore that the above mentioned PRL stimulation tests may help in distinguishing between tumoural and functional hyperprolactinaemia.
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PMID:The effect of metoclopramide, TRH and L-dopa on prolactin secretion in pituitary adenoma and in "functional" galactorrhoea syndrome. 11 17

A pituitary adenoma was removed from a young woman who had acromegaly with galactorrhea-amenorrhea. Postoperatively, the dysmorphic acromegalic syndrome and galactorrhea decreased but amenorrhea, elevated serum GH and PRL concentrations remained. After Bromocriptine administration (5 mg daily) GH and PRL levels became normal, vaginal bleeding ensued within 3 months and a twin pregnancy was induced. An immunocytochemical study of the pituitary adenoma revealed the presence of two well defined, distinct cell types, each secreting one hormone with large preponderance of GH cells.
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PMID:[Twin pregnancy following bromocriptine in an acromegalic patient staying sterile after removal of a pituitary adenoma. Immunocytochemical study of the tumor (author's transl)]. 23 33

Bromocryptine treatment was administered to 15 patients with amenorrhea and galactorrhea (AG) and to 1 patient with amenorrhea. All of them had increased plasma PRL levels. Of these 16 patients, 4 had a normal sella turcica (ST; group STO), 4 had a slight enlargement (group ST+), and 7 had a clear enlargement of ST (ST++) but no evidence of suprasellar extension. Ovulation was restored in 15 patients by bromocryptine treatment only. In one patient, ovulation resumed only after human pituitary gonadotropin treatment in combination with bromocryptine. There was no correlation between basal prolactinemia, PRL stimulability or suppressibility, the size of ST, or the efficiency of bromocryptine treatment. Every patient with normal LH response to either LRH or clomiphene or both resumed ovulation. Ovulation resumed in 3 patients among the 4 with abnormal LH response to either LRH or clomiphene or both. Among the 14 who desired pregnancy, 13 became pregnant. To date, 12 patients (ST++, 5; ST+, 3; STO, 4) have delivered normal babies. The courses of pregnancy were normal. During pregnancy, no change of ST was noted on lateral and frontal skull x-ray performed in every patient at trimonthly intervals. There was no change in the sellar index in 10 patients after pregnancy, as compared to the pretreatment status. In the presence of a pituitary adenoma or in patients with hyperprolactinemia and amenorrhea and galactorrhea, bromocryptine treatment may cure sterility without pituitary complication during pregnancy.
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PMID:Normal pregnancies after treatment of hyperprolactinemia with bromoergocryptine, despite suspected pituitary tumors. 40 Jul 17

This review assesses current knowledge of the control of human prolactin secretion, the means of altering it, and therapeutic regimens soon to reach the practitioner. Prolactin secretion appears to be under the control of hypothalamic neurotransmitter cells that stimulate pituitary lactotrophs via the hypothalamic-pituitary portal system, which is modulated by a prolactin-inhibiting factor and possibly a prolactin-releasing factor. Secretion is further modulated by estrogen and thyroid hormones at the pituitary level. Amenorrhea associated with hyperprolactinemia appears to be caused by hypothalamic dysfunction. In attempting to diagnose pituitary microadenomas as the cause of hyperprolactinemia, a thorough endocrine evaluation must be undertaken. Persons evidencing pituitary adenoma show a poor serum prolactin response to thyrotropin-releasing hormone in 70% of the cases, though false positives also occur. Bromergocryptine and 2-chloro-6-methyl-ergoline-8beta-acetonitrile methanesulfonate (Lergotrile, Lilly) have been used to sustain a reduced serum prolactin level, resulting in resumption of menses, ovulation, and pregnancy in patients without overt evidence of microadenoma. For those with adenoma, either surgical removal or radiation therapy is the conservative treatment.
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PMID:Current concepts of prolacting physiology in normal and abnormal conditions. 40 46

An infertile patient with amenorrhea-galactorrhea syndrome lost vision during a pregnancy occurring after Bromocryptine treatment. A pituitary adenoma was removed, vision recovered, and the pregnancy completed successfully. Two prior episodes of visual loss had occurred during oral contraceptive treatment, an association not heretofore reported. Intrasellar and parasellar tumors made manifest by hormonal influences of pregnancy may become more common as treatment of infertility becomes more refined and successful.
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PMID:Pituitary tumor made symptomatic during hormone therapy and induced pregnancy. 55 26

A young, adult, white female with long-standing amenorrhea-galactorrhea syndrome and known pituitary enlargement since 1969 is presented. Further evaluation revealed PRL levels elevated in the microadenoma range and an empty sella. The presence of a pituitary adenoma, however, could not be confirmed by our studies. The question now arises--in a young woman desirous of pregnancy, should an induction of ovulation be attempted in view of the elevated serum PRL and an empty sella?
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PMID:Primary empty sella syndrome with elevated serum prolactin. 56 54

Increased serum prolactin (hPRL) and increased volume of the sella turcica as detected by roentgenography are compatible with a pituitary adenoma. The empty sella syndrome can increase sella volume, but is usually associated with minimal, if any, endocrine dysfunction. The present case details a young woman with amenorrhea, galactorrhea, elevated serum hPRL, and roentgenographic evidence of an enlarged sella turcica. Pneumoencephalography with hypocycloidal polytomography is interpreted as both an empty sella, and evidence of a pituitary adenoma. The etiology and endocrine findings in the empty sella syndrome are discussed.
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PMID:Galactorrhea, amenorrhea, hyperprolactinemia, and an empty sella. 56 11

A case of primary hypothyroidism associated with postpartum galactorrhea-amenorrhea is reported. The configuration of the sella was compatible with pituitary adenoma, but prolactin dynamics did not support an autonomous secretory state. Replacement therapy with thyroxine led to complete reversal of clinical, radiologic, and biochemical abnormalities.
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PMID:Clinical, biochemical, and radiologic reversibility of hyperprolactinemic galactorrhea-amenorrhea and abnormal sella by thyroxine in a patient with primary hypothyroidism. 56 30

One hundred seventeen patients with amenorrhea and galactorrhea or hyperprolactinemia were evaluated with regard to antecedent factors, results of investigations, and management. Full details of the outcome of prolonged follow-up were available for 104 patients. Patients who developed amenorrhea-galactorrhea after withdrawal of oral contraceptives or postpartum had a lower incidence of pituitary adenomas than did those who developed amenorrhea-galactorrhea spontaneously. Six of a total of 40 tumors were detected only during the follow-up period. This study suggests that patients with spontaneous amenorrhea-galactorrhea have a greater risk of developing a detectable pituitary adenoma than do those with postpill or postpartum symptoms. However, patients with a microadenoma are more likely to have had postpill onset of hyperprolactinemia. Plasma prolactin (PRL) in patients with postpill amenorrhea-galactorrhea increased in proportion to the duration of oral contraceptive use.
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PMID:Antecedent factors and outcome in amenorrhea-galactorrhea. 57 34


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