PCOS and Hyperprolactinemia: what do we know in 2019?

Abstract

Polycystic ovary syndrome (PCOS) and hyperprolactinemia (HPRL) are the two most common etiologies of anovulation in women. Since the 1950s, some authors think that there is a pathophysiological link between PCOS and HPRL. Since then, many authors have speculated about the link between these two endocrine entities, but no hypothesis proposed so far could ever be confirmed. Furthermore, PCOS and HPRL are frequent endocrine diseases and a fortuitous association cannot be excluded. The evolution of knowledge about PCOS and HPRL shows that studies conducted before the 2000s are obsolete given current knowledge. Indeed, most of the studies were conducted before consensual diagnosis criteria of PCOS and included small numbers of patients. In addition, the investigation of HPRL in these studies relied on obsolete methods and did not look for the presence of macroprolactinemia. It is therefore possible that HPRL that has been attributed to PCOS corresponded in fact to macroprolactinemia or to pituitary microadenomas of small sizes that could not be detected with the imaging methods of the time. Recent studies that have conducted a rigorous etiological investigation show that HPRL found in PCOS correspond either to non-permanent increase of prolactin levels, to macroprolactinemia or to other etiologies. None of this recent study found HPRL related to PCOS in these patients. Thus, the link between PCOS and HPRL seems to be more of a myth than a well-established medical reality and we believe that the discovery of an HPRL in a PCOS patient needs a standard etiological investigation of HPRL.

Effects of Aerobic Exercise on Rats with Hyperandrogenic Polycystic Ovarian Syndrome

“…Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder with a global prevalence of 4-21% [1,2]. e clinical manifestations of PCOS include ovulation failure, menstrual disorders, polycystic ovaries, obesity, and hyperandrogenism associated with hirsutism, acne, and alopecia [3,4]. e pathogenesis of PCOS still remains unclear, although recent studies suggest that it is related to genetic, epigenetic, and environmental factors [5].…”

Polycystic Ovary Syndrome and Fibrocystic Breast Disease: An Updated Review

“…Similarly, the relationship between PCOS and hyperprolactinemia is controversial. Although old data showed that the prevalence of hyperprolactinemia in PCOS women was less than 10 to 70 %, a new study did not confirm these results; thus, this relationship requires further investigation [60].…”

“…PRL exerts proliferative, mito-and angiogenic effects on breast lines. Previous studies have shown contrary results regarding the relationship between hyperprolactinemia and the development of benign breast disease [60][61][62][63]. Similarly, the relationship between PCOS and hyperprolactinemia is controversial.…”

Ovulation Induction in Patients with Polycystic Ovarian Syndrome (PCOS) & Hyperprolactinemia (HPRL): Efficacy of Letrozole (LE) Combined with Cabergoline (CE) in Comparison to (LE) Alone

“…Prevalence of (HPRL) is not rare in young women with menstruation-related problem; it varies according to age and manifestations. The most common hypothesis to explain the link between (HPRL) & (PCOS) is a possibly a common hypothalamic-pituitary abnormality for both [8]. It varies from 0.4% in the normal adults or 2.9% in women with adult-onset amenorrhea or up to 75% in women with both amenorrhea & galactorrhea [9].…”