Pulsatile Gonadotrophin Secretion in Hyperprolactinaemic Amenorrhoea and the Response to Bromocriptine Therapy

Moult, P. J. A.; Rees, Lesley; Besser, G. M.

doi:10.1111/j.1365-2265.1982.tb03159.x

Cited by 110 publications

(42 citation statements)

References 19 publications

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“…Normal LH pulsatility can be restored with bromocriptine treatment, resulting in PRL normalization (6)(7)(8)21). Since it has been suggested that bromocriptine can directly affect LH release (22), it is not possible to assert with certainty that the restoration of LH pulsatility is exclusively due to PRL normalization.…”

Section: Discussionmentioning

confidence: 99%

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Early Normalization of Luteinizing Hormone Pulsatility after Successful Transsphenoidal Surgery in Women with Microprolactinomas

Stevenaert¹,

Beckers²,

Vandalem³

et al. 1986

The Journal of Clinical Endocrinology & Metabolism

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ABSTRACT. In eight hyperprolactinemic amenorrheic women who had a microprolactinoma, LH secretion was examined by measuring its concentration in blood samples collected every 15 min for 6 h before and 8 days after successful selective adenomectomy. Computer analysis was used for LH peak evaluation. In both circumstances, serum PRL and basal estradiol (E 2 ) levels were also determined. Before operation, the number of LH peaks ranged from zero to one per 6 h in seven patients and was two per 6 h in the eighth patient. In all patients, serum PRL was normal on the eighth postoperative day, while E 2 levels remained low, similar to the values usually found in the early follicular phase of the cycle in normal women. Postoperatively, mean LH levels were similar to preoperative levels, but there was a dramatic increase in the number of LH peaks (three to five per 6 h) in five of the eight patients.These observations confirm the impairment of LH pulsatility in hyperprolactinemia and demonstrate that normalization of PRL levels by surgery can restore LH pulsatile secretion in certain women as early as the eighth day after operation in the absence of a significant change in serum E 2 levels. Thus, the preoperative impaired pulsatility of LH secretion was probably a central effect of hyperprolactinemia. {J Clin Endocrinol Metab 62: 1044, 1986) T HE MAIN disturbances provoked by hyperprolactinemia in the human concern the hypothalamopituitary-gonadal axis. In the rats, dopamine turnover in the median eminence is increased by hyperprolactinemia, probably by a short loop feedback (1, 2). In man, dopamine infusion reduces serum LH concentrations (3), as well as the frequency of LH pulses (4). Furthermore, hyperprolactinemia is associated with a reduction in frequency or absence of LH pulses (5-8). Normalization of PRL with bromocriptine is followed by restoration of LH pulsatility (5-8), but this action may be due to a central action of bromocriptine rather than a consequence of reduced PRL secretion.Recently, LH pulsatility was found to be restored after transsphenoidal surgery (9). However, since that restoration occurred after resumption of menses and normal ovulatory function, it remained uncertain whether the postoperative increase in the number of LH peaks was due to PRL normalization or to an elevation of serum estradiol (E 2 ) levels. Indeed, the LH positive feedback response to estrogens is impaired in hyperprolactinemia (10) and restored after bromocriptine (11).

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, hyperprolactinemia is associated with a reduction in frequency or absence of LH pulses (5)(6)(7)(8). Normalization of PRL with bromocriptine is followed by restoration of LH pulsatility (5)(6)(7)(8), but this action may be due to a central action of bromocriptine rather than a consequence of reduced PRL secretion.…”

mentioning

confidence: 99%

Early Normalization of Luteinizing Hormone Pulsatility after Successful Transsphenoidal Surgery in Women with Microprolactinomas

Stevenaert¹,

Beckers²,

Vandalem³

et al. 1986

The Journal of Clinical Endocrinology & Metabolism

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“…Thyroid dysfunction interferes with the endocrine regulation of reproductive system [3,4]. Persistent hyperprolactinaemia interrupts the pulsatile secretion of gonadotrophin-releasing hormone thus inhibits the release of luteinizing hormone and follicle-stimulating hormone [5] and directly impairs gonadal sex steroid production.…”

Section: Introductionmentioning

confidence: 99%

Prolactin, Thyroid Stimulating Hormone and Thyroid Hormones (Ft3, Ft4) Concentrations in Female Patients with Inferility: An Observational Study

Subhan¹,

Sadiq²,

Subhan³

2017

J Clin Exp Pathol

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Objective: To determine the variations in thyroid hormones, thyroid stimulating hormone and prolactin levels in females of our population. Materials and methods:Subject characteristics: Patients aged 13 to 60 years were studied for their hormonal profile. The inclusion criteria had patients with complaints of mild reproductive and thyroid dysfunction. Patients with severe disorders and cancerous conditions were excluded from the study.Blood sampling: 3 ml blood was drawn and transferred to clean test tubes. Blood was centrifuged at 3000 rpm for 10-15 min. Serum was separated and stored at -20℃.Hormonal assay: Thyroid stimulating hormone (TSH), Prolactin, FT3 and FT4 were assayed in the serum. Equipment used in laboratory was Eclecsys 2010 (Roche). Principle of the hormonal test was based on ECL (Electrochemiluminescence). Standard kits by Roche were used for chemical analysis.The results were analyzed by using ANOVA in SPSS (version 10.0 for windows).Results: A total of 97 patients were tested. The patients were divided into four major groups, showed overall nonsignificant variation in hormonal level for Prolactin, FT3 and FT4 (p>0.05). About 80% patients were found normal, in TSH estimation. Women from age 16-35 years old were greater in number than any other age group. Means for each hormone were non-significant at p=0.05. Conclusion:Hyperprolactinemia causes reproductive disorders in women, early diagnosis and treatment of this disease is important. In conclusion estimation of prolactin and TSH levels might be considered essential in assessment of patient with fertility disorders.

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“…During the physiologic hyperprolactinemia of lactation [6,[9][10][11] and pathologic hyperprolactinemia in women with prolactinomas [7,8] , GnRH can be suppressed resulting in menstrual cycle dysfunction and amenorrhea. Dopamine has been implicated as the link between hyperprolactinemia and GnRH suppression, however the evidence is weak.…”

Section: Introductionmentioning

confidence: 99%

“…The increased dopamine acts at dopamine receptors to inhibit further prolactin release centrally [2,5] . The prolactin-induced increase in dopamine is also postulated to mediate its suppressive effects on GnRH and TSH secretion [6][7][8][9][10][11][12][13][14] . However, it is not clear that the short-feedback loop operates in the human and whether it mediates prolactin-associated GnRH and TSH suppression.…”

Section: Introductionmentioning

confidence: 99%

Prolactin Suppresses GnRH but Not TSH Secretion

Page-Wilson

Smith²,

Welt³

2006

Horm Res Paediatr

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Background/Aims: In animal models, prolactin increases tuberoinfundibular dopamine turnover, which has been demonstrated to suppress both hypothalamic GnRH and pituitary TSH secretion. To test the hypothesis that prolactin suppresses GnRH and TSH secretion in women, as preliminary evidence that a short-feedback dopamine loop also operates in the human, the effect of hyperprolactinemia on GnRH and TSH secretion was examined. Methods: Subjects (n = 6) underwent blood sampling every 10 min in the follicular phase of a control cycle and during a 12-hour recombinant human prolactin (r-hPRL) infusion preceded by 7 days of twice-daily subcutaneous r-hPRL injections. LH and TSH pulse patterns and menstrual cycle parameters were measured. Results: During the 7 days of r-hPRL administration, baseline prolactin increased from 16.0 ± 3.0 to 101.6 ± 11.6 µg/l, with a further increase to 253.7 ± 27.7 µg/l during the 12-hour infusion. LH pulse frequency decreased (8.7 ± 1.0 to 6.0 ± 1.0 pulses/12 h; p < 0.05) with r-hPRL administration, but there were no changes in LH pulse amplitude or mean LH levels. There were also no changes in TSH pulse frequency, mean or peak TSH. The decreased LH pulse frequency did not affect estradiol, inhibin A or B concentrations, or menstrual cycle length. Conclusion: These studies demonstrate that hyperprolactinemia suppresses pulsatile LH secretion but not TSH secretion and suggest that GnRH secretion is sensitive to hyperprolactinemia, but that TSH secretion is not. These data further suggest that the degree of GnRH disruption after 7 days of hyperprolactinemia is insufficient to disrupt menstrual cyclicity.

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Pulsatile Gonadotrophin Secretion in Hyperprolactinaemic Amenorrhoea and the Response to Bromocriptine Therapy

Cited by 110 publications

References 19 publications

Early Normalization of Luteinizing Hormone Pulsatility after Successful Transsphenoidal Surgery in Women with Microprolactinomas

Early Normalization of Luteinizing Hormone Pulsatility after Successful Transsphenoidal Surgery in Women with Microprolactinomas

Prolactin, Thyroid Stimulating Hormone and Thyroid Hormones (Ft3, Ft4) Concentrations in Female Patients with Inferility: An Observational Study

Prolactin Suppresses GnRH but Not TSH Secretion

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