Treatment of hirsutism in polycystic ovary syndrome with bromocriptine

Murdoch, Alison; Mcclean, K. G.; Watson, M. J.; Dunlop, W.; Taylor, Pat

doi:10.1111/j.1471-0528.1987.tb03105.x

Cited by 21 publications

(6 citation statements)

References 28 publications

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“…Clinical data do not support a therapeutic role for BRC in the treatment of hyperandrogénie signs (hirsutism and acne) or menstrual regulation in PCO, confirming the data of Murdoch et al [25] and in opposition to those of Spruce et al [26] who found an improvement in men strual frequency.…”

Section: Discussioncontrasting

confidence: 47%

Changes in Brain Catecholamine Metabolism during Bromocriptine Treatment in Polycystic Ovary Syndrome

Paradisi

Grossi²,

Venturoli³

et al. 1993

Horm Res

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The role of dopaminomimetic drugs on the brain catecholamine metabolism in the neuroendocrine regulation of the polycystic ovary syndrome (PCO) was investigated. We measured, besides peptide hormones and sex steroids, urinary dopamine (DA), norepinephrine, epinephrine, vanillylmandelic acid, homovanillic acid (HVA), 3,4-dihydroxyphenylacetic acid (DOPAC) and total 3-methoxy-4-hydroxyphenylglycol (MHPG) levels by high-performance liquid chromatography with electrochemical detector in 10 women with PCO before and during long-term bromocriptine (BRC) administration. HVA and DOPAC concentrations were significantly lower (p < 0.001) in PCO patients compared with 12 control subjects in the early follicular phase, whereas MHPG concentrations were significantly higher (p < 0.01) in PCO patients. During BRC administration, HVA, DOPAC and MHPG levels increased significantly (p < 0.01 for HVA and DOPAC, and p < 0.05 for MHPG), prolactin levels dropped markedly (p < 0.01), whereas luteinizing hormone levels did not change (p = NS). These data show (1) a reduced DA activity in PCO which may be normalizable under BRC treatment, but also (2) no major effects of DA metabolism on the inappropriate gonadotropin secretion of the syndrome.

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Section: Discussioncontrasting

confidence: 47%

Changes in Brain Catecholamine Metabolism during Bromocriptine Treatment in Polycystic Ovary Syndrome

Paradisi

Grossi²,

Venturoli³

et al. 1993

Horm Res

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“…Bromocriptine is not therapeutic for hirsutism in PCOS (137). The antiestrogen agent clomiphene citrate is also not useful in the management of the cutaneous manifestations of PCOS.…”

Section: Treatment Of Skin Manifestationsmentioning

confidence: 99%

Diagnosis and management of the dermatologic manifestations of the polycystic ovary syndrome

Lowenstein

2006

Dermatol Ther

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Polycystic ovary syndrome (PCOS) is a complex phenotypic spectrum of primarily hyperandrogenic signs and symptoms. PCOS is the most common endocrine disturbance to affect women of reproductive years. Although patients affected are often very disturbed by the cutaneous manifestations, including acne, hirsutism, alopecia, obesity, and acanthosis nigricans, the clinical manifestations of PCOS ramify far beyond the skin. PCOS frequently causes menstrual abnormalities and infertility. Insulin resistance is both pathogenic and a cause of numerous serious health consequences. The accurate diagnosis and recognition of cutaneous hyperandrogenism in PCOS are discussed. The differential diagnosis is reviewed. The work-up and approach to evaluation of patients with PCOS is presented. Although no uniform treatment approach for the management of the cutaneous manifestations of PCOS has been agreed upon, the data on various treatment options and the author's treatment approach to these patients are presented.

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“…However, bromocriptine, a dopamine agonist, has little or no effect on gonadotropins in women with PCOS. 41,42 Reduced hypothalamic opioid tone was implicated in the etiology of elevated LH. Initial studies in which naloxone, an opioid receptor blocker, was infused showed a lack of LH increase in women with PCOS.…”

Section: Potential Mechanisms Of Altered Gonadotropin Secretionmentioning

confidence: 99%

Regulation of Gonadotropin Secretion: Implications for Polycystic Ovary Syndrome

McCartney¹,

Eagleson²,

Marshall³

2002

Semin Reprod Med

114

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Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenism and chronic anovulation. Although the etiology of PCOS is unknown, perturbations of gonadotropin secretion are one of the hallmarks of this disorder. In normal menstrual physiology, the monotropic rise of plasma follicle-stimulating hormone (FSH) during the luteal-follicular transition is critical for follicular development and subsequent ovulation. One of the mechanisms by which FSH is differentially synthesized involves the luteal slowing of gonadotropin-releasing hormone (GnRH) pulse frequency by ovarian steroids. In PCOS, plasma leutinizing hormone (LH) is commonly increased, FSH is typically in the lower follicular range, and LH (and by inference GnRH) pulse frequency is persistently rapid at approximately one LH pulse per hour. The etiology of the neuroendocrine abnormalities in PCOS remain unclear; however, recent studies have revealed decreased sensitivity of the GnRH pulse generator to inhibition by ovarian steroids, particularly progesterone. This abnormality is reversed by the androgen receptor antagonist flutamide, suggesting that elevated androgen levels may alter the sensitivity of the hypothalamic GnRH pulse generator to steroid inhibition and lead to enhanced LH secretion. As such, women with PCOS require higher levels of progesterone to slow the frequency of GnRH pulse secretion, resulting in inadequate FSH synthesis and persistent LH stimulation of ovarian androgens. The decreased sensitivity of the GnRH pulse generator may help to explain the genesis of PCOS during puberty. In normal early puberty, sleep-entrained increases in LH stimulate ovarian steroids, which subsequently suppress LH frequency and amplitude during the subsequent day. In hyperandrogenemic girls destined to develop PCOS, this nocturnal increase in ovarian steroids may not be adequate to suppress the GnRH pulse generator, leading to a persistently rapid LH pulse frequency, impaired FSH production, and inadequate follicular development.

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Treatment of hirsutism in polycystic ovary syndrome with bromocriptine

Cited by 21 publications

References 28 publications

Changes in Brain Catecholamine Metabolism during Bromocriptine Treatment in Polycystic Ovary Syndrome

Changes in Brain Catecholamine Metabolism during Bromocriptine Treatment in Polycystic Ovary Syndrome

Diagnosis and management of the dermatologic manifestations of the polycystic ovary syndrome

Regulation of Gonadotropin Secretion: Implications for Polycystic Ovary Syndrome

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