28 Case Reports Of Female Hyperprolactinemia

Objective:The aim of this study was to investigate the pathogenesis and clinical characteristics of the hyperprolactinemia (HPL), and the effect of prolactin(PRL) on levels of serum estradiol, follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone(T) will also be evaluated.Methods:Measurement of the levels of serum prolactin, estradiol, luteinizing hormone, follicle stimulating hormone and testosterone were given to the 28 female patients with hyperprolactinemia who visited the gynecology clinic of Second Affiliated Hospital of Dalian Medical University between April 1,2009 and March 31,2010, then detailed history of patients were collected and a checking on the thyroid, breast, pelvic and hair were given. According to patients'history, clinical manifestations and physical examination, the test of thyroid function, liver and renal function, pelvic ultrasound, MRI or CT of the brain/sella had been chosen. After that, the patients were divided into three groups depending on the prolactin level, one group was composed of 11 patients with slight elevated prolactin levels, whose prolactin levels were above normal but lower than 1000 uIU/ml, and one group was composed of 10 patients with moderate elevated prolactin levels, whose prolactin levels between 1000 uIU/ml and 2000 uIU/ml, and another group was composed of 7 patients with severe elevated prolactin levels, whose prolactin levels> 2000 uIU/ml.Results:In the 28 cases of female hyperprolactinemia, nine had microprolactinomas, one had macroprolactinomas, one had hypothyroidism with microprolactinomas, one had hyperthyroidism with adrenal adenoma, two had ovarian cyst with polycystic ovary syndrome, five had polycystic ovary syndrome and eight were idiopathic. In the 28 cases of female hyperprolactinemia,8 with complaints of galactorrhea,5 with complaints of amenorrhea,20 with complaints of menstrual disorders,3 with normal menstruation,7 with complaints of infertility,2 with complaints of headache and one of which with decreased vision and visual field defect. Compared to the normal women, the level of serum luteinizing hormone and follicle stimulating hormone in the blood of the female hyperprolactinemia were significantly lower (P< 0.05), while serum estradiol and testosterone were not significant (P> 0.05).The relationship between levels of serum estradiol, luteinizing hormone, follicle stimulating hormone, testosterone and that of prolactin were not significant (P> 0.05) in the female hyperprolactinemia. Compared to the normal women, serum testosterone level was not significantly different in all groups of the female hyperpro-lactinemia (P> 0.05), and the levels of serum luteinizing hormone and follicle stimulating hormone showed no significant difference in the group whose prolactin increased slightly (P> 0.05), but they showed significant difference in the group whose prolactin increased moderately and severely (P< 0.05), and further more, the serum estradiol levels decreased significant (P< 0.05) in the group whose prolactin increased severely, while in the group whose prolactin increased slightly and moderately it was not different significant (P> 0.05).Conclusion:Among all the causes of hyperprolactinemia, the most common one is pituitary adenoma, and prolactinomas are the most common type of pituitary adenomas, so once hyperprolactinemia has been diagnosed, MRI and CT of the sellar region or brain should be performed to rule out pituitary adenoma. When serum prolactin levels elevate slightly in hyper-prolactinemic women, the luteal phase will shorten only, with the serum prolactin levels raising gradually, infrequent menstruation will occur, even secondary amenorrhea, leading to infertility. Galactorrhea in hyperprolac-tinemic women has a very close relationship with the elevating serum prolactin levels, but the amount of lactating is independent of the degree of elevated prolactin levels. Serum LH and FSH in hyperprolactinemic women are significantly lower than normal in the group of slight and moderate elevated prolactin levels, but in the group of severe elevated prolactin levels they show no difference; Serum E2 in hyperprolactinemic women is significant lower than normal in the group of severe elevated prolactin levels, but in the group of slight and moderate elevated prolactin levels they show no difference; Serum T in hyperprolactinemic women in all group is normal.