Endocrine Abstracts

Background: Prolactin (PRL) hypersecretion is the most common endocrine abnormality due to hypothalamic-pytuitary disorders. Hyperprolactinemia occurs in 20–30% of cases with polycystic ovary syndrome (POS). It is considered that hyperprolactinemia is not involved in POS etiopathogeny, but other factors are implied.

The aim of the study: was to retrospectively evaluate the diagnostic tools (Rotterdam criteria) and therapeuthic approach applied in 78 women with POS, evaluated in our clinic in the last 5 years. Out of the twenty six POS patients with hyperprolactinemia, half presented associated hyperprolactinemic conditions. A percentage of 15.3% presented an associated mycroprolactinoma (46.1% of the hyperprolactinemic cases). Plasma levels of PRL were significantly higher in the patients with mycroprolactinomas as compared to hyperprolactinemic women without a tumor (P<0.001). Other causes of hyperprolactinemia were represented by: combined contraceptive therapy (five cases), psychotropic medication (two patients), chronic methoclopramid treatment (one case), and severe hypothyroidism (three cases). The treatment of tumoral cases consisted of dopaminergic agonists (cabergoline, bromocriptine), in usual doses. The response was favorable, similar to the patients with microprolactinomas, but without POS. Mild hyperprolactinemic cases were regularly followed-up, noticing that the PRL values didn’t increase significantly over time.

Conclusions: Due to the increased incidence of PRL secreting pituitary tumors in patients with POS, often hyperprolactinemia imposes also imagistic diagnosis (pituitary MRI). In hyperprolactinemic patients, factors which could further increase the PRL secretion should be avoided.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.