Endocrine Abstracts

Prolactinoma is a pituitary adenoma producing prolactin. Central hypogonadism is a major consequence of prolactinoma leading, in women, to menstrual troubles and infertility. The aim of this study was to specify gynecological characteristics of prolactinomas.

Patients: This retrospective study included 28 female patients with prolactinoma. Mean age at diagnosis was 35.46 years (ext: 20–78). Mean serum prolactin level was 3442.4 ng/ml (ext: 31.9–76 915). Mean size of adenoma was 17.26 mm (ext: 5–60). It was a microadenoma (<1 cm) in 32.1% (n=9) and a macroadenoma in 67.9% (n=19) of cases.

Results: At diagnosis, history taking reveled a pregnancies average of 1.67 (ext: 0–8) for spontaneous pregnancies and 0.13 (ext: 0–2) for induced ones. Abortions average was 0.30 (ext: 0–2). Parity average was 1.24 (ext: 0–5). Among patients, 78.9% were not using any contraception. Intrauterine device (IUD) was used in 15.8% of patients and progestin in 5.3% of them. Diagnostic circumstances were galactorrhea in 15% (n=3), amenorrhea-galactorrhea in 35% (n=7), menstrual disturbance in 30% (n=6) and tumoral syndrome in 20% of cases (n=4). All patients were treated with dopamine agonists. No patient was treated by surgery. After diagnosis, hypogonadotropic hypogonadism was persistent in 20% of patients (n=4). Fifty per cent of women were using IUD as contraception, 33.3% had no contraception and 16.7% was on progestin. Thirteen pregnancies occurred in seven patients (four microadenomas and three macroadenomas). The number of pregnancies by patient was 1, 2 and 3 in respectively 21.4% (n=3), 14.3% (n=2) and 14.3% (n=2) of patients. During pregnancy, 66.7% of women (n=4) used dopamine agonists with a favorable outcome. Two of them had a macroadenoma.

Conclusion: These results highlight the huge gynecological impact of prolactinoma. A delayed diagnosis or insufficient treatment of this affection may lead to infertility or complicated pregnancies.