Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting 6–10% of reproductive aged women. This syndrome is associated with obesity, menstrual irregularity, infertility, hirsutism and insulin resistance. It has been reported that PCOS is frequently associated with hyperprolactinemia with ranges from 17 to 50%. So for many researchers the difficulty is to differentiate between real PCOS associated with hyperprolactinemia or hyperprolactinemia with PCOS aspect (chronic anovulation and polycystic ovaries.

Objective: This study aims to to identify the cause of hyperprolactinemia in patients with PCOS.

Materials: A prospective study was performed (since 2010–2015) on 100 PCOS.The consensus of Rotterdam was used to make the diagnosis of PCOS. All patients were screened for clinical exam, anovulation, prolactinemia, hypophysis MRI and pelvic ultrasound. The hyperprolactinemic patients were first treated with dopaminergic agonist.

Results: The mean BMI was 27.2 kg/m2 and the mean age 24.5 years. The mean prolactinemia was 65 ng/ml Twelve (n=12) of our patients had hyperprolactinemia (12%). Among them 9 (75%) had micro-prolactinoma, one used neuroleptics and 2 were idiopatic (as no causes was found). All of them were treated with dopaminergic agonist without improvement of the symptomatology.

Discussion: In our study hyperprolactinemia is quite frequent (12%) in PCOS women. In all cases the diagnosis of hyperprolactinemia was made. In order to distinguish PCOS with hyperprolactinemia from hyperprolactinemia with PCOS aspect, agonist dopaminergic were used. The absence of improvement confirm the fact that PCOS and hyperprolactinemia are distinct, in fact patients with PCOS do not respond to bromocriptine treatment because they do not have alterations in hypothalamic dopamine secretion.

Conclusion: It‘s important to make a systematic investigation on the origin of hyperprolactinemia in women with chronic anovulation in order to distinguish it from PCOS. In all of our patient a well-defined cause for the high PRL level was identified.