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  • Title: Discordant patterns of hyperprolactinaemia and galactorrhoea in secondary amenorrhoea.
    Author: Seppälä M, Lehtovirta P, Ranta T.
    Journal: Acta Endocrinol (Copenh); 1977 Nov; 86(3):457-63. PubMed ID: 579018.
    Abstract:
    There were 123 patients with functional secondary amenorrhea of at least 6 months' duration. The upper normal serum prolactin level was 3 ng/ml as measured by radioimmunoassay. Hyperprolactinemia was found in 40 of the 123 patients (33%). Those with peak levels of 60 ng/ml often also had some normal levels. Patients with levels over 120 had demonstrable galactorrhea in 38% of cases. Galactorrhea was found in 10 patients with normal prolactin values. The 5 patients with anorexia nervosa had normal prolactin values and no galactorrhea. 14 of 61 (23%) patients with self-induced weight loss had hyperprolactinemia but galactorrhea was rare. Hyperprolactinemia was found in 4 of 13 patients with stress-related amenorrhea. Amenorrhea after use of oral contraceptives was related to hyperprolactinemia in 10 of 28 patients and 5 had galactorrhea. There were 4 patients with the Chiari-Frommel syndrome; their mean serum prolactin level was 435 ng/ml. 5 patients had pituitary tumors; galactorrhea was present in 3 of them. All of these 5 patients had high serum prolactin levels ranging from 145 to 620 ng/ml. Mild hyperprolactinemia was present in 16 patients with idiopathic amenorrhea but no galactorrhea. 5 of the 9 patients who were hirsute had elevated prolactin. Results show that galactorrhea is not a reliable sign of hyperprolactinemia. The prolactin assay is helpful in the management of patients with amenorrhea.
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