CIRCULATING NITRIC-OXIDE LEVELS IN GALACTORRHEIC, HYPERPROLACTINEMIC,AMENORRHEIC WOMEN

Objective: To test the hypothesis that nitric oxide production is decr eased in hyperprolactinemic, amenorrheic patients with estrogen (E) de ficiency, augmenting the possible risk of cardiovascular disorders. Se tting: Cairo University Hospitals. Design: Prospective, case-controlle d study. Patient(s): Twenty-five galactorrheic, hyperprolactinemic pat ients with amenorrhea of more than 6 months and with low serum E-2, as well as 30 healthy, fertile women (controls) matched for age and body mass index. Intervention(s): Bromocriptine was administered orally to hyperprolactinemic patients, and blood samples were collected before and 6 weeks after treatment. Main Outcome Measure(s): Total nitric oxi de production was determined photometrically using Greiss reagent afte r preliminary conversion of nitrate to nitrite by nitrate reductase. R esult(s): Serum E-2 and nitric oxide levels in hyperprolactinemic, ame norrheic patients (62.5 +/- 3.2 [SE] pg/mL [229 +/- 11.7 pmol/L] and 1 8.4 +/- 2.5 mu mol/L, respectively) were significantly lower than E-2 (114 +/- 6.4 pg/mL [418 +/- 23.5 pmol/L]) and nitric oxide (41.2 +/- 4 .1 mu mol/L) levels observed in normal women during the follicular pha se. The decrease of nitric oxide was associated with elevation of bloo d pressure. Treatment of hyperprolactinemia with bromocriptine restore d normal values of serum nitric oxide and E-2, and normal blood pressu re. Conclusion(s): Hyperprolactinemia with E deficiency exhibits a sig nificant decrease in nitric oxide production, and this decrease may su bject the patient to certain cardiovascular disorders and disturbed ov arian function. (C) 1997 by American Society for Reproductive Medicine .