Objective: To study the clinical cause and course of hyperprolactinemi
a in postmenopausal women. Design: Retrospective case-note study. Sett
ing: Tertiary care hospital. Patient(s): Six postmenopausal women with
hyperprolactinemia. Main Outcome Measure(s): Clinical history and phy
sical examination, serum levels of PRL, LH, FSH, computed tomography (
CT) of the pituitary gland before and after treatment with bromocripti
ne. Result(s): At presentation, the mean age was 57.5 +/- 7.5 SD years
. The mean level of PRL was 1,427 +/- 1,599 ng/mL (1,427 +/- 1,599 mu
g/L). All women suffered from secondary amenorrhea for a mean duration
of 31.8 +/- 5.6 years. Five of six had galactorrhea at some time in t
he past. Pituitary imaging revealed a pituitary macroadenoma in four w
omen, an enlarged sella suggestive of a pituitary macroadenoma in one
woman, and a microadenoma in one. After treatment with bromocriptine,
the PRL level decreased in all women to within normal limits. Five of
six women developed hot flushes after the PRL level returned to normal
. Conclusion(s): Most cases of hyperprolactinemia in postmenopausal wo
men are due to macroadenoma rather than microadenoma, the common findi
ng in younger women. The clinical course is suggestive of a prolonged
disease that was not detected earlier, although clinical signs were pr
esent. These findings are suggestive of an enlargement of microadenoma
s to macroadenomas as time passes. (C) 1997 by American Society for Re
productive Medicine.