HYPERPROLACTINEMIA IN POSTMENOPAUSAL WOMEN

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.