EVIDENCE THAT AN ALTERED PROLACTIN-RELEASE IS CONSEQUENT TO ABNORMAL OVARIAN ACTIVITY IN POLYCYSTIC-OVARY-SYNDROME

Objective: To investigate whether endogenous dopaminergic activity is impaired in polycystic ovary syndrome (PCOS)-affected women and is nor malized by medical ovariectomy. Patients: Women with PCOS untreated (n = 23) and treated for 3 months with GnRH analogue (GnRH-a) administra tion (n = 10) and normal cycling young women (n = 23) as controls. Int erventions: Acute blockade of dopaminergic receptors by the IV adminis tration of 5 mg of the dopaminergic receptor blocking agent; sulpiride (sulpiride test) was performed 3 to 7 days after the initiation of sp ontaneous menses in cycling women or medroxyprogesterone acetate-induc ed menses in PCOS women. In PCOS women treated with GnRH-a administrat ion (goserelin depot, 3.6 mg SC every 28 days), the sulpiride test was repeated 10 to 15 days after the third GnRH-a administration. Main Ou tcome Measure: Basal PRL levels and PRL increase induced by sulpiride. Results: Basal PRL levels and the PRL response to sulpiride were incr eased in women with PCOS. In women with PCOS medical ovariectomy induc ed by GnRH-a administration reversed to normal both basal and sulpirid e-stimulated PRL levels. Conclusions: In women with PCOS the abnormal regulation of PRL and presumably of hypothalamic neurotransmitters con trolling PRL secretion is not a primary alteration but it is Likely de pendent on abnormal ovarian functionality.