Hormonal replacement therapy in menopausal women with a history of hyperprolactinemia

Hyperprolactinemia is involved in almost 30% of infertility problems. At th e onset of menopause, prolactin levels often decrease; however, no data are available regarding the course of hyperprolactinemia after menopause with hormonal replacement therapy (HRT). A retrospective study was undertaken in our department to evaluate the potential role of estrogens in women with a history of hyperprolactinemia. Twenty-two patients, with hyperprolactinemi a before menopause, were followed-up. Group I included 11 patients who with drew bromocriptine treatment when menopause was confirmed. These patients w ere placed on HRT with no other medication administered. HRT was a combinat ion of percutaneous estradiol gel and an oral progestin. Group II included 7 women treated by bromocriptine before menopause and after menopause conco mitantly with HRT. Group III included 4 patients who did not receive HRT or other treatments once menopause was diagnosed. The mean serum prolactin le vel was unchanged in Group I (22.8 +/- 21.7 before and 22.8 +/- 16.1 ng/ml after HRT) while it increased but not significantly from 8.1 +/- 5.2 to 16. 0 +/- 11.7 ng/ml in Group II. The mean duration of HRT was 42.8 +/- 23.8 (7 -81) and 37.3 +/- 31.0 (6-99) months in Group I and II respectively. In Gro up III patients, PRL levels decreased spontaneously from 61.2 +/- 39.8 to 3 3.0 +/- 34.7 ng/ml. In conclusion, in this population of menopausal patient s with a history of moderate hyperprolactinemia, HRT did not seem to affect plasma prolactin levels. (C) 1998, Editrice Kurtis.