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The effect of combined estrogen/progestogen treatment in women with hyperprolactinemic amenorrhea.

Abstract
Eleven women with hyperprolactinemic amenorrhea were treated with a combined estrogen/progestogen preparation (Loestrin 30) for 3 months as hormone replacement therapy because of estrogen deficiency, with a view to protection against osteoporosis. Serum prolactin levels rose during the 1st month of treatment (p < 0.05) but did not rise significantly further during the 2nd and 3rd months. The levels rose in proportion to pretreatment levels by 28% (median), and fell significantly but not completely during the 1-week treatment-free intervals. After the study period, prolactin values appeared to remain stable in those women who continued longer on treatment, and returned to around pretreatment values in those who stopped. In one woman there was radiological evidence of pituitary tumor growth during treatment. This study shows that estrogen/progestogen treatment in standard contraceptive dosage usually leads to only moderate and non-progressive stimulation of pituitary activity in women with hyperprolactinemic amenorrhea, but occasional excessive growth of a prolactinoma can occur and treatment needs to be monitored. Women with relatively high prolactin levels seem to be at particular risk. Safer variations of estrogen therapy such as lower dosage or combination with a protective low dose of a dopamine agonist should also be considered.
AuthorsU M Fahy, P A Foster, H W Torode, M Hartog, M G Hull
JournalGynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (Gynecol Endocrinol) Vol. 6 Issue 3 Pg. 183-8 (Sep 1992) ISSN: 0951-3590 [Print] England
PMID1442163 (Publication Type: Journal Article)
Chemical References
  • Ethinyl Estradiol
  • Prolactin
  • Norethindrone Acetate
  • Norethindrone
Topics
  • Adolescent
  • Adult
  • Amenorrhea (complications, drug therapy)
  • Drug Therapy, Combination
  • Ethinyl Estradiol (administration & dosage, therapeutic use)
  • Female
  • Humans
  • Hyperprolactinemia (complications, drug therapy)
  • Norethindrone (administration & dosage, analogs & derivatives, therapeutic use)
  • Norethindrone Acetate
  • Pituitary Neoplasms (complications, diagnostic imaging)
  • Prolactin (blood)
  • Tomography, X-Ray Computed

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