Serum prolactin and thyroid stimulating hormone levels and polytomography in cases of secondary amenorrhea without galactorrhea

ABSTRACT

Serum prolactin [PRL] and thyroid stimulating hormone [TSH] were determined in 50 patients, presenting with secondary amenorrhea without galactorrhea, as well as 20 women with normal menstrual function as control. There was a significant increase of serum PRL in amenorrheic patients [42.09 +/- 9.63 ng/ml], when compared to that of control [11.1 +/- 4.9 ng/ml] at P < 0.0025. Serum PRL also showed a significant positive correlation to body weight and duration of the complaint in the amenorrheic group. Serum TSH values in both amenorrheic and control groups did not show any significant difference [P > 0.05]. Plain X-ray confirmed the presence of pituitary macro-adenoma in one out of ten hyperprolactinemic patients. When radiological examination was again performed using hypocycloidal polytomography, two further microadenomata were discovered. In the present study, the incidence of hyperprolactinemia and pituitary adenoma in non-galactorrheic amenorrheic patients was 20% and 6 respectively. Thirty percent of hyperprolactinemic patients had pituitary adenoma. In conclusion, serum PRL determination is essential in the diagnostic work-up of amenorrhea, even without galactorrhea. A combination of hyperproclactinemia and positive hypocycloidal polytomography of the sella turcica is specific for the diagnosis of prolactinoma