Hyperprolactinaemia, diagnosis and treatment: a study of 150 cases

ABSTRACT

We reviewed the management of 150 patients with hyperprolactinaemia, who presented with infertility, amenorrhoea, menstrual irregularities and/or galactorrhoea during a 4 year period to evaluate the efficacy of treatment of the condition with bromocriptine. Radiographic evidence of pituitary microadenoma was seen in 23 patients and 7 had macroadenoma. The majority of our patients [53%] had no obvious cause for elevated prolactin levels. Seven patients were taking antidepressants, five had antihypertensive drugs and twelve had taken oral contraceptives for a period of six months or more. Patients with pituitary adenoma had a significantly higher baseline serum prolactin level than those with no adenoma. All patients in the study were treated with bromocriptine to normalise serum prolactin or to achieve pregnancy. The patients without an adenoma required a significantly smaller dose of bromocriptine than those with an adenoma. There was no significant difference in the pregnancy rate between the patients with and those without pituitary adenoma. Similarly, presence of galactorrhoea or a high level of prolactin did not influence the pregnancy rate. No lethal congenital foetal abnormalities were observed. The results obtained from this study indicate the efficacy and safety of bromocriptine therapy in the treatment of hyperprolactinaemia with and without pituitary adenoma