ergoline and Anovulation

84 patients with elevated serum PRL levels, ranging from 25 to 253 ng/ml, were treated with an antiserotonin agent, metergoline, at the dose of 12 mg/day for 90 days. The clinical complaint was of amenorrhea in 70 cases (plus galactorrhea in 44 cases) and of anovulation in 14 cases (plus galactorrhea in 6 cases). Hyperprolactinemia was due to a pituitary adenoma in 18 cases; in 53 cases it was of unknown origin, while in 7 cases it followed treatment with neuroleptics or with oral contraceptives and in 6 cases it followed a puerperium. In patients with amenorrhea, metergoline induced the appearance of menses in 61 cases (94%), and of ovulation in 46 cases (82%). In 13 of the 14 patients with anovulation, ovulation was restored. Galactorrhea disappeared in 40 out of 50 patients. Metergoline normalized serum PRL levels (less than 20 ng/ml) in 46 cases and significantly reduced serum PRL levels in all but 3 of the remaining patients. In spite of suggested nonhormonal contraceptive measures, 14 patients became pregnant; 2 had abortions and the remaining 12 patients completed by vaginal delivery, uneventful pregnancies. These results indicate metergoline as a safe and effective drug in the management of hyperprolactinemic amenorrhea and anovulation. 49 patients were followed for 2 additional months, receiving no treatment (24 cases) or metergoline at a reduced daily dosage (8 mg/day, 25 cases). Within 60 days, 60% of the first group had relapse of the clinical condition and a rebound elevation of serum PRL levels while only 20% of the second group experienced relapse of amenorrhea and rebound elevation of serum PRL levels (p less than 0.01).

Topics: Amenorrhea; Anovulation; Clinical Trials as Topic; Ergolines; Female; Galactorrhea; Humans; Metergoline; Pregnancy; Prolactin

We aimed to develop an anovulation model, using sulpiride-induced hyperprolactinemia in common marmosets. The serum prolactin level gradually increased during the twice-daily administration of sulpiride and reached a plateau after 4 days. Sulpiride produced as big a response at 10 mg kg(-1) as at 50 mg kg(-1). In this study, the length of the ovarian cycle was approximately 30 days in normal common marmosets. Serum progesterone and estradiol levels showed no consistent change during the first 2 months of treatment with sulpiride. When treatment with sulpiride had been continued for more than 2 months, serum progesterone and estradiol levels fell to within the range seen in the follicular phase of the normal cycle and absence of ovulation was recognized by laparoscopy. A single oral administration of cabergoline (at doses between 0.01 and 0.1 mg kg(-1)) dose dependently reduced the elevated serum prolactin level. Bromocriptine (at an oral dose of 10 mg kg(-1)) also reduced the serum prolactin level at 4 and 8 h after its administration. With bromocriptine, the prolactin level had recovered at 24 h, but with cabergoline at doses of 0.05 mg kg(-1) or more, it had still not recovered at 48 h. In anovulatory common marmosets, oral administration of cabergoline at a daily dose of 0.05 mg kg(-1) restored ovarian function and resulted in ovulation in 100% of the group (following a reduction in the serum prolactin level). Bromocriptine at a daily oral dose of 10 mg kg(-1) resulted in ovulation in 67% of the group, but this dose was about 200 times higher than the dose of cabergoline. We could produce an anovulatory model induced by sulpiride repeatedly administered over a long time period. It is suggested that, in this anovulatory model in common marmosets, cabergoline has a potent and long-lasting action as a dopamine D2 receptor agonist, and thus could be a useful drug for the treatment of galactorrhea and hyperprolactinemic amenorrhea and/or anovulation.

Topics: Animals; Anovulation; Bromocriptine; Cabergoline; Callithrix; Disease Models, Animal; Dopamine Agonists; Dopamine Antagonists; Ergolines; Estradiol; Female; Hyperprolactinemia; Menstrual Cycle; Progesterone; Prolactin; Sulpiride; Time Factors

The impact of methergoline, a serotonin antagonist, on the levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), prolactin, estradiol and progesterone was studied in the blood serum of 20 females with hyperprolactinemia-induced ovarian insufficiency who were under a ten-day course of its administration in a dose of 4-12 mg/day. Two patients were studied for gonadotrophin impulse secretion before and during methergoline treatment. It was revealed that the administration of the preparation led to a significant elevation of serum FSH and LH, estradiol and progesterone levels (up to the values characteristic of the preovulation phase) and enhancement of LH impulse secretion by the pituitary body. The possibility of dominant follicle growth and development was stated in the presence of persistent hyperprolactinemia. The authors supposed that the agent's effect was gained due to an enhanced secretion of the gonadotrophin-releasing hormone by the hypothalamus.

Topics: Adolescent; Adult; Anovulation; Ergolines; Female; Gonadotropins, Pituitary; Humans; Hyperprolactinemia; Metergoline; Stimulation, Chemical

Topics: Anovulation; Ergolines; Female; Humans; Infertility, Female; Lisuride; Pregnancy; Prolactin

Topics: Adult; Anovulation; Ergolines; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Metergoline; Ovulation; Ovulation Induction; Prolactin

59 patients affected by amenorrhea or anovulation, 37 of whom also with galactorrhea, and with hyperprolactinemia of unknown origin (idiopathic hyperprolactinemia, 24 patients) or due to a pituitary microadenoma (tumoral hyperprolactinemia, 35 patients) were treated with metergoline (4-12 mg/day) or with bromocriptine (2.5 to 10 mg/day) for 90 days. The effectiveness of the two treatments was assessed on clinical grounds and by evaluating at monthly intervals serum progesterone levels, during the presumed luteal phase, and serum prolactin levels. The success rate with the two drugs was superimposable in terms of disappearance of galactorrhea and return of menses, normalization of prolactin levels and induction of ovulation. Also the number of pregnancies obtained (7 with metergoline, 9 with bromocriptine) was similar. With both drugs, the majority of patients responded to the treatment within the first month.

Topics: Adenoma; Adult; Amenorrhea; Anovulation; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Metergoline; Middle Aged; Pituitary Neoplasms; Pregnancy; Prolactin

19 women with anovulation after discontinuing oral contraceptive agents and with normal plasma-prolactin concentrations were treated with bromocriptine. Ovulation and menstruation were restored in 9 of the 13 amenorrhoeic and 5 of the 6 oligomenorrhoeic patients. The success-rate (74%) indicates that bromocriptine is an effective treatment for post-pill anovulation in normoprolactinaemic women.. The therapeutic efficacy of bromocriptine in the treatment of anovulation was assessed in 19 women who failed to return to fertility following discontinuation of oral contraceptive (OC) use. Plasma concentrations of prolactin were normal. Treatment with bromocriptine restored ovulation and menstruation in 9 of the 13 amenorrheic patients and in 5 of 6 oligomenorrheic women. Given the high success rate (74%), it is concluded that bromocriptine is an effective treatment for postpill anovulation in women with normal prolactin levels.

Topics: Adolescent; Adult; Amenorrhea; Anovulation; Bromocriptine; Contraceptives, Oral; Drug Evaluation; Ergolines; Female; Follow-Up Studies; Humans; Menstruation Disturbances; Oligomenorrhea; Prolactin

Basal serum levels of prolactin were measured in 37 infertile anovulatory patients who had failed to conceive on therapy with clomiphene citrate. Twenty of these patients, 16 of whom had galactorrhoea, had elevated basal serum prolactin values which were suppressed to normal or subnormal values during therapy with bromocriptine, the most commonly effective dose being 2.5 mg twice daily. Ovulation, as assessed by urinary oestrogen and pregnanediol measurements, was induced in 17 of these patients with pregnancy in 14. Ovarian responses short of defined criteria for ovulation were induced initially in eight patients, but these progressed to full ovulatory responses in five patients, either on the same or increased doses of bromocriptine. In all the patients who ovaulated, the prolactin levels had been reduced below the mean value for normal women (10.6 ng-ml). The three patients who failed to ovulate all had values higher than this at a dose of bromocriptine reaching 5.0 mg thrice daily. There seemed to be no value in increasing the dose of bromocriptine once ovulation had been achieved. Of the 17 patients with normal basal prolactin values, only one had an unequivocal response to bromocriptine with ovulation and conception, even though the prolactin values in the majority were suppressed to below normal.

Topics: Adult; Anovulation; Bromocriptine; Ergolines; Female; Humans; Infertility, Female; Prolactin

Twelve anovulatory patients with normal serum prolactin values and six with elevated values were treated with bromocriptine and the effects on serum prolactin, FSH and LH levels were recorded. Ovulation resulted in one patient who had normal prolactin values and in all six who had raised values. No patient with normal basal prolactin values showed an increase in serum FSH during therapy with bromocriptine, whereas 5 of the 6 patients with elevated values showed significant increases. Similar results were obtained for LH. Although these differences were highly significant (P less than 0-005) the majority of the serum FSH and LH values remained within the normal ranges. Five patients with normal basal prolactin values and one with elevated values were also treated with human pituitary gonadotrophin (HPG). An increase in ovarian responsiveness to HPG during therapy with bromocriptine was recorded in the one patient with initially elevated prolactin values. It was concluded that bromocriptine acts by allowing FSH to rise above threshold requirements for follicular stimulation.

Topics: Adult; Anovulation; Bromocriptine; Ergolines; Estrogens; Female; Follicle Stimulating Hormone; Gonadotropins, Pituitary; Humans; Luteinizing Hormone; Ovary; Prolactin