ergoline and Galactorrhea

Among the various endocrine forms impotence associated with hyperprolactinaemia is discussed in this paper. A more relevant clinical picture is particularly due to prolactinoma. A marked reduction or suppression of libido and sexual power are mostly present; sometimes an altered spermatogenesis with oligospermia and infertility may be found; on the contrary galactorrhea and gynaecomastia are less frequent. Symptoms and signs of hypopituitarism or extrasellar growth may be found too. The main physiopathologic aspects as well as biochemical and instrumental diagnostic evaluation methods of prolactinoma in men are examined. The treatment may be pharmacological, surgical or radiant: indications and efficacy of each one are reported. A guide-line in case of macro- or microprolactinoma is explained too. With regard to pharmacological treatment, dopaminergic agonists have been available for more than twenty years and there is a wide experience with bromocriptine. Among the latest dopaminergic agonists, cabergoline is very interesting because it is effective, selective and long-term active; its pharmacological features are mentioned. At last, personal experience in three men, one suffering from micro- and two from macroprolactinoma recently treated with cabergoline is reported. Clinical aspects and hormonal and instrumental data before treatment are presented. Clinical and hormonal evaluations have been made after 2, 3 and 6 months of therapy and TAC control after the sixth month. The results allowed to verify the effectiveness of the drug.

Topics: Cabergoline; Cranial Irradiation; Dopamine Agonists; Erectile Dysfunction; Ergolines; Galactorrhea; Gynecomastia; Humans; Hyperprolactinemia; Hypophysectomy; Infertility, Male; Libido; Male; Pituitary Neoplasms; Prolactinoma; Treatment Outcome

Topics: Adenoma; Adult; Diagnosis, Differential; Ergolines; Female; Follow-Up Studies; Galactorrhea; Genital Diseases, Female; Humans; Hypophysectomy; Hypothyroidism; Infertility, Female; Pergolide; Pituitary Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Prolactin; Sella Turcica; Tomography, X-Ray Computed; Visual Field Tests

Topics: Adrenergic alpha-Antagonists; Adrenocorticotropic Hormone; Amenorrhea; Antineoplastic Agents; Bromocriptine; Cyproheptadine; Ergolines; Estrogens; Female; Galactorrhea; Growth Hormone; Humans; Hypothalamus; Levodopa; Pituitary Gland; Pituitary Neoplasms; Pregnancy; Prolactin

Topics: Adrenocorticotropic Hormone; Amenorrhea; Blood Glucose; Cushing Syndrome; Erectile Dysfunction; Ergolines; Female; Galactorrhea; Gonadotropins; Growth Hormone; Hormones; Humans; Lactation; Luteinizing Hormone; Male; Metergoline; Pancreatic Hormones; Pimozide; Pituitary Gland; Postpartum Period; Pregnancy; Prolactin; Receptors, Dopamine; Serotonin Antagonists; Thyrotropin

Fibrocystic breast disease is one of the most frequent conditions of the breast among women from 30 to 49 years, with a frequency of about 60%, hence the interest in studying and treating it with the most advanced and effective resources.. To compare the efficacy and adverse events of alpha dihydroergocryptine with cabergoline in patients with fibrocystic breast disease.. A prospective, longitudinal, open, comparative study between alpha-dihydroergocryptine and cabergoline, made in the service of Gynecology and Obstetrics at the Dr. Miguel Silva General Hospital in Morelia, Michoacán. 171 patients diagnosed with fibrocystic breast disease were randomly assigned to the alpha-dihydroergocryptine or the cabergoline group. Assessments were made at baseline and every month subsequently. The following symptoms were evaluated: breast tenderness, breast pain, lumps and nipple discharge. The concentrations of prolactin were determined and an ultrasound was performed at baseline and at 3 and 6 months, patients were questioned about adverse events.. 171 patients were included (81treated with alpha-dihydroergocryptine and 90 with cabergoline); 156 completed the study. The age limits were 18 and 51 years. The evolution time prior to study entry was 17.71 +/- 18.3 months for the alpha-dihydroergocryptine group and 18.57 +/- 20.35 for the cabergoline group. 15 patients discontinued treatment due to adverse events (8 of the alpha-dihydroergocryptine group and 7 of the cabergoline group). The most common adverse event was headache.. In this study alpha-dihydroergocryptine was better tolerated and had better clinical response compared with cabergoline; breast pain and breast tenderness disappeared within the first month of treatment. Adverse events were similar for both treatments.

Topics: Adolescent; Adult; Cabergoline; Dihydroergocryptine; Ergolines; Female; Fibrocystic Breast Disease; Galactorrhea; Gastrointestinal Diseases; Headache; Humans; Mastodynia; Middle Aged; Prolactin; Prospective Studies; Treatment Outcome; Young Adult

Thirty-one patients with hyperprolactinemia were admitted for protocol study. Twenty-one of these patients had no findings of prolactinoma by computerized axial tomography (CAT) scanning; 10 had documented tumor by CAT scan. The patients were assigned to either Parlodel or Pergolide treatment on the basis of random numbers tables. They were treated for 6 months continuously and followed during this time with radiologic survey, hormonal evaluation, and blood chemistry determinations. Patients in both groups showed a decrease in prolactin levels, whether they were treated with Parlodel or Pergolide. The response was similar whether patients had hyperplasia or pituitary tumors. Patients with pituitary tumors tended to have a diminution in the size of their lesions regardless of the dopamine agonist used. The types of side effects experienced by various groups were similar regardless of the treatment. It is concluded that both Pergolide and Parlodel are useful in the treatment of hyperprolactinemic syndromes, although neither one appears to be superior to the other.

Topics: Adolescent; Adult; Aged; Amenorrhea; Bromocriptine; Clinical Trials as Topic; Dopamine; Ergolines; Female; Galactorrhea; Humans; Middle Aged; Pergolide; Pituitary Neoplasms; Pregnancy; Prolactin; Random Allocation

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

Topics: Acromegaly; Bromocriptine; Clinical Trials as Topic; Ergolines; Female; Galactorrhea; Humans; Lactation; Parkinson Disease; Pregnancy

To examine the monitoring, management, and outcomes of pituitary tumors in pregnancy.. A national, prospective, observational, population-based case series study was conducted in all U.K. consultant-led obstetric units over 3 years using the U.K. Obstetric Surveillance System. To evaluate rates of adverse pregnancy outcomes, women with a macroprolactinoma (10 mm or greater) or nonfunctioning pituitary adenoma, diagnosed before or during pregnancy, were compared with two comparison groups: 1) a U.K. Obstetric Surveillance System cohort with singleton (n=2,205) or twin (n=27) pregnancy; and 2) data from the Office of National Statistics (n=2,703,102). Main outcome measures were the incidence, management, and frequency of adverse maternal and offspring outcomes of pituitary tumors in pregnancy.. There were 71 confirmed cases of pituitary tumors in pregnancy (49 macrolactinoma, 16 nonfunctioning adenomas, three acromegaly, three Cushing's disease). The women with pituitary tumors were 4 years older than comparison women (P<.001). None of the nine women treated with surgery or radiotherapy before pregnancy had symptomatic tumor expansion. This occurred in 6 of 40 women with macroprolactinomas and one of seven nonfunctioning adenomas diagnosed before conception and in three of five women with nonfunctioning adenomas diagnosed in pregnancy. Two women had pituitary apoplexy, both of whom also had symptoms of expansion of tumor or surrounding pituitary tissue. To within the level of accuracy possible, there was no evidence that pituitary tumors were associated with adverse pregnancy outcomes (pregnancy-induced hypertension, preeclampsia, preterm labor, stillbirth). Women with nonfunctioning adenomas were more likely to have cesarean delivery compared with women in a control group (relative risk 2.06, confidence interval 1.26-3.36, P=.035).. The majority of women with macroprolactinomas and nonfunctioning adenomas have good pregnancy outcomes. Nonfunctioning pituitary adenomas occur more commonly in pregnancy than previously thought and can present de novo with symptoms of pituitary expansion in pregnancy.

Topics: Adenoma; Adult; Amenorrhea; Antineoplastic Agents; Bromocriptine; Cabergoline; Case-Control Studies; Cesarean Section; Dopamine Agonists; Ergolines; Female; Galactorrhea; Humans; Incidence; Pituitary Neoplasms; Pre-Eclampsia; Preconception Care; Pregnancy; Pregnancy Complications, Neoplastic; Premature Birth; Prolactinoma; Prospective Studies; Stillbirth; United Kingdom; Vision Disorders; Young Adult

Prolactin (PRL)-secreting macroadenomas usually measure between 10 and 40 mm. Giant (adenoma size ≥40 mm) PRL-tumors are not common, and larger prolactinomas (maximal diameter ≥60 mm) are rare, and their management outcomes have not been well characterized.. We have identified 18 subjects (16 men, 2 females) with giant PRL-adenomas (size ≥60 mm; PRL > 1000 ng/ml) and summarized their characteristics and response to treatment.. Mean age was 36.3 ± 13.5 years (range 12-59 years). Mean adenoma size was 71.8 ± 10.2 mm (60-92 mm). Complaints at presentation included headaches in 11 patients, visual deterioration in 9, sexual dysfunction in 9 males, and behavioral changes in two. Fourteen (78 %) had visual field defects. Mean PRL at presentation was 28,465 ng/ml (range 1300-270,000). All patients were treated with cabergoline (3.9 ± 2.0 mg/week), except for one who received bromocriptine. Treatment achieved PRL normalization in 11/18 patients within a median interval of 20 months. Visual improvement occurred in 12/14 patients with pre-treatment visual abnormalities. Nine patients underwent surgery (transsphenoidal, 7; transcranial, 2). None of the seven patients with elevated PRL before surgery achieved remission post-operatively. After a follow-up of 7.8 ± 5.1 years, 15/18 patients had significant adenoma shrinkage. Eleven patients are normoprolactinemic, 3 are partially controlled (PRL < 3 × ULN), and 4 remain with significantly elevated PRL. Most patients reported disappearance or improvement of their complaints.. These enormous PRL-adenomas are invasive but respond fairly well to medical treatment. Long-term therapy with high dose cabergoline together with a pituitary surgery in some patients was the key for their successful management, achieving biochemical and clinical remission in most patients.

Topics: Adolescent; Adult; Antineoplastic Agents; Bromocriptine; Cabergoline; Child; Ergolines; Female; Galactorrhea; Headache; Hormone Antagonists; Humans; Male; Middle Aged; Neurosurgical Procedures; Pituitary Neoplasms; Prolactinoma; Sexual Dysfunction, Physiological; Treatment Outcome; Tumor Burden; Vision Disorders; Young Adult

Hobby keeping of goats and sheep confronts veterinarians with new challenges that rarely have to be faced in livestock husbandry. During the last five years five goats were presented to the Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universität Berlin, Germany, with inappropriate lactation syndrome. Four of these animals had been previously treated with cabergoline without enduring success. According to the request of the owners (informed consent) and the clinical severity of the cases, a mastectomy was performed in all five animals.. Surgery was performed under general anaesthesia using ketamine and xylazine, and with the patients in a recumbent position.. Mastectomy in small ruminants requires knowledge of the anatomy of the udder and the possible positions of the supplying blood vessels. Our patients displayed a variety of dispositions of the Vena epigastrica caudalis superficialis. Special attention should be paid to a careful and blunt dissection of the mammary gland, and immediate control of haemorrhage, to maintain a clear view on the anatomic structures. Furthermore, dissection of the glandular tissue should be strictly avoided to prevent milk contamination of the surgical area. A sufficient skin flap has to be left to cover the surgical area after removal of the udder.. Even though udder amputation appears to be a radical and high-risk procedure, all five goats survived the surgery. The wound healing occurred in a reasonable time without any severe complications. In goats that are kept as "hobby animals" and in which an inappropriate lactation syndrome cannot be treated conservatively, mastectomy is a reasonable and promising therapy.

Topics: Animals; Cabergoline; Dopamine Agonists; Ergolines; Female; Galactorrhea; Goat Diseases; Goats; Mastectomy; Recurrence; Surgical Flaps; Treatment Outcome

Topics: Adenoma; Adult; Antineoplastic Agents; Cabergoline; Diagnosis, Differential; Diagnostic Errors; Ergolines; Female; Galactorrhea; Humans; Hyperprolactinemia; Magnetic Resonance Imaging; Menstruation Disturbances; Pituitary Neoplasms; Prolactin

We report clinical presentation, response to medical treatment, and long-term follow-up of 39 children and adolescents with prolactinoma (F:M; 30:9) (30 macro and 9 microadenoma) diagnosed at the age of 9-20 years. Mean duration of follow up was 56 months. All patients were treated with bromocriptine (BC) at doses ranging from 2.5 to 20 mg/day or by cabergoline at doses ranging from 0.5 to 2 mg/week orally. Two patients received external conventional radiotherapy after surgery. In patients with macroprolactinoma (F:M; 21:9), headache and/or visual defects were the first symptoms. All females had primary or secondary amenorrhea. Growth arrest was not observed in any patient and pubertal development was appropriate for their age. Spontaneous or provocative galactorrhea was observed in 23 patients (all females) and none of male patient had gynecomastia. Mean serum prolactin (PRL) concentration at the time of diagnosis was 322.50 ng/ml in patients with microadenoma, 522.38 ng/ml in patients with macroadenoma and 2,294.86 ng/ml in patients with macroadenoma with suprasellar extension. In 25 patients, BC normalized PRL levels and caused variable, but significant, tumor shrinkage. Cabergoline normalized PRL concentrations in 14 patients. Pregnancy occurred in 6 patients while on treatment. Pregnancies were uncomplicated, and the patients delivered normal newborns at term. Impairment of other pituitary hormone secretion was documented at the time of diagnosis in only one patient. Postoperatively six patients had other pituitary hormone deficiencies. In conclusion, the medical treatment with dopaminergic compounds is effective and safe in patients with prolactinoma with onset in childhood, allowing preservation of the anterior pituitary function.

Topics: Adolescent; Amenorrhea; Bromocriptine; Cabergoline; Child; Dopamine Agonists; Ergolines; Female; Galactorrhea; Humans; Male; Pregnancy; Prolactin; Prolactinoma; Retrospective Studies; Treatment Outcome; Young Adult

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

One hundred ninety-one hyperprolactinemic patients (78 women and 13 men; 54 with pituitary macroadenoma, 53 with microadenoma, and 84 with idiopathic disease) were treated for 2 to 48 months with one or two of the following prolactin (PRL)-lowering drugs: bromocriptine, metergoline, and lisuride. All of the three drugs used were highly effective in lowering PRL levels and restoring gonadal function both in females and in males in the majority of patients with either idiopathic or tumorous disease. In poorly responsive patients, increasing the drug doses resulted in further PRL lowering for all the three drugs. Mild side effects were frequently encountered with initiation of drug treatment but spontaneously subsided in most cases; severe side effects, necessitating stopping of the treatment, occurred in only 12 instances, but changing of the drug allowed PRL-lowering treatment to be continued in 11 of them.

Topics: Adenoma; Adolescent; Adult; Amenorrhea; Bromocriptine; Erectile Dysfunction; Ergolines; Female; Galactorrhea; Humans; Lisuride; Male; Metergoline; Middle Aged; Ovarian Function Tests; Pituitary Neoplasms; Pregnancy; Prolactin; Visual Fields

Topics: Amenorrhea; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pregnancy; Risk; Surveys and Questionnaires

Topics: Adenoma; Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Hyperprolactinemia; Lisuride; Pituitary Neoplasms; Pregnancy; Prolactin

Topics: Adult; Amenorrhea; Drug Evaluation; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Luteinizing Hormone; Pergolide; Pregnancy; Prolactin

8 or 12 mg/day methergolin was administered for an average of 8 months to 80 patients with hyperprolactinaemia of tumoural (20 cases), idiopathic (39 cases), and iatrogenic (21 cases) origin. The success of the treatment was apparent in the return of ovulation and the establishment of pregnancy in 80% of patients with microadenoma, and 85% of those with a normal sella turcica.

Topics: Adenoma; Adolescent; Adult; Dose-Response Relationship, Drug; Ergolines; Female; Galactorrhea; Humans; Metergoline; Ovulation; Pituitary Neoplasms; Pregnancy; Prolactin; Sella Turcica

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Humans; Infertility, Female; Lisuride; Pregnancy; Prolactin

Twenty-five patients, aged 23-39, with amenorrhea of 18 to 168 months' duration, galactorrhea, hyperprolactinemia (prolactin levels of 45 to 370 ng/ml), and radiologic evidence of a pituitary microadenoma, were treated with bromocriptine or lergotrile, 7.5 mg daily for 2 to 16 weeks until conception occurred. All conceived and were delivered of infants. Follow-up during pregnancy included frequent office visits and monthly visual field examinations from the sixth month until delivery. All the pregnancies resulted in single infants and uneventful and no neurological or visual symptoms developed. All infants born were normal. Twelve patients breast-fed while the others did not by choice. Menstrual function resumed in two patients after delivery and one of them subsequently conceived spontaneously. We believe that the presence of a pituitary microadenoma without neurological or visual symptoms should not be a contraindication to ovulation induction and pregnancy. Most of such pregnancies are uneventful. If symptoms arise during pregnancy, they can be treated medically or, in extreme emergencies, surgically.

Topics: Adenoma; Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Infant, Newborn; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Prolactin

A 19-year-old girl with primary amenorrhea, galactorrhea, and hyperprolactinemia is described. Her high serum prolactin levels (95 ng/ml) did not increase after thyrotropin-releasing hormone and sulpiride, but markedly decreased after acute bromocriptine and metergoline administration. The results of other pituitary function tests were normal. Tomography of the sella turcica and CT scan of the skull were also normal. The patient was treated with metergoline, a prolactin-lowering drug which is believed to act as a serotonin antagonist, for 30 months. Serum prolactin rapidly decreased after institution of treatment, with actual normalization (less than 20 ng/ml) by the 3rd month. At this time the low serum luteinizing hormone levels began to rise and fluctuate in the normal follicular range. Galactorrhea disappeared, and menarche occurred during the 15th month of treatment. 15 further menstrual bleedings ensued over the following 15 months, albeit at irregular time intervals; ovulation was suggested by finding elevated serum progesterone levels in the presumed luteal phase by about 1 year following the menarche. The available data on 38 patients with primary amenorrhea and hyperprolactinemia reported in the literature are reviewed. 15 of them were treated with bromocriptine, and either pregnancy or cyclic menses occurred in 11. Hyperprolactinemic primary amenorrhea may be more common than previously recognized, and it may probably be successfully treated by prolactin-lowering drugs or by surgical ablation of a pituitary adenoma in a high percentage of cases.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Lactation Disorders; Luteinizing Hormone; Metergoline; Pregnancy; Progesterone; Prolactin; Sulpiride; Thyrotropin-Releasing Hormone

This is a report about 20 sterile women in whom the amenorrhoea or oligomenorrhoea was accompanied by hyperprolactinaemia. Parlodel, Lysenyl, and Deprenon were used for treatment. The therapy was followed by pregnancy of 70 per cent of the women.

Topics: Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Infertility, Female; Lisuride; Oligomenorrhea; Pregnancy; Prolactin

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Humans; Kidney Function Tests; Liver Function Tests; Menstruation; Metergoline; Ovulation Induction; Pregnancy; Prolactin; Sella Turcica

It has been reported that the plasma growth hormone (GH) and prolactin (PRL) levels in acromegalic patients were suppressed after intensive administration of dopaminergic drugs, but we found that the plasma GH levels in some acromegalic patients were not suppressed. Plasma GH and PRL levels after a single oral administration of CB-154 (2.5mg) and L-DOPA (1g) were measured in 18 active acromegalic patients with and without galactorrhea. 1. The mean plasma GH levels after the administration were clearly suppressed in 8 patients with galactorrhea, while they were not suppressed in 10 patients without galactorrhea. These drugs were more effective in suppressing plasma GH levels in acromegalic patients with galactorrhea and hyperprolactinemia. 2. We calculated the responsiveness of the plasma GH level as follows: GH responsiveness (%) = (mean plasma GH level after the administration of CB-154 or L-DOPA)/ (basal GH level) x 100. The basal plasma PRL levels were inversely correlated with GH responsiveness (CB-154: r=-0.690, p less than 0.01. L-DOPA: r=-0.541, p less than 0.05). It was found that the effect of dopaminergic drugs on plasma GH levels was closely correlated with basal PRL levels in acromegalic patients. This implies that the chronic administration of CB-154 may be effective in acromegalic patients with galactorrhea and hyperprolactinemia.

Topics: Acromegaly; Adult; Ergolines; Female; Galactorrhea; Growth Hormone; Humans; Levodopa; Male; Middle Aged; Pregnancy; Prolactin

10 amenorrhea-patients and 5 galactorrhea-amenorrhea-patients were treated wi2-Br-alpha-ergocryptine (CB 154) as a specific prolactin inhibitor. Side-effects, such as headaches, dizziness, and nausea could be reduced to a minimum by delivering the drug with the meal at night. Before and under the treatment hormone levels were determined in plasma and 24-hour-urine. In the beginning all 15 patients showed a hyperprolactinaemia with a nearly always simultaneously existing hypogonadotropinaemia and the absence of LH-peaks. Also the estrogen- and progesterone-concentrations were on the lower normal level or extremely suppressed. In all patients CB 154 therapy led to a quick decrease of the prolactin levels, to a regaining of typical LH- and FSH-episodes, as well as to a regeneration of ovarian function. 5 women reacted with an ovulation, 3 became pregnant. The galactorrhea diminished significantly and stopped finally after a treatment of one week to 6 months. Discontinuation of CB 154-therapy, however, often provoked the galactorrhea-amenorrhea-syndrome again. For women with normoprolactinaemic amenorrhea a gestagen- and estrogen-test were carried out in order to classify the amenorrhea-type and it was tried to induce an ovulation with Dyneric. For patients with a strong desire for children and without any organic cause for their sterility, in cases of ovarian insufficiency grade I and II a HMG-HCG-treatment was often indicated. In spite of a precise control in order to avoid an overstimulation of the ovaries about 1% of the Dyneric-treated and even 30% of the HMG-HCG-treated patients developed ovarian cysts. In spite of high doses of gonadotropins only 32,5% of our sterility-patients (group I and II) became pregnant, whereas about 60% of the hyperprolactinaemic amenorrhea-patients (group VI) conceived under CB 154 treatment.

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Gonadotropins; Humans; Lactation Disorders; Luteinizing Hormone; Ovulation; Pregnancy; Prolactin; Syndrome

Studies of prolactin secretion in humans have confirmed the concept, derived originally from animal investigations, that prolactin is predominantly controlled by tonic inhibition from the hypothalamus. The locus of action of dopamine and dopaminergic agents such as the ergot alkaloids inhibiting prolactin secretion appears to be primarily at the pituitary level, though a hypothalamic action to increase secretion of prolactin inhibitory factor may also contribute. Prolactin hypersecretion, through any of several possible mechanisms, is frequently but not always found in patients with galactorrhea. Recent studies have shown that hyperprolactinemia is considerably more common than was previously appreciated among patients without galactorrhea. It is present in at least two-thirds of all patients with pituitary tumors and in a significant minority of patients with secondary amenorrhea. Its clinical measurement in these conditions is therefore of considerable diagnostic importance. Whatever the pathophysiology of its production, hyperprolactinemia of all forms is responsive to treatment with the newer ergot alkaloids. The potential use of these agents for therapeutic purposes, particularly in the treatment of infertility, appears to be wider than was originally anticipated.

Topics: Acetonitriles; Amenorrhea; Bromocriptine; Dopamine; Ergolines; Ergot Alkaloids; Female; Galactorrhea; Humans; Levodopa; Pituitary Neoplasms; Pregnancy; Prolactin; Prolactin Release-Inhibiting Factors

Eleven women with secondary amenorrhoea and hyperprolactinaemia were treated with lisuride, a new semisynthetic ergot derivative. Acute administration of lisuride (100 microgram orally) significantly suppressed serum prolactin (PRL) levels in nine out of eleven subjects. In these nine patients, prolonged treatment with lisuride (50--200 microgram daily) lowered PRL levels into the normal range, menstrual cycles were resumed and eight patients ovulated. Two patients, in whom lisuride failed to lower PRL levels into the normal range, did not resume normal menstruation. These data demonstrate that lisuride may be used clinically to lower PRL levels and to restore cyclic gonadotrophin secretion and ovulation in amenorrhoeic patients with hyperprolactinaemia.

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Humans; Lisuride; Ovulation; Pregnancy; Prolactin; Syndrome; Thyrotropin-Releasing Hormone

Lergotrile mesylate is an ergot alkaloid derivative modified to eliminate the vasoconstrictive properties of the parent compound while preserving the properties that inhibit pituitary secretion. Administration of the drug to women with amenorrhea-galactorrhea resulted in the lowering of serum prolactin concentrations. The duration of action was short, so that prolactin levels were near base line 6 to 8 hours after a 2.0-mg dose and morning prolactin concentrations were not persistently suppressed. Initial therapy was accompanied by the development of postural hypotension. Tolerance to this side effect of the drug developed after several days of treatment with gradually increasing doses. In one patient, long-term treatment resulted in reduction of breast secretions, resumption of menses, and conception.

Topics: Acetonitriles; Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Humans; Hypotension, Orthostatic; Lactation Disorders; Pregnancy; Prolactin

Forty women with secondary amenorrhea and galactorrhea, thirty-six of whom had associated hyperprolactinemia, were studied prior to therapy with ergocryptine. Abnormal sella tomographic findings were present in 23. The findings on sellar tomography, basal serum prolactin concentrations, and pharmacologic stimulation/suppression of the serum prolactin failed to predict subsequent responders and nonresponders to ergocryptine. Pituitary stimulation for hormone responsiveness did differentiate subsequent responders to ergocryptine from nonresponders. The serum growth hormone response to hypoglycemia was the most definitive predictor. Return of apparently ovulatory function occurred in 29 patients, 11 of whom conceived and have delivered healthy infants.

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pituitary Function Tests; Pregnancy; Prognosis; Prolactin; Sella Turcica

The development of homologous prolactin assays, multiple pituitary stimulation, tomography, and computerised axial tomography permit more detailed investigation of patients with secondary amenorrhoea than was formerly possible. 39% of 90 patients with secondary amenorrhoea had hyperprolactinaemia. 10 patients (11% of total) had pituitary tumours. 8 of these women had galactorrhoea (27% of those with galactorrhoea). For patients with hyperprolactinaemia but no tumour, bromocriptine is the treatment of first choice rather than clomiphene or human gonadotrophins. The best treatment for patients with detectable tumour is controversial, particularly when the tumour is confined to the sella turcica. Whether or not these tumors are true neoplasms remains to be determined. Clinically, a history of secondary anemorrhoea with or without galactorrhoea following withdrawal of oral contraceptives remains the commonest presenting syndrome.

Topics: Amenorrhea; Bromocriptine; Contraceptives, Oral; Diagnosis, Differential; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pituitary Function Tests; Pituitary Neoplasms; Pneumoencephalography; Pregnancy; Prolactin; Tomography; Tomography, X-Ray Computed

The present study was undertaken to investigate not only the effectiveness of bromoergocryptine therapy in 13 women with amenorrhea-galactorrhea and hyperprolactinemia without evidence of organic pathology, but also to assess the value of pretreatment evaluation in predicting the response to therapy. Sella turcica tomography, base line serum follicle-stimulating hormone, luteinizing hormone (LH), thyroid-stimulating hormone, T4, plasma cortisol levels, and the growth hormone reserve were normal in all patients. The pretreatment administration of LH-releasing factor (LRF) (100 microng subcutaneously) resulted in either a normal or excessive release of LH. On bromoergocryptine therapy, cyclic menses were reintiated in 10 of the women, while conception occurred prior to reinitiation of menses in the remaining three women. The time required for resumption of menses or conception on therapy correlated well with the magnitude of gonadotropin response to LRF. No correlation was seen with pretreatment prolactin levels nor with the degree of suppression of prolactin during bromoergocryptine therapy. In four women the mean prolactin levels during therapy were above normal, and in one patient prolactin levels approached pretreatment values during therapy. The initiation of cyclic menses despite continued hyperprolactinemia may indicate a possible direct effect of bromoergocryptine on hypothalamic LRF secretion as a partial explanation for its therapeutic action. On discontinuation of bromoergocryptine therapy, serum prolactin levels rapidly returned to pretreatment values or higher in all of the patients studied. In contrast to previous studies in which amenorrhea recurred in all patients after discontinuation of therapy, three of our patients maintained cyclic menses despite continued hyperprolactinemia. The recurrence of hyperprolactinemia after discontinuation of bromoergocryptine would indicate a persistent autonomy of the mechanisms involved. Periodic endocrine evaluation will be necessary to substantiate the presence or absence of pituitary microadenoma in these women.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Evaluation Studies as Topic; Female; Galactorrhea; Gonadotropin-Releasing Hormone; Humans; Lactation Disorders; Pituitary Gland; Pregnancy; Prolactin

Twenty patients with hypogonadism (19 women with amenorrhoea and 1 man with impotence and infertility), galactorrhoea and hyper-prolactinaemia (range: 36 to 344 ng/ml) were studied. The radiological study of the sella turcica, including in all cases hypocycloidal tomograms, allowed classification of the patients into 3 groups: group I (n = 4) had a grossly enlarged sella turcica, group II (n = 12) had localized alterations indicating the probable existence of a prolactin-secreting microadenoma ("microdeformation") while group III patients presented no radiological abnormality. Before treatment, all the patients were submitted to a complete evaluation of the function of their anterior pituitary, including the LH and FSH responses to iv administration of Gn-RH. All the group I patients had low basal LH levels and a blunted response to Gn-RH. The basal LH and in response to Gn-RH were normal in most of the group II patients and in all of the group III patients. An exaggerated FSH response to Gn-RH was observed in 6/12 patients with microdeformation (group II) but not in groups I and III patients. A low LH and a blunted LH response to Gn-RH is highly suggestive of the existence of a pituitary prolactin-secreting adenoma in case of amenorrhoea and hyper-prolactinaemia patients; a normal response does not however rule out such a diagnosis. The reasons for a exaggerated FSH response to Gn-RH in patients with suspected prolactin-secreting microadenoma remain to be investigated though this pattern can also occur in other cases of amenorrhoea. Hence the Gn-RH test might contribute to the assessment of the hypothalamo-pituitary axis of patients with hyper-prolactinaemia. Six patients treated for 4 months with bromocriptine (CB-154) were submitted to re-evaluation of their pituitary gonadotrophins reserve. All the women experienced restoration of menses with 39 days of treatment and the male patient regained potency. It was observed that bromocriptine treatment and subsequent normalized prolactin levels in the 4 group II women tested were associated with normalization of their previously exaggerated FSH response to Gn-RH; LH responses were also diminished in these cases. These data are compatible with the hypothesis that hyper-prolactinaemia per se could interfere with the endogenous secretion of Gn-RH at the hypothalamic level. In one patient with grossly enlarged sella turcica and a previous lack of an LH and FSH response to Gn-RH, bromocriptine treatment restored. Gonadotropin levels in basal conditions and after gonadotropin-releasing hormone (Gn-RH) stimulation in 20 patients with hypogonadism, galactorrhea, and hyperprolactinemia are reported and, in some cases, results after treatment with bromocriptine are included. The radiological study of the sella turcica allowed classification of the patients in 3 groups: 1) grossly enlarged sella turcica, 2) localized alterations indicating the probable existence of a prolactin-secreting microadenoma, and 3) no radiological abnormality. All the Group 1 patients had low basal luteinizing hormone (LH) levels and a blunted response to Gn-RH. Basal LH and the response to Gn-RH were normal in most of Group 2 and in all of Group 3. An exaggerated follicle stimulating hormone (FSH) response to Gn-RH was observed in 6 of 12 patients in Group 2 but not in the other groups. It is suggested that the Gn-RH test might contribute to the assessment of the hypothalamo-pituitary axis of patients with hyperprolactinemia. 6 patients teated for 4 months with bromocriptine experienced restoration of menses or regained potency. These results are compatible with the hypothesis that hyperprolactinemia per se could interfere with the endogenous secretion of Gn-RH at the hypothalamic level.

Topics: Adolescent; Adult; Bromocriptine; Ergolines; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Hypogonadism; Lactation Disorders; Luteinizing Hormone; Male; Pituitary Hormone-Releasing Hormones; Pregnancy; Prolactin

Twenty hyperprolactinemic patients with galactorrhea were studied to determine their gonadotropic responses to various stimuli. Five women lacked response to gonadotropin following the administration of clomiphene citrate. Ten patients who had luteinizing hormone releasing hormone (LRH) tests before and during bromocriptine administration exhibited varied FSH and LH responses that apparently were unaffected by bromocriptine therapy. A loss of the normal positive feedback of estrogens at the level of the hypothalamus was demonstrated in most patients before and during bromocriptine therapy. Long-term treatment with bromocriptine in 11 women resulted in a decrease of serum prolactin, cessation of lactation in all, and pregnancy in 8. These results suggest that the failure of normal secretion of gonadotropins in hyperprolactinemic women may result from 1) inadequate release of endogenous LRH, and 2) loss of the positive feedback of estrogens, as a result of the same hypothalamic disturbance that provokes the hyperprolactinemia. In turn, the elevated prolactin levels may exert a short-loop negative feedback at the hypothalamic level, inhibiting cyclic gonadotropin release.

Topics: Bromocriptine; Clomiphene; Depression, Chemical; Drug Administration Schedule; Ergolines; Estradiol; Feedback; Female; Follicle Stimulating Hormone; Galactorrhea; Gonadotropin-Releasing Hormone; Gonadotropins, Pituitary; Humans; Hypothalamus; Lactation Disorders; Luteinizing Hormone; Pregnancy; Progesterone; Prolactin

Ten patients with galactorrhea and amenorrhea were treated with 2-bromo-alpha-ergocryptine (CB-154). All patients had normal anteroposterior and lateral x-rays of the sella turcica and normal or low gonadotropin levels. Before treatment, serum prolactin (PRL) levels were between 80 and 1575 ng/ml. Prior to initiating therapy, six patients were further evaluated by the intravenous administration of thyrotropin-releasing of a pituitary etiology in all patients. During treatment, PRL levels were measured at monthly intervals. After 1 month, serum PRL concentrations were reduced between 13% and 99%. In eight subjects there was complete cessation of galactorrhea. During treatment, nine patients resumed ovulatory menstrual cycles and three patients conceived. After discontinuing therapy, five of seven subjects had a recurrence of galactorrhea, amenorrhea, and hyperprolactinemia.. Clinical and pituitary effects of 2-bromo-alpha-ergocryptine (CB-154) in 10 patients with galactorrhea-amenorrhea syndrome are reported. Pretreatment testing with hormones suggested a pituitary disorder in all cases. 1 month after treatment with 3 daily doses of CB-154 (2 mg), prolactin concentrations decreased between 13-99%. Galactorrhea was completely suppressed in 8 patients, 9 patients had a return to normal ovulatory menstrual cycles, and 3 conceived. However, once treatment was discontinued, 5 of 7 patients had a recurrence of galactorrhea, amenorrhea, and hyperprolactinemia.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Lactation Disorders; Luteinizing Hormone; Pituitary Gland; Pituitary Hormone-Releasing Hormones; Pregnancy; Prolactin; Thyrotropin-Releasing Hormone

A patient is described with a galactorrhea-amenorrhea syndrome and an enlargement of the sella turcica. Pregnancy occurred after induction of ovulation with bromocriptine (and 2.5 years after pituitary irradiation). Periodic assessment of the visual fields showed an increase in size of the blind spots after 10 weeks and a moderate bitemporal hemianopsia after 22 weeks, which improved spontaneously after 30 weeks of pregnancy. One month after delivery the visual field of the left eye was almost normalized, while that of the right eye showed a definite improvement. Prior radiotherapy need not prevent visual complications from enlargement of pituitary adenomas during pregnancy.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Estradiol; Female; Follicle Stimulating Hormone; Galactorrhea; Hemianopsia; Humans; Lactation Disorders; Luteinizing Hormone; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Prolactin; Syndrome; Visual Fields

Of 28 patients presenting with amenorrhea-galactorrhea, pituitary tumors were confirmed in eight. Six patients had occult hypothyroidism and the rest had an endocrine profile suggestive of pituitary tumor or of an idiopathic etiology. Treatment with bromocryptine resulted in suppression of the inappropriate lactation and restoration of regular menstrual function. In five cases, however, the galactorrhea was only diminished and in four of these cases, normal ovarian function did not return. Of the 19 patients that were seeking fertility and continued the medication for at least 20 days, nine pregnancies resulted. A similar response to bromocryptine was observed regardless of the underlying cause of the amenorrhea-galactorrhea.. 28 women with amenorrhea-galactorrhea were investigated endocrinologically and treated with bromocryptine 2.5 mg twice daily, ranging from 18 to 150 days. These women were classified into 6 with hypothyroidism, having prolactin (PRL) over 30 ng/ml, thyroid stimulating hormone (TSH) over 8 mcU/ml, luteinizing hormone (LH)6-20 mlU/ml and greater than follicle stimulating hormone (FSH); 8 with radiologically diagnosed pituitary tumors, LH, FSH, and increased PRL; 9 with similar endocrine profiles and suspected pituitary tumors; and 3 with high PRL considered idiopathic. 5 of the hypothyroid group were followed, and achieved ovulation, reduced TSH, PRL, and lactation, and 3 became pregnant. Of the 8 with tumors, 5 menstruated, 4 ovulated, 3 conceived, 3 had reduced lactation, 2 had reduced PRL, and 1 failed to respond clinically; 9 with suspected tumors took bromocryptine for at least 20 days, resulting in 4 pregnancies and 3 with regular menses. The 3 idiopathic cases showed lower PRL and regular ovarian function, 1 pregnancy, yet 1 developed pseudocyesis and recurrent galactorrhea. 2 women had to stop bromocryptine because of vomiting. This drug is longer-acting than L-dopa and safer than estrogen-progestagen combinations in cases of pituitary tumors. Bromocryptine reduces galactorrhea and associated hypothyroidism temporarily.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Hypothyroidism; Lactation Disorders; Luteinizing Hormone; Pituitary Neoplasms; Pregnancy; Prolactin; Thyrotropin

Topics: Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Lactation; Pregnancy

Seven women with amenorrhea and galactorrhea, and no evidence of pituitary adenoma, were treated with brom-ergocryptine for two to 24 weeks. All seven patients had the resumption of regular menses within eight weeks, but six patients required 24 weeks of therapy to completely cease lacting. Two of the five women attempting to conceive became pregnant. Four of the five nonpregnant patients had a total recurrence of their symptoms after discontinuing the drug. Brom-ergocryptine appears to be very effective in inhibiting prolactin secretion and thus reestablishing normal ovulatory menstrual cycles and fertility.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pregnancy; Prolactin

Topics: Acromegaly; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Parkinson Disease; Pregnancy

Topics: Adult; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pregnancy

A 33-year-old woman who had had amenorrhoea and galactorrhoea for ten years and had hyperprolactinaemia was treated with metergoline, a serotonin antagonist. There was a marked decrease in plasma prolactin levels. After two months, ovulation and pregnancy occurred. This is the first such report.. A case study of a 33-year-old hyperprolactinemic woman becoming pregnant after treatment with metergoline is reported. The patient had also had amenorrhea and galactorrhea for 10 years. Treatment twice a day with 4 mg metergoline, a serotonin antagonist, markedly decreased plasma prolactin levels. 2 months later the patient became pregnant and delivered a normal, healthy boy. This is the 1st report of ovulation induction by metergoline.

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Humans; Ovulation; Pregnancy; Prolactin

Topics: Adult; Ergolines; Female; Galactorrhea; Humans; Lactation; Lactation Disorders; Metergoline; Pregnancy; Prolactin; Puerperal Disorders

Prolactin interferes with the function of the corpus luteum, as was demonstrated by repeatedly finding a short luteal phase in the ovulatory cycles of two hyperprolactinaemic women after prolactin supression by bromocriptine had been discontinued. In hyperprolactinaemic ovulatory cycles excretion of pregnanediol in urine was less and plasma-progesterone concentrations were lower than in normo-prolactinaemic cycles. When the amenorrhoea-galactorrhoea syndrome recurred the symptoms appeared in the following order: (1) serum-prolactin increased and the luteal phase became shorter; (2) galactorrhoea appeared; (3) ovulation was missed; (4) menstruation was missed. All these abnormalities may be treated by prolactin suppression, but the effect of treatment does not persist for long after bromocriptine administration ceases.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Luteal Phase; Menstruation; Ovulation; Pregnancy; Prolactin; Syndrome; Time Factors

Bromocriptine 2-5 mg twice daily is effective in the treatment of both normoprolactinaemic and hyperprolactinaemic secondary amenorrhoea. This was demonstrated by the restoration of menstrual cycle and/or ovulation in 9 of 18 normoprolactinaemic and in 8 of 14 hyperprolactinaemic patients taking bromocriptine. Serum-prolactin level decreased in both groups of patients, and usually menstruation was recovered within 8 weeks'treatment. Galactorrhoea disappeared in 7 of 9 hyperprolactinaemic patients, and 2 became pregnant. After treatment had ceased spontaneous menstrual activity continued in 4 patients. 16 patients had side-effects the commonest being nausea and vertigo. These usually disappeared with the dosage was reduced, but 5 patients refused to continue. These results point to a new approach in the treatment of secondary amenorrhoea, even in those patients whose clinical findings give no indication of prolactin suppression.

Topics: Adolescent; Adult; Amenorrhea; Bromocriptine; Drug Evaluation; Ergolines; Female; Follow-Up Studies; Galactorrhea; Humans; Menstruation; Ovulation; Pregnancy; Prolactin; Puerperal Disorders

Fourteen women with amenorrhea-galactorrhea were treated with bromo-ergocryptine. Serum prolactin hPRL, hLH, hFSH, estradiol 17-beta (E2), and progesterone values were determined before and during treatment. No consistent pretreatment hormonal pattern was found. During treatment hPRL levels fell in 13 of 14 patients, and E2 rose in 12 of 14 patients. Levels of hLH became normal, and amounts of hFSH did not change. Galactorrhea lessened in all cases and ceased in 11. Menses resumed in 11 patients and 3 women became pregnant. Cessation of galactorrhea and resumption of menses occurred irrespective of initial hPRL or hLH levels. It is suggested that improvement of galactorrhea and resumption of menses in some patients with normal hPRL values are the result of increased serum E2 levels and may be due to a direct action of bromo-ergocryptine on the ovary. Bromo-ergocryptine may also be effective in treatment of amenorrhea, unassociated with galactorrhea or elevated hPRL levels.

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Estradiol; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Lactation Disorders; Luteinizing Hormone; Middle Aged; Pregnancy; Prolactin

Fifteen patients with galactorrhea-amenorrhea syndromes were studied before, during, and after treatment with bromergocryptine. Galactorrhea and amenorrhea were noted after pregnancy (6 patients), after oral contraceptive therapy (5 patients), and in association with pituitary adenoma (4 patients). Before treatment prolactin values were elevated ranging from 27 to 125 ng/ml, while luteinizing hormone and progesterone levels failed to show ovulatory peaks or luteal phase progression. Eleven patients had luteinizing hormone-releasing hormone tests before therapy. Response was normal in 8, subnormal in 2 pituitary adenoma, and supranormal in 1 patient with premature ovarian failure. Treatment with bromergocryptine was associated with a lowering of serum prolactin, cessation of lactation in all, and return of ovulatory menses in 14 of 15 patients. All relapsed when therapy was discontinued. Four patients became pregnant while on therapy. Long-term bromergocryptine therapy is effective for all forms of galactorrhea-amenorrhea syndromes studied.

Topics: Adenoma; Amenorrhea; Bromocriptine; Chiari-Frommel Syndrome; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pituitary Function Tests; Pituitary Neoplasms; Pregnancy; Recurrence; Syndrome

Topics: Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Hypogonadism; Male; Pituitary Neoplasms; Pregnancy; Prolactin

Topics: Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pregnancy

In ten patients with amenorrhea-galactorrhea who had hyperprolactinemia, ovulation could not be induced clomiphene citrate or exogenous gonadotropins. Treatment with bromocryptine in eight of these patients resulted in suppression of PRL in all, cessation of galactorrhea and ovulation in seven and conception in five.

Topics: Amenorrhea; Bromocriptine; Ergolines; Female; Fertility; Galactorrhea; Gonadotropins, Pituitary; Humans; Lactation Disorders; Menotropins; Ovary; Ovulation; Pregnancy; Prolactin; Thyrotropin

A woman developed amenorrhoea and galactorrhoea after partial removal of a pituitary tumor during pregnancy. Hyperprolactinaemia was supressed by therapy with bromocryptine (CB 154, Sandoz) resulting in cessation of galactorrhoea in two months, spontaneous menstruation after eight months, and pregnancy after twelve months.

Topics: Adenoma, Chromophobe; Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pituitary Neoplasms; Pregnancy; Syndrome

11 patients suffering from amenorrhea-galactorrhea, and 26 puerperas for whom lactation was not indicated were treated with 2-Br-alpha-ergocryptine. The drug led to a regression of galactorrhea, and to normal menstrual cycles in all patients, except in one who was suffering from hypophyseal adenoma. Lactation was effectively inhibited in all 26 puerperas after only a few days of treatment. Results showed that 2-Br-alpha-ergocryptine has a powerful inhibitory action on the hypophyseal secretion of prolactin, both during puerperium and in nonpuerperal conditions.

Topics: Adult; Amenorrhea; Ergolines; Female; Galactorrhea; Gonadotropins, Pituitary; Humans; Lactation; Lactation Disorders; Pituitary Gland; Pituitary Gland, Anterior; Pregnancy; Prolactin; Puerperal Disorders

Topics: Adult; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Pregnancy

Lergotrile (Compound 83636), a specific inhibitor of prolactin release, was administered to 5 women with galactorrhea. Only 1 of the 5 had an elevated serum prolactin (hPRL) value, but Compound 83636 induced a decrease in serum hPRL in all cases. All patients had cessation of breast secretion within 72 days after initiation of lergotrile. LRH administration (100 pg) evoked a variable gonadotropin response before and during treatment with the ergot alkaloid. By contrast, serum prolactin values remained essentially unaltered after injection of LRH under the same conditions.

Topics: Acetonitriles; Adult; Contraceptives, Oral; Ergolines; Female; Follicle Stimulating Hormone; Galactorrhea; Gonadotropin-Releasing Hormone; Humans; Lactation Disorders; Luteinizing Hormone; Menstruation; Mesylates; Pregnancy; Prolactin; Time Factors

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Infertility, Female; Lactation Disorders; Ovulation; Pregnancy

Administration of Brom-ergocryptine (CB-154) has a dramatic effect on breast secretion. Inhibition of lactation occurs within three to four weeks in women with amenorrhea and galactorrhea. Resumption of normal ovulatory function was documented by serum progesterone levels, as well as pregnancy, in three of four women attempting to conceive. Serum prolactin levels become normal following initiation of Brom-ergocryptine. Discontinuation of Brom-ergocryptine was found to result in a return of both inappropriate lactation and elevation of serum prolactin in this study. No deleterious side effects of Brom-ergocryptine have been found in any of the volunteers either clinically or on the basis of sequential laboratory studies.

Topics: Adult; Amenorrhea; Breast Feeding; Bromocriptine; Ergolines; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Lactation; Lactation Disorders; Luteinizing Hormone; Pregnancy; Progesterone; Prolactin; Radioimmunoassay

Topics: Adult; Amenorrhea; Bromocriptine; Ergolines; Female; Galactorrhea; Humans; Infertility; Lactation; Lactation Disorders; Male; Pregnancy; Prolactin

Topics: Amenorrhea; Brain; Bromocriptine; Depression, Chemical; Dopamine; Ergolines; Female; Galactorrhea; Humans; Lactation Disorders; Male; Pregnancy; Prolactin; Receptors, Drug; Syndrome

Four women with the amenorrhoea-galactorrhoea syndrome were treated with 2-Br-a-ergocryptine (CB-154). In 3 patients, lactation was inhibited and ovulation was induced. Furthermore, pregnancy was achieved in one of them. In the remaining case, neither was lactation inhibited nor ovulation induced. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) were measured sequentially in the 4 CB- 154 treated women. They showed high serum PRL levels and acyclic patterns of serum FSH and LH. CB-154 suppressed PRL secretion and stimulated FSH and LH secretion in 3 cases where lactation was inhibited and ovulation was induced. In the one unsuccessful case, serum PRL decreased only slightly and the serum FSH and LH showed no marked changes.

Topics: Adult; Amenorrhea; Bromocriptine; Depression, Chemical; Ergolines; Ergot Alkaloids; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Lactation Disorders; Luteinizing Hormone; Ovulation; Pregnancy; Prolactin; Stimulation, Chemical; Time Factors

2 Bromo-alpha-ergocryptine, a specific prolactin inhibitor, was administered to 9 patients suffering from galactorrhea-amenorrhea syndrome of varying aetiology. Plasma levels of FSH, LH, prolactin, total estrogens and progesterone were measured by radioimmunoassy before and after treatment initiation. Prior to treatment, plasma prolactin levels were in all cases supraphysiological. FSH and LH levels were, with the exception of one patient, in the low cyclic range. One patient had subnormal gonadotropin levels, presumably reflecting hypophyseal insufficiency following surgical removal of a pituitary adenoma. Mean plasma levels of total estrogens were in the lower normal range. Administration of CB 154 led in all cases to a reduction of plasma prolactin levels. In eight cases, galactorrhea was suppressed during the first month of treatment. Eight patients menstruated and seven ovulated as indicated by the basal body temperature (BBT) or plasma progesterone measurement. The postoperative hypophyseal tumor patient did not, with the exception of galactorrhea suppression, respond to treatment, presumably due to hypophyseal insufficiency. 2 patients conceived during the course of treatment. One patient, who developed galactorrhea-amenorrhea syndrome as a result of psychopharmacological drug administration received 7,5 mg/day CB 154. Prolactin secretion, as indicated by plasma levels, was inhibited but the inhibitation was much slower in onset than that exhibited by the other patients and this patient ovulated only after 5 months of treatment. Upon withdrawal of CB 154 therapy after 6 to 7 months, the patients redeveloped galactorrhea-amenorrhea syndrome, so that a definitive cure could not be demonstrated.

Topics: Adult; Amenorrhea; Bromocriptine; Contraceptives, Oral; Ergolines; Estrogens; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Hypophysectomy; Lactation Disorders; Luteinizing Hormone; Pregnancy; Progesterone; Prolactin; Psychotropic Drugs; Radioimmunoassay; Syndrome

An acromegalic patient with galactorrhea was treated with an ergot alkaloid, 2-Br-alpha-ergocryptine (CB-154). Serum prolactin decreased rapidly to normal level by CB-154 and the complete cessation of galactorrhea was noted. The inhibitory effect of CB-154 On growth hormone (GH) release was also noted, but slight. The mechanism of inhibitory action of CB-154 on both prolactin and GH secretion was discussed in connection with the experimental model of pituitary tumors, in which both hormones were produced by a single type of tumor cells. The discontinuation of CB-154 treatment was associated with the return of both prolactin and GH levels to the initial high values with resumption of galactorrhea.

Topics: Acromegaly; Ergolines; Female; Galactorrhea; Growth Hormone; Humans; Lactation Disorders; Levodopa; Pregnancy; Prolactin

Recent progress in the field of radioimmunology, especially as regards prolactin (PRL) assay, as well as the use of new drugs have opened new perspectives for a better understanding of the "amenorrhoea-galactorrhea syndrome" both from the diagnostic and therapeutic points of view. This syndrome which formerly was considered infrequent, is now observed more and more often, perhaps as a result of the more widespread use of drugs such as phenothiazines, reserpine derivatives, alpha-methyldopa and tricyclic antidepressants, as well as owing to the large-scale use of estrogens and above all of estrogen-progestogen contraceptives. The problems of etiopathogenesis and management of the amenorrhea-galactorrhea syndrome are complicated by the fact that a variety of factors are responsible, as is shown also by the classical nosographic classification with the Forbes-Albright syndrome in the presence of a pituitary tumour, the Chiari-Frommel syndrome of amenorrhea-galactorrhea following pregnancy, and the Argonz-del Castillo-Ahumada syndrome in the absence of lither pregnancy or tumor.

Topics: Adult; Amenorrhea; Ergolines; Estradiol; Female; Follicle Stimulating Hormone; Galactorrhea; Humans; Lactation Disorders; Luteinizing Hormone; Pituitary Hormone Release Inhibiting Hormones; Pregnancy; Progesterone; Prolactin; Radioimmunoassay; Syndrome