1/33. Isolated galactorrhea with normal serum prolactin levels: clinical implications.Detailed endocrine-metabolic studies were performed on five women who were otherwise well but who had had inappropriate breast secretions for variable periods of time (three months to 16 years). Our results suggest that the presence of a lactose-containing breast secretion, which strictly defines galactorrhea, does not necessarily indicate a recognizable abnormality if normal hypothalamic-pituitary function is present. In these regularly menstruating women with isolated galactorrhea, we suggest a minimum initial evaluation, but careful long-term follow-up studies to identify those cases which may progress to the other recognized, more serious amenorrhea-galactorrhea syndromes.- - - - - - - - - - ranking = 1keywords = amenorrhea (Clic here for more details about this article) |
2/33. polycystic ovary syndrome: a connection to insufficient milk supply?Despite advances in lactation skills and knowledge, insufficient milk production still continues to mystify mothers and lactation consultants alike. Based on 3 cases with similar threads, a connection is proposed between polycystic ovary syndrome (PCOS) and insufficient milk supply. Described are the etiology and possible symptoms of PCOS such as amenorrhea/oligomenorrhea, hirsutism, obesity, infertility, persistent acne, ovarian cysts, elevated triglycerides, and adult-onset diabetes, along with possible pathological interference with mammogenesis, lactogenesis, and galactopoiesis. Clinical suggestions include guidelines for screening mothers and careful monitoring of babies at risk. Further research is necessary to confirm the proposed association and to develop therapies with the potential to improve lactation success.- - - - - - - - - - ranking = 1keywords = amenorrhea (Clic here for more details about this article) |
3/33. Pituitary function testing in amenorrhea-galactorrhea-hyperprolactinemia.Fifteen patients, age 16 to 55, presented with amenorrhea-galactorrhea-hyperprolactinemia. Pituitary function was evaluated by bolus injections of insulin, luteinizing hormone-releasing hormone (LHRH), and thyrotropin-releasing hormone (TRH) in 13 and by LHRH and TRH in 2. Responses to growth hormone (GH), thyroid-stimulating hormone (TSH), cortisol (F), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin were measured. GH, TSH, and F responses were normal in most cases. LH responses were decreased (P less than 0.025) in patients with abnormal sellar tomography, whereas FSH responses tended to decrease with elevated prolactin levels. Prolactin responses were absent in five of the seven cases which could be evaluated. The clinical value of such testing appears to be limited to an individualized basis, although some prognosis of ovulatory response to bromocriptine therapy may be obtained from the gonadotropin response.- - - - - - - - - - ranking = 5keywords = amenorrhea (Clic here for more details about this article) |
4/33. hyperprolactinemia, galactorrhea and amenorrhea in women with a spinal cord injury.Six women with a traumatic spinal cord injury (SCI) developed hyperprolactinemia, amenorrhea and galactorrhea. Five of them had thoracic level lesions and 1 had a lumbosacral lesion. Two were postpartum and 1 was pregnant at the time of injury. Transient diabetes insipidus developed in 1 patient. Temporary administration of bromocriptine decreased prolactin levels, caused cessation of lactation and restored ovulatory cycles. The syndrome disappeared spontaneously in all 6 patients. Pituitary stalk concussion resulting from the trauma might cause this phenomenon, with the level of the cord injury playing a role. Being pregnant or early postpartum can predispose women to develop this syndrome.- - - - - - - - - - ranking = 5keywords = amenorrhea (Clic here for more details about this article) |
5/33. acromegaly as the amenorrhea-galactorrhea syndrome.The presence of amenorrhea with galactorrhea, elevated prolactin levels, and a pituitary tumor does not always imply the diagnosis of a prolactinoma. Other pituitary disorders, including acromegaly, should be considered.- - - - - - - - - - ranking = 5keywords = amenorrhea (Clic here for more details about this article) |
6/33. Neurogenic galactorrhea-amenorrhea.Neuroendocrine function in two women with galactorrhea-amenorrhea arising from abnormalities in the PRL reflex arc was compared to that of normal women. Basal gonadotropins were lower than normal, and one patient lacked episodic secretion of LH; however, the serum gonadotropin rise after iv LRH was in the normal range in both patients. Mean basal PRL levels were slightly elevated in one patient and were normal in the other, and the PRL levels after TRH, chlorpromazine, and levodopa testing were similar to those seen in normal women. breast stimulation did not increase PRL levels in either patient. PRL levels fell with bromergocryptine therapy, galactorrhea ceased, and normal menses resumed. These studies indicate that chronic afferent impulses originating in the PRL reflex arc can result in galactorrhea and amenorrhea and that bromergocryptine therapy in such patients can restore normal menses.- - - - - - - - - - ranking = 6keywords = amenorrhea (Clic here for more details about this article) |
7/33. Primary amenorrhea associated with hyperprolactinemia: four cases with normal sellar architecture and absence of galactorrhea.hyperprolactinemia is an uncommon cause of primary amenorrhea. The diagnosis should be sought even in the absence of galactorrhea and sellar abnormality, particularly when thelarche and pubarche have occurred. Reduction of serum PRL levels followed by menarche can be anticipated within a few months of starting bromocriptine therapy in the majority of cases.- - - - - - - - - - ranking = 5keywords = amenorrhea (Clic here for more details about this article) |
8/33. Resolution of acromegaly, amenorrhea-galactorrhea syndrome, and hypergastrinemia after resection of jejunal carcinoid.A young woman presented with acromegaly and amenorrhea-galactorrhea with hypersomatotropinemia and hyperprolactinemia. In addition, she had hypergastrinemia with abnormal secretory dynamics and evidence of a large pituitary tumor with suprasellar extension and erosion of the floor of the sella turcica. Evaluation of secretory diarrhea revealed a large abdominal tumor, which on removal was found to be a carcinoid of the jejunum. Postoperatively, the acromegaly, amenorrhea-galactorrhea, and hypergastrinemia resolved, and the pituitary returned to normal size, with regrowth of the sella floor. The carcinoid tumor was shown by immunoperoxidase staining to contain GH-releasing hormone.- - - - - - - - - - ranking = 6keywords = amenorrhea (Clic here for more details about this article) |
9/33. The treatment with 2-brom-alfa ergocriptine in the syndrome amenorrhea-galactorrhea.In this study, the authors present the results obtained in thirteen cases with amenorrhea-galactorrhea treated with 2-brom-alfa-ergocriptine in which the menstruation has reoccurred in eleven patients, three of them becoming pregnant. The authors have accurately described the evolution of the three pregnancies, which were delivered at term and the children born were normal. The present study was elaborated in the Sterility Department of the Clinic of obstetrics and gynecology "Giulesti", University School of medicine, Bucharest. The study refers to the use of 2-brom-alfa-ergocriptine (Parlodel-Sandoz) in the treatment of the amenorrhea-galactorrhea syndrome associated with sterility.- - - - - - - - - - ranking = 6keywords = amenorrhea (Clic here for more details about this article) |
10/33. galactorrhea and amenorrhea in a patient with an empty sella.A report of a patient with amenorrhea and galactorrhea who was shown, by tomopneumoencephalogram, to have an empty sella is presented. Endocrinologic testing revealed only a blunted human growth hormone response to insulin-induced hypoglycemia and acyclicity of plasma gonadotropins. Thyroid testing, ACTH, and metopirone responses were normal. In addition, plasma prolactin levels were found to be within the normal range. Most significantly, after the pneumoencephalogram the patient's menses returned and have continued at regular monthly intervals for 6 months. During this time there has been a significant decrease in the galactorrhea. This is the first patient described with an empty sella and galactorrhea. The clinical and endocribologic aspects of the empty sella are discussed.- - - - - - - - - - ranking = 5keywords = amenorrhea (Clic here for more details about this article) |
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