Imperial College London
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Professor Niamh Martin

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology
 
 
 
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Contact

 

n.martin

 
 
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Location

 

6N5Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Abbara:2018:10.1159/000489264,
author = {Abbara, A and Clarke, S and Nesbitt, A and Ali, S and Comninos, A and Hatfield, E and Martin, NM and Sam, AH and Meeran, K and Dhillo, W},
doi = {10.1159/000489264},
journal = {Neuroendocrinology},
pages = {105--113},
title = {Interpretation of serum gonadotropin levels in hyperprolactinemia},
url = {http://dx.doi.org/10.1159/000489264},
volume = {107},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background/Aims: Hyperprolactinemia is a common cause of amenorrhea due to hypogonadotropic hypogonadism. Prolactin is hypothesized to impede the reproductive axis through an inhibitory action at the hypothalamus. However, limited data exists to aid the interpretation of serum gonadotropins in the context of hyperprolactinemia. Methods: Serum gonadotropin values were reviewed in 243 patients with elevated serum monomeric prolactin due to discrete etiologies at a tertiary reproductive endocrine centre between 2012 and 2015. The cause of hyperprolactinemia was categorized by an experienced endocrinologist / pituitary multidisciplinary team, unless superseded by histology. The most frequently encountered diagnoses were Microprolactinoma (n=88), Macroprolactinoma (n=46), Non-Functioning Pituitary Adenoma (NFPA) (n=72), Drug-Induced Hyperprolactinemia (DIH) (n=22) and Polycystic Ovarian Syndrome (PCOS) (n=15). Results: In patients with prolactinoma and modestly raised serum prolactin levels (<4000 mU/L), increasingly FSH-predominant gonadotropin values were observed with rising prolactin level, consistent with a progressive reduction in hypothalamic GnRH pulsatility. Patients with prolactinoma and higher prolactin values (>4000 mU/L) were more likely to have a reduction in serum levels of both FSH and LH, consistent with direct pituitary gonadotrope dysfunction. Patients with macroadenoma and extremes of serum gonadotropin values (either serum FSH or LH >8 IU/L) were more likely to have NFPA than prolactinoma. Patients with polycystic ovarian syndrome (PCOS) and hyperprolactinemia had LH-predominant secretion in keeping with increased GnRH pulsatility despite a raised prolactin level. Conclusion: The pattern of gonadotropin secretion in patients may reflect the etiology of hyperprolactinemia.
AU  - Abbara,A
AU  - Clarke,S
AU  - Nesbitt,A
AU  - Ali,S
AU  - Comninos,A
AU  - Hatfield,E
AU  - Martin,NM
AU  - Sam,AH
AU  - Meeran,K
AU  - Dhillo,W
DO  - 10.1159/000489264
EP  - 113
PY  - 2018///
SN  - 0028-3835
SP  - 105
TI  - Interpretation of serum gonadotropin levels in hyperprolactinemia
T2  - Neuroendocrinology
UR  - http://dx.doi.org/10.1159/000489264
UR  - http://hdl.handle.net/10044/1/59123
VL  - 107
ER  -
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