Functional Delineation of Hyperprolactinemic-Amenorrhea¹

To account for the development of PRL hypersecretion and acyclic gonadotropin release, the separate functional activity of the pituitary and the ovary were assessed in two overlapping groups of patients with amenorrhea-galactorrhea and comparable levels of hyperprolactinemia. Group I was composed of 13 patients with a ‘probable’ microadenoma and Group II was composed of 5 patients with surgically documented pituitary PRL-secreting microadenomata. Pituitary functional capacity was determined by alternating pulses of LRF (10 μg) and TRF (200 μg)—3 doses of each. When responses in the early follicular phase (EF) of normal women were used as a reference point, there appeared to be a progressive decline in pituitary LH sensitivity (Δ max to 1st pulse) as well as reserve (net integrated release during 2nd and 3rd pulses) from Group I to Group II patients. In contrast, there was an increase in pituitary sensitivity and reserve for FSH in both groups of patients. Hence, there exists a marked reduction of the LH/F...