Increased androgen secretion in patients with prolactinomas: the impact of altered HPA function

Moria, Yosra; Kortbawi, Rouba; El-Asmar, Nadine; Arafah, Baha M.

doi:10.1007/s11102-019-00948-w

Cited by 5 publications

(6 citation statements)

References 31 publications

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“…In a prospective study including 101 medically and 22 surgically treated patients with prolactinoma and normal cortisol reserve, decreases in the adrenal steroid DHEA-S paralleled PRL reduction after treatment with dopamine agonist or surgery [72]. However, this study did not report on clinical symptoms of hyperandrogenism [72]. It is also unclear whether there is a link between hyperprolactinaemia and female pattern hair loss [73].…”

Section: Womenmentioning

confidence: 83%

“…Hyperandrogenism may be also a manifestation of hyperprolactinaemia due to stimulation of adrenal androgen production [51,[70][71][72]. In a prospective study including 101 medically and 22 surgically treated patients with prolactinoma and normal cortisol reserve, decreases in the adrenal steroid DHEA-S paralleled PRL reduction after treatment with dopamine agonist or surgery [72].…”

Section: Womenmentioning

confidence: 99%

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Hyperprolactinaemia

Samperi

Lithgow

Karavitaki

2019

JCM

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Hyperprolactinaemia is one of the most common problems in clinical endocrinology. It relates with various aetiologies (physiological, pharmacological, pathological), the clarification of which requires careful history taking and clinical assessment. Analytical issues (presence of macroprolactin or of the hook effect) need to be taken into account when interpreting the prolactin values. Medications and sellar/parasellar masses (prolactin secreting or acting through "stalk effect") are the most common causes of pathological hyperprolactinaemia. Hypogonadism and galactorrhoea are well-recognized manifestations of prolactin excess, although its implications on bone health, metabolism and immune system are also expanding. Treatment mainly aims at restoration and maintenance of normal gonadal function/fertility, and prevention of osteoporosis; further specific management strategies depend on the underlying cause. In this review, we provide an update on the diagnostic and management approaches for the patient with hyperprolactinaemia and on the current data looking at the impact of high prolactin on metabolism, cardiovascular and immune systems.

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Section: Womenmentioning

confidence: 83%

Section: Womenmentioning

confidence: 99%

Hyperprolactinaemia

Samperi

Lithgow

Karavitaki

2019

JCM

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“…After cabergoline treatment, the patients were found to have significantly decreased DHEAS response to ACTH stimulation as previously shown (18). Another study by Moria et al comprising of 122 medically and 26 surgically treated patients with prolactinoma, reported a decrease in DHEAS levels after treatment (19). However, the study did not have a control group and the effects of hyperprolactinemia could not be evaluated at baseline.…”

Section: Discussionmentioning

confidence: 63%

Evaluation of Hyperandrogenemia in Women with Prolactinoma

Ünal¹,

Karaca²,

Ünlühızarcı³

et al. 2020

Turk J Endocrinol Metab

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Objective: Differential diagnosis of androgen excess disorders revealed the occurrence of hyperprolactinemia. However, an elevated level of prolactin (hyperprolactinemia) is a very infrequent cause of hyperandrogenemia in clinical practice. This study aimed to investigate the presence of hyperandrogenism/hyperandrogenemia in women with prolactinoma before and after treatment with cabergoline. Material and Methods: Twenty women diagnosed with prolactinoma in the recent past and 15 healthy women between the ages of 18 to 50 were enrolled in the study. Patients were evaluated at the baseline and after six months of cabergoline treatment. Patients were carefully noted for any signs and symptoms of hyperandrogenemia and concentration of androgen in blood. Further, adrenocorticotropin stimulation test was performed to analyze cortisol, dehydroepiandrosterone sulfate (DHEAS), androstenedione, 11-deoxycortisol (11-S), and 17-hydroxyprogesterone (17-OHP) responses. Results: A significantly higher level of prolactin compared to the control group was seen in prolactinoma patients, which reverted to normal levels after cabergoline treatment. Estradiol (E2) concentration was lower in patients with prolactinoma than control group and it did not show a significant increase after being treated with cabergoline. Patients with prolactinoma exhibited decreased sex hormone-binding globulin (SHBG) concentration in blood, which also increased significantly after the treatment. The levels of basal androstenedione, DHEAS, 17-OH progesterone, 11-S, and cortisol were found to be similar between the two groups. Basal and stimulated DHEAS and androstenedione levels decreased significantly after cabergoline treatment in prolactinoma patients. The presence of acne, hirsutism, and androgenic alopecia were similar in both groups. Pelvic ultrasonography revealed polycystic ovary (PCO) in nine patients with prolactinoma, which was significantly more frequent than in the control group. Among the 9 PCO patients, normal ovarian morphology was restored in three patients after the treatment. Conclusion: From the data, it may be suggested that hyperprolactinemia may not lead to clinically significant hyperandrogenemia and hirsutism. Moreover, the treatment of hyperprolactinemia does not lead to significant improvement in hirsutism score of the patients, if exists.

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“…Hence, nonclassic congenital adrenal hyperplasia, Cushing’s syndrome, hyperprolactinemia, and androgen-secreting tumors need to be excluded. 5,18…”

Section: Adolescencementioning

confidence: 99%

“…Hence, nonclassic congenital adrenal hyperplasia, Cushing's syndrome, hyperprolactinemia, and androgen-secreting tumors need to be excluded. 5,18 Polycystic ovary morphology (PCOM) is a common finding identified in women with clinical features typical of PCOS. The 2003 Rotterdam criteria included PCOM in the diagnostic criteria for PCOS.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of polycystic ovary syndrome throughout life

Louwers¹,

Laven²

2020

Clin Med�Insights�Reprod�Health

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Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. It is a complex disease in which genetic, endocrine, environmental, and behavioral factors are intertwined, giving rise to a heterogeneous phenotype with reproductive, metabolic, and psychological characteristics. Polycystic ovary syndrome affects women’s health and their quality of life across the life course. During different life stages, the polycystic ovary syndrome phenotype can change, which requires a personalized diagnostic approach and treatment. Polycystic ovary syndrome is a major cause of anovulatory infertility; this disorder is also associated with hirsutism and acne. Diagnosing polycystic ovary syndrome during adolescence is challenging because the polycystic ovary syndrome criteria include normal physiological events that occur during puberty. With increasing age, the syndrome evolves from a reproductive disease to a more metabolic disorder. Along with metabolic disturbances, including insulin resistance and abnormalities of energy expenditure, polycystic ovary syndrome is recognized as a major risk factor for the development of type 2 diabetes and cardiovascular disease in later life. Moreover, there is evidence for familial clustering of endocrine and metabolic features of polycystic ovary syndrome. Environmental factors such as diet and obesity appear to contribute to the phenotype. Treatment should be tailored to the specific concerns and needs of the individual patient and involves restoring fertility, treatment of the metabolic complaints, treatment of androgen excess, and providing endometrial protection. The complexity of the disorder, and the impact on quality of life, requires a timely diagnosis, screening for complications, and management strategies for the long-term health issues associated with polycystic ovary syndrome. The syndrome remains underdiagnosed, and women experience significant delays to diagnosis.

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Increased androgen secretion in patients with prolactinomas: the impact of altered HPA function

Cited by 5 publications

References 31 publications

Hyperprolactinaemia

Hyperprolactinaemia

Evaluation of Hyperandrogenemia in Women with Prolactinoma

Characteristics of polycystic ovary syndrome throughout life

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