Two year treatment with oral contraceptives in hyperprolactinemic patients.
G Testa, et al (Universita di Pavia, Varese, Italy; Universita di Milano, Italyu; Istituto Ricerche Farmacologiche ” Mario Negir,” Milano, Italy) Contraception 58: 69-73, 1998.
The objective of the study has been that increased use of oral contraceptives (Ocs) may play a role in the development of pituitary prolactin secreting adenoma. The symptoms, serum PRL levels, and radiologic aspects of a group of young patients with hyperprolactinemia after 2 years of OC intake were prospectively assessed.
Conclusion- Endogenous or exogenous estrogen treatment does not promote growth of pituitary adenomas after 2 years.
Editorial comments: Clinical problems associated with hyperprolactinemia include anovulatory irregular bleeding and hypoestrogenism. Treatment with bromocriptine usually induces ovulatory cycles, causes regular bleeding, and raises estrogen levels. However, bromocriptine therapy is expensive and has adverse effects. Thus if a woman with hyperprolactinomia without a pituitary micoradenoma does not wish to conceive, she can be treated with low-dose Ocs. Regular bleeding episodes occur, and the estrogen in the OC will prevent bone loss. Adverse effects are less with Ocs than bromocriptine and Ocs. Like pregnancy, they do not stimulate the growth of prolactin secreting microadenomas.
There are 2 articles on the impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.
1) Prevalence of Impaired Glucose Tolerance and Diabetes in Women with Polycystic Ovary Syndrome.
DA Ehrmann, et al (Univ of Chicago). Diabetes Care 22: 141-146, 1999.
2) Prevalence and Predictors of Risk for Type 2 Diabetes Mellitus and Impaired Glucose Tolerance in Polycystic Ovary Syndrome: A Prospective, Controlled Study in 254 Affected Women.