Androgen suppression and clinical improvement with dopamine agonists in hyperandrogenic-hyperprolactinemic women.
OBJECTIVE
To examine the effect of dopamine agonist (DA) treatment on clinical and biochemical features in hirsute, hyperprolactinemic (HPRL) women and the relationship between prolactin (PRL) and androgens.


METHODS
We evaluated 80 hirsute HPRL women (age, 27 +/- 1 years [mean +/- SE]) with neuroleptic treatment, prolactinoma and idiopathic HPRL (12, 13 and 55, respectively). DA, mainly bromocriptine, was administered for 11 +/- 1 months. Response indicators were Ferriman-Gallwey hirsutism (FGS) and Leeds acne (LAS) scores, circulating PRL, dehydroepiandrosterone sulfate (DHEAS), free and total testosterone, and androstenedione.


RESULTS
Baseline PRL correlated positively with DHEAS (r = .23, P = .03) and free testosterone (r = .36, P < .001). In all women, FGS, LAS, PRL, free testosterone, DHEAS and androstenedione decreased by 40-85% during DA treatment (P < .001). The decline in free testosterone was higher when PRL was > or = 65 ng/mL than when PRL was < 65 (P = .03) and correlated positively with basal DHEAS (r = .40, P < .001).


CONCLUSIONS
Our data suggest a modulation by PRL of adrenal androgen production. DA treatment reduces PRL and serum androgens. It results in a significant clinical improvement in acne and hirsutism. Therefore, DA is recommended as monotherapy for hyperandrogenic.
Hagag
P
P
Endocrine Institute and Biochemistry Wing, Assaf Harofeh Medical Center, Zerifin, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. phagag@asaf.health.gov.il
Hertzianu
I
I
Ben-Shlomo
A
A
Weiss
M
M
D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D006628:Hirsutism / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D017588:Hyperandrogenism / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D006966:Hyperprolactinemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D011388:Prolactin / Q000097:blood; D011863:Radioimmunoassay; D014057:Tomography, X-Ray Computed
D000728:Androgens; D018491:Dopamine Agonists; D011388:Prolactin