Reproductive disorders in women with hyperprolactinemia: pathogenesis, clinical manifestations, diagnosis
Objective. To make a brief review of printed works on reproductive disorders in women with hyperprolactinemia (hyperPRL), by analyzing the possibility of using these data in the clinical practice of an obstetrician/gynecologist.Vagapova G.R.
Material and methods. Foreign and Russian articles published in the past 7 years, which had been selected in Pubmed using the key words: prolactin, hyperPRL, reproduction, infertility, menstrual cycle disorders, and diagnosis, were employed.
Results. The types and manifestation of reproductive disorders in women with hyperPRL directly depend on the etiological cause that determines the extent and duration of an increase in the level of prolactin (PRL). Contrary to the stable association of hyperPRL exclusively with anovulation and amenorrhea, there is conclusive evidence that elevated PRL levels in reproductive-age women may be manifested by various forms of impaired fertility (from regular ovulation with luteal phase defect to anovulation) and all types of menstrual dysfunction (from regular menstrual cycles to abnormal uterine bleeding and amenorrhea). The prevalence of hyperPRL is shown to vary in different groups: its prevalence is not greater than 1.2–4.1% in the general population; that is 7.9% in patients with menstrual cycle disorders and as high as 15.7–17% among infertile women.
Conclusion. It is concluded that it is necessary to include the definition of PRL into all the diagnostic algorithms for infertility and all menstrual cycle disorders in reproductive-aged women.
Keywords
prolactin
hyperprolactinemia
reproduction
infertility
menstrual cycle disorders
diagnosis
References
1. Horseman N.D., Gregerson K.A. Prolactin actions. J. Mol. Endocrinol. 2014; 52(1): 95-106.
2. Freeman M.E., Kanyicska B., Lerant A., Nagy G. Prolactin: structure, function, and regulation of secretion. Physiol. Rev. 2000; 80(4): 1523-631.
3. Grattan D.R. 60 YEARS OF NEUROENDOCRINOLOGY: The hypothalamo-prolactin axis. J. Endocrinol. 2015; 226(2): 101-22.
4. Carre N., Binart N. Prolactin and adipose tissue. Biochimie. 2014; 97: 16-21.
5. Newbern D., Freemark M. Placental hormones and the control of maternal metabolism and fetal growth. Curr. Opin. Endocrinol. Diabetes Obes. 2011; 18(6): 409-16.
6. Tenorio F.C.A., Simões M.J., Teixeira V.W., Teixeira A.A.C. Effects of melatonin and prolactin in reproduction: review of literature. Rev. Assoc. Med. Bras. 2015; 61(3): 269-74.
7. Ladyman S.R., Augustine R.A., Grattan D.R. Hormone interactions regulating energy balance during pregnancy. J. Neuroendocrinol. 2010; 22(7): 805-17.
8. Kokay I.C., Petersen S.L., Grattan D.R. Identification of prolactin-sensitive GABA and kisspeptin neurons in regions of the rat hypothalamus involved in the control of fertility. Endocrinology. 2011; 152(2): 526-35.
9. Araujo-Lopes R., Crampton J.R., Aquino N.S., Miranda R.M., Kokay I.C., Reis A.M. et al. Prolactin regulates kisspeptin neurons in the arcuate nucleus to suppress LH secretion in female rats. Endocrinology. 2014; 155(3): 1010-20.
10. Navarro V.M., Castellano J.M., McConkey S.M., Pineda R., Ruiz-Pino F., Pinilla L. et al. Interactions between kisspeptin and neurokinin B in the control of GnRH secretion in the female rat. Am. J. Physiol. Endocrinol. Metab. 2011; 300: E202-10.
11. Brown R.S., Herbison A.E., Grattan D.R. Prolactin regulation of kisspeptin neurones in the mouse brain and its role in the lactation-induced suppression of kisspeptin expression. J. Neuroendocrinol. 2014; 26(12): 898-908.
12. Liu X., Brown R.S., Herbison A.E., Grattan D.R. Lactational anovulation in mice results from a selective loss of kisspeptin input to GnRH neurons. Endocrinology. 2014; 155(1): 193-203.
13. Sonigo C., Bouilly J., Carr´e N., Tolle V., Caraty A., Tello J. et al. Hyperprolactinemia-induced ovarian acyclicity is reversed by kisspeptin administration. J. Clin. Invest. 2012; 122(10): 3791-5.
14. Millar R.P., Sonigo C., Anderson R.A., George J., Maione L., Brailly-Tabard S. et al. Hypothalamic-pituitary-ovarian axis reactivation by kisspeptin-10 in hyperprolactinemic women with chronic amenorrhea. J. Endocr. Soc. 2017; 1(11): 1362-71.
15. Abbara A., Jayasena C.N., Christopoulos G., Narayanaswamy S., Izzi-Engbeaya C., Nijher G.M. et al. Efficacy of kisspeptin-54 to trigger oocyte maturation in women at high risk of ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF) therapy. J. Clin. Endocrinol. Metab. 2015; 100(9):3322-31.
16. Donato J.J., Frazão R. Interactions between prolactin and kisspeptin to control reproduction. Arch. Endocrinol. Metab. 2016; 60(6): 587-95.
17. Bernard V., Young J., Chanson P., Binart N. New insights in prolactin: pathological implications. Nat. Rev. Endocrinol. 2015; 11(5): 265-75.
18. Chanson P., Maiter D. Prolactinoma. In: Melmed S., ed. The Pituitary. London, UK: Academic Press; 2017: 467-514.
19. Gaytan F., Gaytan M., Castellano J.M., Romero M., Roa J., Aparicio B. et al. KiSS-1 in the mammalian ovary: distribution of kisspeptin in human and marmoset and alterations in KiSS-1 mRNA levels in a rat model of ovulatory dysfunction. Am. J. Physiol. Endocrinol. Metab. 2009; 296(3): E520-31.
20. Bouilly J., Sonigo C., Auffret J., Gibori G., Binart N. Prolactin signaling mechanisms in ovary. Mol. Cell. Endocrinol. 2012; 356(1-2): 80-7.
21. Binart N., Bachelot A., Bouilly J. Impact of prolactin receptor isoforms on reproduction. Trends Endocrinol. Metab. 2010; 21(6): 362-8.
22. Gorvin C.M. The prolactin receptor: Diverse and emerging roles in pathophysiology. J. Clin. Transl. Endocrinol. 2015; 2(3): 85-91.
23. Halperin J., Devi S.Y. Reproductive actions of prolactin mediated through short and long receptor isoforms. Mol. Cell. Endocrinol. 2014; 382(1): 400-10.
24. Shibli-Rahhal A., Schlechte J. Hyperprolactinemia and infertility. Endocrinol. Metab. Clin. North Am. 2011; 40(4): 837-46.
25. Melmed S., Casanueva F.F., Hoffman A.R., Kleinberg D.L., Montori V.M., Schlechte J.A. et al. Diagnosis and treatment of hyperprolactinemia: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2011; 96(2): 273-88.
26. Дедов И.И., Мельниченко Г.А., ред. Российские клинические рекомендации. Эндокринология. М.: ГЭОТАР-Медиа; 2016. 592с. [Dedov I.I., Melnichenko G.A., ed. Russian clinical guidelines. Endocrinology. Moscow: GEOTAR-Media; 2016. 592p. (in Russian)]
27. Peuskens J., Pani L., Detraux J., De Hert M. The effects of novel and newly approved antipsychotics on serum prolactin levels: a comprehensive review. CNS Drugs. 2014; 28(5): 421-53.
28. Kulshreshtha B., Pahuja I., Kothari D., Chawla I., Sharma N., Gupta S. et al. Menstrual cycle abnormalities in patients with prolactinoma and drug-induced hyperprolactinemia. Indian J. Endocr. Metab. 2017; 21(4): 545-50.
29. Gordon C.M., Ackerman K.E., Berga S.L., Kaplan J.R., Mastorakos G., Misra M. et al. Functional hypothalamic amenorrhea: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2017; 102(5): 1413-39.
30. Khine Y.M., Taniguchi F., Harada T. Clinical management of endometriosis-associated infertility. Reprod. Med. Biol. 2016; 15(4): 217-25.
31. Soto-Pedre E., Newey P.J., Bevan J.S., Greig N., Leese G.P. The epidemiology of hyperprolactinaemia over 20 years in the Tayside region of Scotland: the Prolactin Epidemiology, Audit and Research Study (PROLEARS). Clin. Endocrinol.(Oxford). 2017; 86(1): 60-7.
32. Lee D.Y., Oh Y.K., Yoon B.K., Choi D. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problem. Am. J. Obstet. Gynecol. 2012; 206(3): 213. e1-5.
33. Alpañés M., Sanchón R., Martínez-García M.Á., Martínez-Bermejo E., Escobar-Morreale H.F. Prevalence of hyperprolactinaemia in female premenopausal blood donors. Clin. Endocrinol. (Oxford). 2013; 79(4): 545-9.
34. Vilar L., Fleseriu M., Bronstein M.D. Challenges and pitfalls in the diagnosis of hyperprolactinemia. Arq. Bras. Endocrinol. Metab. 2014; 58(1): 9-22.
35. Adra A., El Zibdeh M.Y., Malek A.M., Hamrahian A.H., Abdelhamid A.M.S., Colao A. et al. Differential diagnosis and management of abnormal uterine bleeding due to hyperprolactinemia. Middle East Fertil. Soc. J. 2016; 21(3): 137-47.
36. Hamid A.M.S., Borg T.F., Madkour W.A.I. Prevalence of hyperprolactinemia and thyroid disorders among patients with abnormal uterine bleeding. Int. J. Gynaecol. Obstet. 2015; 131(3): 273-6.
37. Иловайская И.А. Гиперпролактинемия в акушерско-гинекологической практике. Акушерство и гинекология. 2017; 4: 149-54. http://dx.doi.org/10.18565/aig.2017.4.149-54 [Ilovayskaya I.A. Hyperprolactinemia in obstetric/gynecological practice. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (4): 149-54. (in Russian) http://dx.doi.org/10.18565/aig.2017.4.149-54]
38. Whitaker L., Critchley H.O.D. Abnormal uterine bleeding. Best Pract. Res. Clin. Obstet. Gynaecol. 2016; 34: 54-65.
39. Roberts-Wilson T.K., Spencer J. B., Fantz C.R. Using an algorithmic approach to secondary amenorrhea: avoiding diagnostic error. Clin. Chim. Acta. 2013; 423: 56-61.
40. Klein D.A., Poth M.A. Amenorrhea: an approach to diagnosis and management. Am. Fam. Physician. 2013; 87(11): 781-8.
41. Bo Q., Dong F., Li X., Wang Z., Ma X., Wand C. Prolactin related symptoms during risperidone maintenance treatment: results from a prospective, multicenter study of schizophrenia BMC Psychiatry. 2016; 16: 386.
42. Dessimoz C., Browaeys P., Maeder P., Lhermitte B., Pitteloud N., Momjian S., Pralong F.P. Transformation of a microprolactinoma into a mixed growth hormone and prolactin-secreting pituitary adenoma. Front. Endocrinol. (Lausanne). 2011; 2: 116.
43. Kasum M., Oreskovi S., Cehi E., Sunj M., Lila A., Ejubovi E. Laboratory and clinical significance of macroprolactinemia in women with hyperprolactinemia. Taiwan. J. Obstet. Gynecol. 2017; 56(6): 719-24.
44. Samson S.L., Hamrahian A.H., Ezzat S.; AACE Neuroendocrine and Pituitary Scientific Committee; American College of Endocrinology (ACE). American Association of Clinical Endocrinologists, American College of Endocrinology disease state clinical review: clinical relevance of macroprolactin in the absence or presence of true hyperprolactinemia. Endocr. Pract. 2015; 21(12): 1427-35.
Received 08.12.2017
Accepted 22.12.2017
About the Authors
Gulnar Rifatovna Vagapova, MD, PhD, DMSc, Professor, Corresponding Member of the Academy of Sciences of the Republic of Tatarstan,Head of the Department of Endocrinology of Kazan State Medical Academy – Branch Campus of Russian Medical Academy of Continuing Professional Education,
Ministry of Health of Russia. 420012, Russia, Kazan, Mushtari str. 11. Tel.: +78432676151. E-mail: ksma.rf@tatar.ru, g.r.vagapova@gmail.com.
ORCID ID 8493-7893. SCOPUS ID 56663181000. SCIENCE INDEX 7643-4987
For citations: Vagapova G.R. Reproductive disorders in women with hyperprolactinemia: pathogenesis, clinical manifestations, diagnosis. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 19-26. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.19-26
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