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. 2024 Feb;309(2):651-658.
doi: 10.1007/s00404-023-07277-1. Epub 2023 Nov 14.

Prolactin levels in functional hypothalamic amenorrhea: a retrospective case-control study

Clara Selzer  1 , Johannes Ott  2 , Didier Dewailly  3 , Rodrig Marculescu  4 , Johanna Steininger  1 , Marlene Hager  1
Affiliations

Prolactin levels in functional hypothalamic amenorrhea: a retrospective case-control study

Clara Selzer et al. Arch Gynecol Obstet. 2024 Feb.

Abstract

Purpose: Functional hypothalamic amenorrhea (FHA) is due to hypothalamic dysregulation. Literature lacks data about prolactin in FHA women, although both prolactin levels and FHA are associated with stress. Moreover, polycystic ovarian morphology is common in FHA and there is an association between FHA and polycystic ovary syndrome. Thus, the aim of this study was to assess prolactin levels in FHA patients and controls with a special focus on factors influencing prolactin levels, that could be considered as "sensors" of the hypothalamic-pituitary dysregulation.

Methods: In a retrospective cohort study, 140 women with clearly defined FHA were compared to 70 healthy, normally ovulating women matched for age. The main outcome parameter was prolactin. Factors associated with prolactin levels > 12 µg/L were tested using a multivariable binary logistic regression model.

Results: The median prolactin level was 11.5 µg/L (interquartile range, IQR 7.5-14.4), which was similar to the control group (median 10.7, IQR 8.3-14.5; p = 0.065). Only two women had hyperprolactinemia (prolactin > 25 µg/L; 1.4%). In a multivariable binary logistic regression model eating disorder (odds ratio, OR 0.206; p = 0.040), excessive exercise (OR 0.280; p = 0.031) and TSH (OR 1.923; p = 0.020) were significantly associated with prolactin levels > 12 µg/L.

Conclusion: Women with FHA have similar prolactin levels to healthy age-matched individuals. Eating disorders and excessive exercise where associated with prolactin levels < 12 µg/L, in contrast to TSH.

Keywords: Hypogonadotropic hypogonadism; Polycystic ovary syndrome; Prolactin; Stress.

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Conflict of interest statement

The authors have no relevant financial or non-financial interest to disclose.

Figures

Fig. 1
Fig. 1
Distribution of prolactin levels in FHA patients and control
See this image and copyright information in PMC

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