| Abstrakt: |
Estrogens are a potent stimulus of prolactin secretion as illustrated by the increase during female puberty. High estrogen levels may lead to lactotroph hyperplasia and even pituitary adenoma. Prolactinoma in a girl treated with estrogens has been described (J Ped 1988, 133:337-9).Methods: In 30 girls with constitutional tall stature prolactin levels were measured before, during and, in part of them, after Ethinyl Estradiol (EE) therapy, 200 microgram/day. At the start of treatment mean age was 12.7 yrs (range 10.3-15.9} and pubertal stage was B3-B4: all were premenarcheal. Reference data were obtained from 25 healthy girls with mean age 13.4 yrs (range 11.7-15.1), pubertal stage B3-B5 and pre- or perimenarcheal. Blood was drawn between 9.00 and 12.00 am.Results: In the control group mean prolactin was 0.19 U/l (range 0.09-0.37). In the EE group mean prolactin at the start of treatment was 0.19 U/l (range 0.05-0.51), not different from the control data. On EE (3-18 months) mean prolactin significantly increased (ANOVA P<0.001). Mean values at 3,6,9,12,15 and 18 months were 0.45. 0.41, 0.40. 0.33. 0.32 and 0.30 U/l respectively. The treatment values at each time were significantly higher compared to the control values as well (Wilcoxon P<0.001). After EE discontinuation prolactin values significantly decreased to 0.14 U/l (range 0.07-0.24), not different from pretreatment or control data.Conclusion: High dose estrogen treatment results in prolactin hypersecretion, which normalizes after estrogen withdrawal. Follow-up of these girls should be done to exclude long-term consequences as hyperprolactinoma and/or prolactinoma. |
