HYPERPROLACTINEMIC HIPOGONADISM: PREDICTION OF EFFECTIVENESS TREATMENT AND MANAGEMENT

Abstract

Hyperprolactinemia syndrome (HPRL) is one of the most common neuroendocrine diseases, leading to the development of hypogonadism in young women. The aim of the study was to study the effectiveness of treatment of menstrual and reproductive disorders caused by hyperprolactinemia, depending on the nature of the relationship of gonadotropic hormones. Materials and methods. 98 women of reproductive age were monitored, of which 78 — with functional HPRL and 20 healthy women. Clinical-anamnestic, enzyme-linked immunosorbent, instrumental (perimetry, computed tomography), functional, statistical research methods were used. The effectiveness of therapy for menstrual and reproductive disorders caused by HPRL, depending on the nature of the relationship of gonadotropic hormones (GH). Results. In patients of reproductive age with HPRL there are four types of GH secretion: the first — LH and FSH levels are reduced; the second — the level of LH is increased and FSH is reduced; third — the level of LH is reduced and FSH is increased; the fourth type — LH and FSH levels are both elevated. As a result of the treatment, ovarian function was restored in the first type of GH secretion in 83.6% of patients, in the second type — in 66.7% of patients, in the third — in 37.5%. In the group of women with HPRL and high levels of GH normalization of the menstrual cycle and restoration of reproductive function did not occur. Conclusions. Detection of four types of GH secretion in HPRL indicates the presence of different pathogenetic features of this pathology, which must be taken into account when prescribing personalized therapy to restore ovarian function and fertility, timely use of assisted reproductive technologies. Key words: hyperprolactinemia, hypogonadism, pathogenetic features, prognosis, therapy.