Postpartum amenorrhea-galactorrhea of

Abstract

Recent studies of the control and function of the hypothalamic-pituitary complex have developed more interest in, and therefore disclosed more cases of, the amenorrhea-galactorrhea syndrome. Although some authors believe this to be a manifestation of pituitary chromophobe adenoma, analysis of series of such tumors rarely reveals pathologic lactation to be a prominent symptom. This paper reports 4 cases of the secondary amenorrhea-galactorrhea syndrome, puerperal in onset and hypothyroid-associated; 3 cases had low urinary gonadotropin levels and none had evidence of pituitary tumor. All patients responded rapidly and completely to simple thyroid replacement therapy. The authors suggest that the Chiari-Frommel syndrome is a symptomatic diagnosis, and that thyroid as well as pituitary pathology should be excluded as an etiologic factor. A multifactorial pathophysiology is offered and supporting evidence reviewed.