Low-normal Thyroid Function Research Articles

Galactorrhea-amenorrhea syndrome associated with heroin addiction

Three patients with galactorrhea and amenorrhea associated with the long-term use of heroin are reported, introducing a possible etiologic factor for the amenorrhea-galactorrhea symptom complex. The patients, heroin addicts, had copious galactorrhea and amenorrhea and demonstrated low gonadotropin values, hypoestrogenism, and normal thyroid and adrenal function. The possibility of a pituitary tumor was excluded in all the cases. The clinical picture, the laboratory, radiologic, and laparoscopic findings, and the results of the biopsies are described. The mechanism of action of heroin is probably pharmacologic blockage of the hypothalamus or the hypothalamic-pituitary axis. As a consequence, the hypophysis is not stimulated by the gonadotropin-releasing factors and is not inhibited by the prolactin-inhibiting factor, producing hypoestrogenism and secretion of prolactin, clinically manifested by amenorrhea and galactorrhea. This symptom complex is probably a temporary syndrome which will disappear or improve after cessation of heroin use.