Effects of estrogen replacement therapy on pituitary size, prolactin and thyroid-stimulating hormone concentrations in menopausal women

There are few studies in the literature investigating pituitary size at an age consistent with the menopause and the influence of estrogen replacement therapy on pituitary height. We therefore evaluated the effect of estrogen on pituitary size, prolactin and thyroid-stimulating hormone (TSH) levels in menopausal women. Sixty-nine women were evaluated, 47 using estrogen and 22 controls. The measure of pituitary height was obtained from magnetic resonance imaging. Hormone evaluation did not show a statistically significant difference in mean (+/- standard deviation) prolactin level between the group using estrogen (7.6 +/- 6.4 ng/ml) and controls (5.1 +/- 3.4 ng/ml; p = 0.15), yet mean TSH level was significantly higher in the treated group (1.9 +/- 1.5 vs. 1.2 +/- 0.9 mu U/ml; p = 0.03). Mean pituitary height in the estrogen-treated group (5.2 +/- 1.4 mm) was greater than in the controls (4.4 +/- 1.4 mm; p = 0.04). However, when such potential confounders as age, prolactin and TSH levels, treatment and duration of estrogen exposure were considered, the magnitude of difference did not attain significance. In conclusion, estrogen may play a role in pituitary size, since a mean difference in pituitary height, estimated as 0.78 mm, was detected between the groups in favor of the estrogen-treated group. This suggestion can be investigated in further studies.